One of the more exciting EMS products I have seen lately is the new Propaq LT Vital Signs Monitor from Welch-Allyn (to view webpage click link, select country, then hit SUBMIT button to view). Welch-Allyn is a great family owned company, who several years ago bought MRL Defibrillators, and Protocol Systems. Both of these leading edge companies offered high quality technology combined with a history of innovation and market leadership. Under the Welch-Allyn banner both have moved forward to bring several new technologies to the EMS market. I have been a longtime personal fan of Welch-Allyn.
They simply make great quality products. I still carry my old Welch-Allyn Guedel Laryngoscope Blade, and trust it over anything else when the chips are down. I will not take a manual BP without a Welch-Allyn made Tycos brand BP cuff. Ambulance agencies often rely on very inexpensive stethoscopes and blood pressure cuffs. I see many who will spend a small fortune on a fancy light bar, but won’t spend more than 15 bucks on a BP cuff. Then they want to know why the ER Nurses don’t trust them, when they roll in with incorrect vital signs.
The Propaq LT is very compact and lightweight at less than 2 pounds, yet designed with the rigors of the pre-hospital care environment in mind. The device is has a 75G force limitation, exceeding the durability of almost any electronic device ever produced for EMS use. It offers the proprietary Propaq Motion Tolerant BP Technology in their Non-Invasive Blood Pressure feature. This means that the device can weed out motion artifact induced errors. My experience tells me this will be a very popular product. They even offer a package of the Propaq LT combined with an AED for BLS. Never before has this level of technology been offered to such a broad range of clinical care providers. It will mean many EMT’s need to learn a little more about the benefits and challenges of continuous vital signs monitoring.
Note; Another adaptation of this technology is the Mobile Acuity Workstation, developed for military & homeland defense applications. It gives you a mobile monitoring station capable of monitoring vitals on many patients simultaneously and wirelessly.
The first thing EMT’s need to know about vital signs monitoring is – Always Take Your First BP Manually. No matter how good the device, you need to get a manual base line first. It can tell you a lot about the patient’s condition beyond the BP itself. For example, you can hear heart irregularities as the systolic pressure presents. You can tell if the heartbeat is weak or strong. You can hear if the pulse is fast or slow. In only a few heartbeats, you can hear the signs of real problems early enough to react quickly. Also when the initial manual reading is very similar to those that the monitor produces, you know you can have real confidence in the ongoing readings from the device.
The real value of these devices is to take readings much more frequently, and to note changes in these readings earlier than manual methods would allow. I will say it again for emphasis, the reason you monitor vital signs is not to make them easier to get, it is to help you get more of them!
Most vital signs monitors have alarms, which are not really put there for EMS users. Offering one version of a device for different types of end users is much more efficient to manufacture. The real purpose of Alarms is to alert someone outside the patient’s room of a change in condition. You can just turn them off in the field, unless both caregivers elect to ride in the front leaving the patient alone in the back (not recommended). Sometimes they can annoy more than inform.
Another benefit is the monitors memory. The Propaq LT can remember 20 full value sets of multi-parameter vital signs. This is great for more accurately reconstructing the call when charting. No more transcribing from the notes on your arm, or scrawled on 4 x 4’s.
How diligent are you in taking regular vital signs? I have often been satisfied documenting just two sets on the way to the hospital. By taking more frequent and complete sets of vital signs, a good monitor can give you the chance to spot trends early. This gives you the opportunity to treat important changes in your patients status before they become life threatening. Many ALS Providers have already learned the advantages of multi-parameter monitors, that they now have built into their defibrillators. Critical Care Transport Teams, won’t leave home without ’em. The Propaq LT will bridge the gap in what is available for ALS Providers still using basic defib/pacers, and EMT’s looking for a solution at their level of care.