VCAD receives new cardiac monitors

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Vernon County Ambulance District put five new Phillips Heartstart MRx monitors into service last week, and while they are not quite Dr. McCoy's tricorder from Star Trek, they are a dramatic step forward.

In regards to the new monitor's capabilities, veteran paramedic Rob Spencer said, "I've paced a lot of patients and I've defibrillated a lot of patients. You can't get any better."

The five new monitors were purchased with a lease agreement with Phillips. VCAD will pay $1,500 per month for five years for the monitors after which they will have the option to purchase the monitors or upgrade to newer ones.

VCAD chose to make the change to Phillips this summer after learning their three PhysioControl LifePak 12 monitors would not be supported or upgraded after November. Foremost Equipment has purchased VCAD's three LifePak 12 and two LifePak 15 monitors for $43,000. VCAD's 2017 budget estimated receiving $30,000 from the sale of the LifePak monitors.

VCAD will pay $90,000 for the Heartstart monitors over the five years of the lease contract. The lease saves $40,000 off the retail price of the monitors. Repairs and maintenance will be paid for by Phillips.

When the contract expires, VCAD will have the option to purchase the monitors for a low price, or upgrade to newer monitors.

According to VCAD's Denise Hopkins, two new LifePak 15 monitors would cost between $50,000 and $60,000.

"They are the best monitors money can buy and we got them cheap" Spencer said.

Although similar to the VCAD's old monitors from PhysioControl, the new monitors from Phillips have several features that will improve patient care.

According to Spencer, the Phillips Heartstart monitor weighs three pounds less than the LifePak, the batteries last nine hours as opposed to 35 minutes and have an onboard charger. The Heartstart also delivers a real-time 12-lead electrocardiogram.

Monitoring and defibrillating a patient's heart are the monitor's most critical uses.

Spencer said the Phillips monitor has both an automatic and manual defibrillation mode. In the automatic mode, the monitor verbally prompts the ambulance crew through current CPR procedures, analyzes the patients heart every two minutes, and if necessary will deliver an appropriate shock based on the patient's body mass. The Heartstart will not allow a patient to receive a shock that does not need one.

"The real-time 12-lead is priceless," Spencer said.Spencer said this allows faster detection of changes in a patient's heart rhythm, and the Phillips monitor can identify 50 percent more heart attack patients. It will also pick up internal bleeding in patients that have been injured.

"It has a 96 percent accuracy on all cardiac episodes," Spencer said. "If you have something wrong with your patient it will let you know."

The Phillips monitors feature end tidal carbon dioxide detection, which measures a patients breathing and will sound an alarm if the patient stops breathing. End tidal CO2 measures how much carbon dioxide is present at the end of a patient's breath. It is used mainly to diagnose respiratory problems and to verify placement of endotracheal tubes in trauma patients.

Spencer said the end tidal CO2 is used on patients who are having problems breathing or have been intubated.

"It's going to tell me if a patient is at risk for respiratory failure, or even if they are faking asthma," Spencer said.

Additionally, the Phillips Heartstart has a universal pulse oximetry probe that goes on a patient's finger and measures the amount of oxygen in a patients blood. This helps the paramedic or emergency medical technician treat patients with breathing or heart problems. It also provides a real-time pulse rate monitor, which measures how many times the patient's heartbeats each minute. The universal probe can be used on both children and adults.

Spencer said the Phillips Heartstart's automatic blood pressure monitor is more accurate than VCAD's previous monitors, especially when used while the ambulance is driving down the road.

While transporting a patient, Spencer or another paramedic can monitor how the patient is trending to see if one of the patient's vital signs (pulse, respirations, blood pressure) are starting to average lower or higher which can indicate a change in the patient's condition.

In operation, the Heartstart has a simpler menu system and important buttons are color-coded. When it becomes necessary to shock a patient's heart, the unit has a clearly distinguished dial and two large buttons -- one to charge the unit and the other to deliver to shock to the patient's heart.t While in this mode, the monitor only displays critical information in a large easily interpreted format.