OP was abit antagonistic, but I think this is a valid question. Let me put my spin on it.
Reasons for removal:
1. If you have a symptomatic 50 year old male, with a normal 12-lead, you still treat the symptoms. So a negative 12 lead does not stop or start the care that was provided prior to the introduction of 12 leads.
2. It was thought that field 12 leads would quicken the treatment in the ER. Most credible ERs have their own door to needle time parameters, that occur regardless of what a prehospital 12 lead shows, and regardless of whether or not the patient comes in by ambulance. Even in the presence of a positive EMS 12 Lead, the ER will still do their own 12 lead prior to beginning treatment. You could make the arguement that a positive EMS 12 lead may make the ER staff move a bit faster, but how many minutes are actually saved ? At the ERs I usually transport to, they must complete a 12 lead within 5-10 minutes of the patients arrival. My heads-up, may mean that the 12 lead machine is in the patient's room and not in the hall. I realize your anectdotal experience may be different.
3. The technology is expensive, and with what i perceive to be little return, I ask if those thousands of dollars would be better spent on capnography, CPAP, salaries, or benefits ?
4. I dont want to speak for everyone, but i dont know that i can claim a 12lead has saved the life of any of my patients, whereas, i know that CPAP has.
My arguements for keeping the technology:
1. It does help you identify the asymptomatic (i just feel weak or sick, or i have right arm pain) patient or the unusual symptomatic patient (26 year old with chest pain -- or female in her 30s), that you might have missed. But this is a small percentage of cardiac patients.
2. If you live in a rural area, based on a positive 12 lead, you may decide to transport the patient to the more distant hospital that performs CABG, versus the local hospital that can only do thrombos. Then again, if you live in a rural area, you may not have the EMS resources to have your ALS ambulance out of county for 2-3 hours.
Remove 12 Lead from ambulances ???????
in General EMS Discussion
Posted
OP was abit antagonistic, but I think this is a valid question. Let me put my spin on it.
Reasons for removal:
1. If you have a symptomatic 50 year old male, with a normal 12-lead, you still treat the symptoms. So a negative 12 lead does not stop or start the care that was provided prior to the introduction of 12 leads.
2. It was thought that field 12 leads would quicken the treatment in the ER. Most credible ERs have their own door to needle time parameters, that occur regardless of what a prehospital 12 lead shows, and regardless of whether or not the patient comes in by ambulance. Even in the presence of a positive EMS 12 Lead, the ER will still do their own 12 lead prior to beginning treatment. You could make the arguement that a positive EMS 12 lead may make the ER staff move a bit faster, but how many minutes are actually saved ? At the ERs I usually transport to, they must complete a 12 lead within 5-10 minutes of the patients arrival. My heads-up, may mean that the 12 lead machine is in the patient's room and not in the hall. I realize your anectdotal experience may be different.
3. The technology is expensive, and with what i perceive to be little return, I ask if those thousands of dollars would be better spent on capnography, CPAP, salaries, or benefits ?
4. I dont want to speak for everyone, but i dont know that i can claim a 12lead has saved the life of any of my patients, whereas, i know that CPAP has.
My arguements for keeping the technology:
1. It does help you identify the asymptomatic (i just feel weak or sick, or i have right arm pain) patient or the unusual symptomatic patient (26 year old with chest pain -- or female in her 30s), that you might have missed. But this is a small percentage of cardiac patients.
2. If you live in a rural area, based on a positive 12 lead, you may decide to transport the patient to the more distant hospital that performs CABG, versus the local hospital that can only do thrombos. Then again, if you live in a rural area, you may not have the EMS resources to have your ALS ambulance out of county for 2-3 hours.
What are your thoughts ?