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Philips MRx Cardiac Monitors
In 2006, Jackson County EMS purchased the Philips MRx Cardiac Monitor for its five ambulances. Upgrading the monitors brought a cost of $16,500 per unit but also a vast improvement in the diagnostic capabilities Paramedics could provide. The first five monitors purchased by the county were funded from SPLOST dollars. The new monitors allow Paramedics to utilize the typical three lead ECG, it provides an improved diagnostic 12-lead ECG, End-Tidal CO2 (ETCO2) Non-Invasive Blood Pressure monitoring, and Pulse Oximetry. We will briefly explain each component and it's significance in patient care.
The cardiac monitor serves many important purposes and the technological improvements in the last several years have significantly improved pre-hospital care provided by Paramedics. A cardiac monitor is basically a large volt meter. Its basic function is to measure the electrical activity produced by the heart. The measurements obtained by the device are displayed on a screen and available in a printable format to allow the Paramedic to inspect and interpret what the electrical status of the heart is. The Philips MRx comes with several additional features that now allow personnel to measure numerous different vital signs and cardiac functions.
Three Lead ECG
The three lead ECG has been in use for years by EMS. Utilizing the three leads allows Paramedics to view the basic electrical activity of the heart. A three lead can show electrical abnormalities that are caused by many different factors but it essentially shows what the patient's heart is doing at the time the ECG is attached to the patient. Paramedics often use the three lead to determine the rate and rhythm of the heart which the Paramedic uses as an assessment tool to determine if the patient's condition is a result of a cardiac problem.12-Lead ECG
The diagnostic 12-lead ECG allows the Paramedic to view the electrical activity of the heart from 12 different directions. Viewing the heart from the 12 different directions allows the Paramedic to determine if there is evidence of a heart attack or other electrical conduction abnormality. With evidence of a heart attack, the Paramedic can ensure the appropriate care is provided and that the patient is transported to the appropriate facility capable of meeting the needs of the patient. Certain hospitals in the area are equipped and capable of managing specific cardiac emergencies while many are not. By utilizing the 12-lead to determine this ensures that the patient is transported to the best facility first instead of being transported to another hospital where they will have to be transferred from to receive the best, appropriate care. Transporting to the correct facility reduces the time a patient will wait to receive that care, but it also prevents the patient from having to pay extra bills by being taken to the first hospital and then moved to another.End-Tidal CO2 (ETCO2)
End-Tidal CO2 (ETCO2) is the measurement of expired carbon dioxide. When we breathe in, oxygen and other atmospheric gases are introduced into the body, when we breathe out, other respiratory gases are exhaled, one of which is carbon dioxide. With ETCO2 monitoring, the exhaled carbon dioxide is captured by a device attached to the cardiac monitor and measured. The measurement is displayed on the monitor's screen in two different forms. One form is a quantitative measurement which is the numerical carbon dioxide value. The other form is a qualitative measurement which is also displayed on the monitor screen as a wave form and is evaluated by Paramedics to determine the patient's respiratory status. Today, ETCO2 is referred to as the gold standard when evaluating whether a patient is properly intubated.
By obtaining both forms of ETCO2 on the monitor, Paramedics are sure that the patient is properly intubated. Paramedics also use ETCO2 to evaluate a patient's respiratory status using the qualitative wave form displayed on the monitor screen by evaluating the different wave forms displayed as the patient exhales. This evaluation assists the Paramedic in determining which treatment options to utilize.
Pulse Oximetry is measured using an infrared light that passes through the skin and is collected by a sensor on the other side of the light. The light that is received in the sensor determines the amount of oxygen attached to the red blood cells that circulate throughout the body. The measurement is displayed on the screen of the monitor and allows personnel to monitor the oxygen percentage present in the patient's body.
Non-Invasive Blood Pressure Monitoring
Non-invasive blood pressure monitoring allows personnel to obtain and monitor a patient's blood pressure using the cardiac monitor. Personnel can measure the blood pressure manually by activating the monitor as they see fit, or they can set the monitor to measure the blood pressure at set intervals allowing them to concentrate on caring for the patient during transport. The measured blood pressure is displayed on the screen.Pulse Oximetry
Pulse Oximetry is measured using an infrared light that passes through the skin and is collected by a sensor on the other side of the light. The light that is received in the sensor determines the amount of oxygen attached to the red blood cells that circulate throughout the body. The measurement is displayed on the screen of the monitor and allows personnel to monitor the oxygen percentage present in the patient's body.