# Diagnostic equipment



## Wireless Solutions (Oct 16, 2012)

What Diagnostic Equipment do EMT, EMT Basic and First Responder personnel need when dispatched to a potential STEMI patient?


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## Christopher (Oct 16, 2012)

Wireless Solutions said:


> What Diagnostic Equipment do EMT, EMT Basic and First Responder personnel need when dispatched to a potential STEMI patient?



Maalox and a stack of refusals.


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## Medic Tim (Oct 16, 2012)

Christopher said:


> Maalox and a stack of refusals.



I wish there was a like button here.


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## ffemt8978 (Oct 16, 2012)

Christopher said:


> Maalox and a stack of refusals.



Okay, my co-workers are now looking at me funny because I LOL'd at that one.  :rofl:


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## NomadicMedic (Oct 16, 2012)

Pneumatic wrench, a tuning fork and an EOA.


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## 7887firemedic (Oct 16, 2012)

A Paramedic


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## NomadicMedic (Oct 16, 2012)

7887firemedic said:


> A Paramedic



Winner.


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## Christopher (Oct 16, 2012)

n7lxi said:


> Winner.



Only if that paramedic is allowed to interpret the ECG. If they must listen to the squawk box or transmit the ECG, an EMT-B with a 12-Lead is more than adequate. South Dakota does a great job with this.


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## Brandon O (Oct 16, 2012)

7887firemedic said:


> A Paramedic



But who's going to walk and feed him?


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## TransportJockey (Oct 16, 2012)

n7lxi said:


> Pneumatic wrench, a tuning fork and an EOA.



Lol you might have to explain an EOA, old man


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## Akulahawk (Oct 17, 2012)

Brandon Oto said:


> But who's going to walk and feed him?


Not only that, but what about when they get cranky?


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## Akulahawk (Oct 17, 2012)

Wireless Solutions said:


> What Diagnostic Equipment do EMT, EMT Basic and First Responder personnel need when dispatched to a potential STEMI patient?


Since you don't know if you're dealing with a STEMI patient, you go with what you have. You go with hands, eyes, brains, BP cuff, and stethoscope. And a hugely inquisitive attitude. If you suspect the patient is having an MI (I've seen more than a few of those as a Basic, courtesy of some odd regulations) you need to get the patient to someone that can make a more definitive diagnosis and/or get pointed toward someone that can do actually definitive care. Know which facilities can provide definitive care. Trust me on this: 10 or 15 minutes on the road can save the patient HOURS waiting for a transfer.


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## JPINFV (Oct 17, 2012)

n7lxi said:


> Pneumatic wrench, a tuning fork and an EOA.




Meh... sonic screwdriver.


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## DesertMedic66 (Oct 17, 2012)

TransportJockey said:


> Lol you might have to explain an EOA, old man


I have no clue what it means :wacko:


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## Aidey (Oct 17, 2012)

JPINFV said:


> Meh... sonic screwdriver.



Win.


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## JPINFV (Oct 17, 2012)

Aidey said:


> Win.


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## Christopher (Oct 17, 2012)

firefite said:


> I have no clue what it means :wacko:



Esophageal obturator airway...showcased on Emergency! in a few episodes. Basically imagine a wand sticking out of the bowl of a BVM mask that you ram into somebody's gullet.






Cuff in the gullet, mask seals around the mouth...blammo! Poor man's SGA.

Good news is if your service would like to get sued, you can still buy them!


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## abckidsmom (Oct 17, 2012)

Christopher said:


> Esophageal obturator airway...showcased on Emergency! in a few episodes. Basically imagine a wand sticking out of the bowl of a BVM mask that you ram into somebody's gullet.
> 
> 
> 
> ...



I'm not even that old and I used them.


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## usalsfyre (Oct 17, 2012)

Christopher said:


> Esophageal obturator airway...showcased on Emergency! in a few episodes. Basically imagine a wand sticking out of the bowl of a BVM mask that you ram into somebody's gullet.
> 
> 
> 
> ...



:rofl::rofl::rofl::rofl::rofl:

Sadly, ambulances in a particular EMS council in VA were REQUIRED to carry these as recently as 2004....


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## usalsfyre (Oct 17, 2012)

abckidsmom said:


> I'm not even that old and I used them.



Who are you kidding, your an EMS dinosaur


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## abckidsmom (Oct 17, 2012)

usalsfyre said:


> Who are you kidding, your an EMS dinosaur



33.  THIRTY THREE.   Who cares that in the dark ages, they let adolescents do this?


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## abckidsmom (Oct 17, 2012)

usalsfyre said:


> :rofl::rofl::rofl::rofl::rofl:
> 
> Sadly, ambulances in a particular EMS council in VA were REQUIRED to carry these as recently as 2004....



They were required to have "a backup airway" and they could pick which ones, IIRC.  We had combitubes right up till we switched to Kings.


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## Christopher (Oct 17, 2012)

usalsfyre said:


> :rofl::rofl::rofl::rofl::rofl:
> 
> Sadly, ambulances in a particular EMS council in VA were REQUIRED to carry these as recently as 2004....



We can still use Esophageal Detector Devices instead of capnography....it's embarrassing really.


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## usalsfyre (Oct 17, 2012)

abckidsmom said:


> 33.  THIRTY THREE.   Who cares that in the dark ages, they let adolescents do this?



If it makes you feel any better I'm at least an EMS woolly mammoth at this point. Firetender? EMS amoeba.....

The reason your a dinosaur is the same reason I'm a mammoth, they DID let adolescents do this...


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## usalsfyre (Oct 17, 2012)

abckidsmom said:


> They were required to have "a backup airway" and they could pick which ones, IIRC.  We had combitubes right up till we switched to Kings.



Maybe it was just Warren County that had a fetish for EOAs, because you could find one on nearly every truck in the county.


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## abckidsmom (Oct 17, 2012)

This has been a very helpful thread to the OP. 

I'm going to add one more thing to the list of diagnostic equipment I need every time I find myself in a dark alley with no help. 

A tri-quarter. I really need a tri-quarter.


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## Aidey (Oct 17, 2012)

Tricorder. I don't think 3 quarters will get you very far in a dark alley 

We might have come up with more helpful suggestions if the OPs name wasn't "Wireless Solutions" which makes me strongly suspect they are selling something.


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## NomadicMedic (Oct 17, 2012)

The EOA sucked eggs. As an EMT-D back in the day I was running codes armed with an EOA (or the even more sucktastic EGTA) and an LP5 with the optional cassette recorder. 

So, I guess I'm an EMS dino, too.


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## ffemt8978 (Oct 17, 2012)

abckidsmom said:


> This has been a very helpful thread to the OP.
> 
> I'm going to add one more thing to the list of diagnostic equipment I need every time I find myself in a dark alley with no help.
> 
> A tri-quarter. I really need a tri-quarter.





Aidey said:


> Tricorder. I don't think 3 quarters will get you very far in a dark alley
> 
> We might have come up with more helpful suggestions if the OPs name wasn't "Wireless Solutions" which makes me strongly suspect they are selling something.



They are, but I think the bigger issue is that a STEMI is not something an EMT, basic, or FR can even diagnose...much less treat.  It is well beyond the scope of practice for those levels, so there is no need to have diagnostic equipment for them.


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## abckidsmom (Oct 17, 2012)

n7lxi said:


> The EOA sucked eggs. As an EMT-D back in the day I was running codes armed with an EOA (or the even more sucktastic EGTA) and an LP5 with the optional cassette recorder.
> 
> So, I guess I'm an EMS dino, too.



Those tapes were the best, though. Never a dull moment listening to them.


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## Brandon O (Oct 18, 2012)

I think there is no reason except money why Basics could not carry and record 12-leads, diverting and activating for STEMIs based on either transmission or computer interpretation.


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## Milla3P (Oct 18, 2012)

usalsfyre said:


> :rofl::rofl::rofl::rofl::rofl:
> 
> Sadly, ambulances in a particular EMS council in VA were REQUIRED to carry these as recently as 2004....



EOAs are still required on ALL ambulances in Rhode Island. Frowny Face.


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## NYMedic828 (Oct 18, 2012)

Brandon Oto said:


> I think there is no reason except money why Basics could not carry and record 12-leads, diverting and activating for STEMIs based on either transmission or computer interpretation.



If a company is going to spend $20-30,000 to purchase a, for example sake, lifepak-15 then they may as well spend $20,000 on training two EMTs to be medics. They get paid more for an ALS transport.


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## Christopher (Oct 18, 2012)

NYMedic828 said:


> If a company is going to spend $20-30,000 to purchase a, for example sake, lifepak-15 then they may as well spend $20,000 on training two EMTs to be medics. They get paid more for an ALS transport.



The ideal device would cost between $3,000 and $7,000 and incorporate an AED and a 12-Lead ECG, either with transmission or printer capabilities.

Something like the Physio-Control ReadyLink with an AED.


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## NYMedic828 (Oct 18, 2012)

Christopher said:


> The ideal device would cost between $3,000 and $7,000 and incorporate an AED and a 12-Lead ECG, either with transmission or printer capabilities.
> 
> Something like the Physio-Control ReadyLink with an AED.



Does an AED/12-lead capable device exist outside of a full telemetry device?

I don't know much on the financial end of things but was under the impression that the primary cost of a monitor was its 12 lead capability. Is pulseox, ETCO2, NIBP really that much of an additional cost by comparison?


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## Christopher (Oct 18, 2012)

NYMedic828 said:


> Does an AED/12-lead capable device exist outside of a full telemetry device?
> 
> I don't know much on the financial end of things but was under the impression that the primary cost of a monitor was its 12 lead capability. Is pulseox, ETCO2, NIBP really that much of an additional cost by comparison?



That'd be somewhat correct. Each of those "features" are usually licensed from some other company...which you pay to integrate into your monitor. Cardiac monitor user manuals these days look like something in a NASCAR race 

ReadyLink is pretty cheap, it just needs an AED bolted onto it.

As an aside, I see no use in spending money on a computerized analysis if the 12-Lead will be transmitted.


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## Brandon O (Oct 18, 2012)

Christopher said:


> That'd be somewhat correct. Each of those "features" are usually licensed from some other company...which you pay to integrate into your monitor. Cardiac monitor user manuals these days look like something in a NASCAR race
> 
> ReadyLink is pretty cheap, it just needs an AED bolted onto it.



In the meantime, a separate AED and 12-lead device are a fairly cost-effective approach.


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## Christopher (Oct 18, 2012)

Brandon Oto said:


> In the meantime, a separate AED and 12-lead device are a fairly cost-effective approach.



A Zoll AED Pro with real-time CPR feedback and the ReadyLink would be pretty schweet...if ReadyLink wasn't saddled with the non-free LIFENET system.


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