On the 12th Day of Christmas happy Medic gave to me…
12 Lead EKG
The usual dispatch to a Doctor’s office just after 5pm brings groans from most Paramedics and it did indeed on this day from the engine crew I was with. This particular office was not just across the street from the main hospital, but the odd ER entrance meant the ambulance actually had to drive out and around the block to go back around…long story short, it was not as easy as walking across the street.
Up on the tenth or eleventh floor, hidden in the maze of endocrinologists, proctologists and podiatrists was the door we were looking for. Inside we were led to a back room where our patient awaited us, with her daughter and new physician.
Stop me if you’ve heard this one before…
Mom has been having trouble sleeping and now sleeps in a chair in the living room. She gets winded often and has trouble keeping her balance when she stands. Here at the Doctor’s office she became pale, diaphoretic and experienced a syncopal episode, then awoke and vomited. Each and every outward warning sign was flashing bright and each red flag was raised high in the sky. Only our physician friend either didn’t see them or knew something we did not.
As I helped her to recline she immediately began to vomit again and I had one of those bad feelings we tend to get when the best thing for her heart is not exactly what her lungs want and vice-a-versa.
With our basic interventions going and the assessment continuing, I knew we had an ongoing cardiac event, even before the electrodes went on, but of course, I needed to see where it was and where it was going.
The 12 lead was applied, with great effort on her wet skin despite towels and napkins, and it found all sorts of variations, from Anterior to Lateral and Septal, this was the big one and had been for some time. We didn’t even need the machine to pause and interpret what it saw, we were in treatment mode and already moving towards the elevator.
Knowing we were only 3 minutes away from the cath capable ER across the street, the decision was made to call ahead ASAP to get the team moving.
It would have been nice to immediately transmit that 12 lead as soon as we saw trouble. I would also have loved to had that monitor transmitting all vital signs to the ER as we were moving through the Dr’s office, then the elevator, then the lobby, and then transmit when she clutched her chest and went unconscious. I had no time to grab my radio, select the proper channel, call, wait for response, then describe our changes.
So, on our 12th, and final Day of Christmas, your Happy Medic would like an information network that my equipment can communicate over to area hospitals and for the hospitals to be able to monitor and trend that information in real time. Instead of infrequent snap shots of my patient, I’d like them to see what I see: a continuous stream of information.
There are some products that can transmit, some hospitals that will accept, but if I can get real time information sent from a racecar to my phone, maybe we can use that technology to help us save precious time pre-hospital.
Merry Christmas everyone. Thanks for reading, we’ll see you in 2011.