Do you have a cardiac monitor on a BLS rig?

[patzyboi]

And why would you use it?

To determine rate and rhythm of the heart? EMT's can only interpret if a rhythm is regular or irregular?

And just wondering, if a patient went into cardiac arrest, would you look at the monitor or check carotid artery?

 

[EpiEMS]

We do have them. It's good to have it if there's a medic intercept and they don't even need to bother moving their monitor to the transporting unit. Additionally, having the monitor is helpful - if unnecessary - for SpO2 monitoring, heart rate monitoring, and BP (auto cuff after taking an initial pressure manually -- useful if there's other trauma care being done, say). Additionally, I can acquire a 12-lead if it's helpful to have monitoring (not that I'm by any means qualified to interpret one, but I can surely place one, which means I can transmit for STEMI activation if my system one day gets its act together).

Having a monitor isn't necessary, but it's certainly helpful.

If the patient arrested, I'd pull out the AED, start BLS measures, and call for a medic.

 

[DesertMedic66]

AED are all that are carried on BLS around here.

 

[EpiEMS]

AED are all that are carried on BLS around here.

What do you use for SpO2 monitoring on your BLS units?

 

[DesertMedic66]

What do you use for SpO2 monitoring on your BLS units?

They are optional in my county. So my ambulance company does not carry them.

Other companies and our ALS 911 units carry an SpO2 monitor that is seperate from the monitor. Our ALS monitors don't even have auto BP.

 

[EpiEMS]

They are optional in my county. So my ambulance company does not carry them.

Other companies and our ALS 911 units carry an SpO2 monitor that is seperate from the monitor. Our ALS monitors don't even have auto BP.

Gotcha -- It's a feature used too often out of laziness, which, I suppose, could be problematic.

 

[ATFDFF]

All the BLS units in my system have our old LP12s. They will routinely transmit 12-leads to the hospital prior to meeting up with an ALS intercept, that's the main reason they have them.

 

[Clare]

All ambulances in New Zealand carry a manual monitor/defibrillator either an MRx or LP12

Emergency Medical Technicians can acquire a 12 lead ECG and do basic interpretation of a rhythm strip while Paramedic and Intensive Care Paramedic can interpret 12 leads.

First Responders at events and in rural locations carry an AED because all they do is advanced first aid

 

[EpiEMS]

All the BLS units in my system have our old LP12s. They will routinely transmit 12-leads to the hospital prior to meeting up with an ALS intercept, that's the main reason they have them.

I can't help but think that this could be very useful, especially in areas where BLS is the only EMS available. Could -- potentially -- become the standard of care eventually.

All ambulances in New Zealand carry a manual monitor/defibrillator either an MRx or LP12

Emergency Medical Technicians can acquire a 12 lead ECG and do basic interpretation of a rhythm strip while Paramedic and Intensive Care Paramedic can interpret 12 leads.

Do your EMTs transmit 12-leads to the ED for MD evaluation? (And can EMTs manually defibrillate?)

 

[Outbac1]

All ambulances in our system have LP12 monitors. In fact all units have the exact same equipment and meds on board. Our PCPs do 12leads and basic interpratation. They can then use that to call for ALS backup or if no ALS prenotify the hospital.

The only differences in equipment carried are on the units in and around Halifax. They don't carry TNK as they are within an hour of the cath lab.
All units the same is one of the benefits of a single province wide provider.

 

[EpiEMS]

All ambulances in our system have LP12 monitors. In fact all units have the exact same equipment and meds on board. Our PCPs do 12leads and basic interpratation. They can then use that to call for ALS backup or if no ALS prenotify the hospital.

By basic interpretation, do you mean that the PCPs are doing a 12-lead so as to determine "This is normal, we can transport" versus "This is abnormal, let's contact ALS for an intercept (or alternatively pre-notify)"? Or is it in greater depth?

 

[VirginiaEMT]

We do have them. It's good to have it if there's a medic intercept and they don't even need to bother moving their monitor to the transporting unit. Additionally, having the monitor is helpful - if unnecessary - for SpO2 monitoring, heart rate monitoring, and BP (auto cuff after taking an initial pressure manually -- useful if there's other trauma care being done, say). Additionally, I can acquire a 12-lead if it's helpful to have monitoring (not that I'm by any means qualified to interpret one, but I can surely place one, which means I can transmit for STEMI activation if my system one day gets its act together).

Having a monitor isn't necessary, but it's certainly helpful.

If the patient arrested, I'd pull out the AED, start BLS measures, and call for a medic.

So are you saying your monitor and AED are separate units?

 

[EpiEMS]

So are you saying your monitor and AED are separate units?

There's an LP15 and there's Phillips HeartStart FRx AED in the rig. Usually, we're not BLS-only (usually EMT-P/EMT staffing). When we are BLS staffed (EMT/EMT, or AEMT/EMT), the FRx is intended for the BLS providers (though the LP15 does have an AED mode, I've not used it for a BLS-managed arrest).

 

[NomadicMedic]

None of the BLS ambulances in my county have a monitor. Since we are totally an intercept service, all of the paramedics carry their own life pack 15 and ALS gear that is brought on to each BLS ambulance for patient care.

 

[EpiEMS]

None of the BLS ambulances in my county have a monitor. Since we are totally an intercept service, all of the paramedics carry their own life pack 15 and ALS gear that is brought on to each BLS ambulance for patient care.

For a cardiac arrest, do you usually meet BLS on scene?

(quasi-related question)

 

[NomadicMedic]

We are dispatched simultaneously and usually arrive first or just as BLS does. It's very, very rare that BLS will be on scene at an arrest for any significant amount of time (read: more than 3 or 4 minutes) without ALS.

Unless, of course, the patient is an "alpha" sick person that arrests while BLS is there, or if its right next door to the fire station where the ambulance is.

 

[EpiEMS]

I'm liking this Delaware system more and more.

Y'all use LP 15s?

 

[NomadicMedic]

I'm liking this Delaware system more and more.

Y'all use LP 15s?

That's correct. We carry two on each medic unit, with a third "spare" at each station.

Anyway, to get back on topic, some BLS units I've worked on in the past used Zoll monitors locked into AED mode. If a medic got on, he could enter a code to make it a manual defib.

 

[EpiEMS]

Anyway, to get back on topic, some BLS units I've worked on in the past used Zoll monitors locked into AED mode. If a medic got on, he could enter a code to make it a manual defib.

I'm fairly sure the LPs have a similar option. Not sure about any other manufacturers, though.

For a BLS service, it might be cheaper (hence, preferable, if cost is a major concern) to have a single-role AED, let the intercepting ALS unit stock the monitor. I'd imagine this is standard practice for many services, given the cost of a monitor/defibrillator.

 

[Trashtruck]

And why would you use it?

To determine rate and rhythm of the heart? EMT's can only interpret if a rhythm is regular or irregular?

And just wondering, if a patient went into cardiac arrest, would you look at the monitor or check carotid artery?

No, the BLS units do not have cardiac monitors. They carry AED's, not cardiac monitors. They do not have a pulse ox, either.
I suppose if they did have monitors on the BLS units, they could use the NIBP, pulse ox, and place it in AED mode. The CPR metronome is helpful, too.

I would look at the monitor AND check for a pulse simultaneously