ReadyLink 12-Lead ECG by Physio-Control (update)

Now that I'm starting to get caught up on my regular duties after my recent trip to EMS World Expo 2011 there are a few products I'd like to highlight from the trip.

The first is Physio-Control's ReadyLink 12-Lead ECG.

You may recall that Physio-Control allowed ems12lead.com the privilege of announcing the launch of this product back at the beginning of August.

One thing I know now (that for whatever reason I didn't understand at the time) is that the ReadyLink 12-Lead ECG has a monitor screen! 

I snapped this photo with my Droid X on the show floor at EMS World Expo 2011.

Apparently the monitor screen is so that basic EMTs can tell if there is wandering baseline, loose lead or muscle tremor artifact. However, to me this is a big deal!

I can imagine the ReadyLink 12-Lead ECG being placed along side AEDs on commercial jet airliners. At any rate, I just wanted to clarify that the ReadyLink 12-Lead ECG has a monitor screen for anyone who, like me, thought it did not.

You will recall that when we announced the product launch we called the the ReadyLink 12-Lead ECG a "game changer" and so it is for rural systems that can now be tied into existing systems of care that are already using the LIFENET.

This is especially important in light of recent evidence that while PCI centers have done an amazing job shortening door-to-ballon times since the advent of the D2B Alliance, there are still significant delays for STEMI patients transferred from non-PCI hospitals.

That shouldn't be a surprise to anyone with a special interest in regional systems of care for acute STEMI.

More than 34% of patients transferred for PCI had a delay in total treatment time (> 120 minutes from presentation at initial hospital). The reasons for the delay included:

  • Awaiting transportation (26%)
  • Emergency department delays (14%)
  • Diagnostic dilemma (9%)
  • Cardiac arrest (6%)

Keep in mind this does not include prehospital time prior to presentation at the initial hospital.

To measure these delays correctly would require that we measure from 9-1-1 call to reperfusion. But let's put that issue aside for the time being.

The point is that 40% of the delays from referring hospitals could be completely eliminated if EMS was capable of identifying acute STEMI in the fiend and bypassing them altogether in the first place.

Even without that there are opportunities for improvement for the transferring hospitals and EMS needs to be a part of that solution (since 50% of acute STEMI patients self-report to non-PCI hospitals).

There is no acceptable reason that an acute STEMI patient should be sitting around waiting for a transport ambulance if the local 9-1-1 system has a unit available.

That's a totally legitimate emergency call and EMS systems that "don't do interfacility transport" need to reconsider their policy for life-threatening emergencies (like acute STEMI) where every minute counts.

6 Comments

  • Ron says:

    I don't know why someone hasn't done this sooner. It makes perfect sence and putting the leads on isn't rocket science.
    I had one sitting in front of me at EXPO and didn't notice it had a display. Guess there was too much Vegas going on.

  • Yeah, I guess we were all a little busy! :) You probably caught a draft up your kilt and had to adjust yourself.

  • Kevin Franklin says:

    Tom

    You bring up some great points but don’t forget that what the patient needs is the more expeditious manner of travel with the appropriate en route care. Most parts of the country that is a helicopter crew with education, protocols and equipment and medications that prevent the 6% you mentioned in your article from arresting during that time.

  • Kevin -

    I would suggest that depends on the transport time. Nothing prevents re-arrest like reperfusion! However, even if we agree that the patient would be best served by aeromedical transport, the sooner the helicopter takes off the better. In other words, it's still an opportunity for first-medical-contact to transmit an ECG to a decision maker who can get something rolling early. 

  • Kevin Franklin says:

    Tom

    You are exactly right about that and I am all for spearheading paramedic (911) diagnosis of STEMIs and initiating a rapid transport. Here in West Michigan we have began to do this and have incredible times from 911 paramedic arrival to arrival in CVL when using the benefits of both paramedic diagnosis and airmedical transport and treatment en route.

  • Dave says:

    Walk in STEMI patients at non-PCI hospitals = a significant challenge.  I highly recommend http://www.projectupstart.com/ as a source for great tools and related assets.  It is FREE!

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EMS 12-Lead

Cardiac Rhythm Analysis, 12-Lead ECG Interpretation, Resuscitation

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Comments
Nathan
68 y.o. male with weakness: “Treat the monitor, not the patient?”
Much more worried about HYPERkalemia than hypokalemia. Extreme wide QRS + Peaked T Wave is strongly indicitive of HyperK
2014-10-02 14:55:20
Nathan
68 y.o. male with weakness: “Treat the monitor, not the patient?”
This is huuuugely wide. Thinking hyperkalemia. Start with Calcium. Not going to hurt anything with it - and may save the patient.
2014-10-02 14:40:52
steve
68 y.o. male with weakness: “Treat the monitor, not the patient?”
I have seen this before except it was worse. Based on 3 diuretics and presence of wide bizarre ecg I would go with hyperkalemia . This pt requires electrolyte balancing not a PCI My pt presented Brady, hypotensive , simular morphology ecg with pauses and did not respond to fluid atropine or pacing ended up…
2014-10-02 14:01:53
Colleen
68 y.o. male with weakness: “Treat the monitor, not the patient?”
Allergies? O2, combivent, Calcium. Repeat 12lead ekg. 2nd set of signs. Depending on 2nd Ekg and 2nd set of signs with combivent, reassessment of patient after interventions. Depending on reassessment, 2nd/3rd VS, and 2nd EKG, would determine my decision on where to transport. Per Massachusetts protocols.
2014-10-02 05:57:52
Billy Bob
68 y.o. male with weakness: “Treat the monitor, not the patient?”
Well I will lean with Dave and go with more education; this is a classic sine wave EKG and with more education hopefully we all could spot this from across the door because again as Dave said this is something rarely seen in EMS if at all; this is the ONE TIME I will advocate…
2014-10-02 02:49:58

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