# Medical Design Project - Help Wanted



## Adam Wallace (Nov 8, 2015)

Hi All,

My name is Adam Wallace and I am a Final Year Undergraduate Product Design Student at Loughborough University.

I am hoping if you might be able to provide some information and feedback to a medical product I am designing at University. 

The 9 month project is aimed at supporting paramedics in diagnosing what is wrong with a casualty at the scene of an emergency. I have been advised that current  products are bulky and awkward to use in the field. They also only provide a snapshot of information about a casualty, when it would be beneficial to have an understanding of the bigger picture.

I am thinking of designing a 24 hour heart beat monitor device that would have two or three sensors to ensure the reading is across the heart. 
- I would like to gain a better understanding of who would this device usually be aimed at? 
- What would be the best way for the paramedic to interact with it and read the device whilst in the field? 
- What are the needs and desires of a paramedic when taking a heart beat reading? (What do you want to be able to do and how?)
- If a paramedic suspects the problem to be heart or blood related (Heart Rate, Blood Pressure, Glucose Levels etc) what process do they carry out when testing for these?
- Is there a diagnosis reporting procedure that must be followed when a paramedic has treated a casualty?

If at all possible I would really value any thoughts or feedback that you may have on the subject. 

Many thanks and kind regards,

Adam Wallace


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## RedAirplane (Nov 8, 2015)

I don't understand what you mean by "24 hour" monitor. To the best of my knowledge, few, if any, paramedics are with patients for that long.

With a few exceptions, paramedics work in stabilization and transport, so I seem to be missing the intent of your product.


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## Adam Wallace (Nov 8, 2015)

The idea is that the product would be a wearable device aimed at specific people which a paramedic could read if they were called to an incident. This way they could get a bigger picture of what was happening to the casualty


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## NomadicMedic (Nov 8, 2015)

Paramedics all carry their own monitor, which has to be used if any electrical therapy is instituted. 

Sounds like you have more questions than you have answers, and you're not really sure what you want to invent. 

In short, such a device isn't needed in the field and hospitals (who already use continuous telemetry) have many options already commercially available. 

I suggest visiting a local paramedic service in your area and get a better idea of how paramedics operate.


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## akflightmedic (Nov 8, 2015)

Adam Wallace said:


> The idea is that the product would be a wearable device aimed at specific people which a paramedic could read if they were called to an incident. This way they could get a bigger picture of what was happening to the casualty



To elaborate further, it seems you think "at risk" people would have this device on all the time and when they call for an emergency, the paramedics could then access the data and perform interventions if needed.

Sounds like a great idea in theory, horrible in practice.

Paramedics on an emergent scene will not care about the data from the past 24 hours. They will attach their monitor and assess the data NOW in real time. And we can actually see "old events" on our 12 leads. No we do not know when they occurred but this is irrelevant in the larger scheme of treating the emergency in front of them.

In a routine situation, cardiologists already send some patients home with 24 hour telemetry to capture this data. It is very relevant to the care they would provide on a non emergency basis. 

I think you might want to listen to DE's advice and then circle back after that visit.


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## Ewok Jerky (Nov 8, 2015)

The product you have in mind already exists on some level.

https://en.m.wikipedia.org/wiki/Holter_monitor

Generally these devices are interrogated by cardiologists in the outpatient setting not paramedics in the field.


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## chaz90 (Nov 8, 2015)

Current products are a bit bulky and cumbersome, but they work really, really well for their intended purpose. I can monitor continuous EKGs, acquire 12 leads, use the NIBP function, monitor waveform EtCO2, SpO2, SpCO, SpMet, body temp, transcutaneously pace, cardiovert, defibrillate, and wirelessly transmit all this data using a single piece of equipment. Modern monitors are pretty darn good devices with highly visible screens, decent portability, good battery life, and high durability and reliability. 

If you want a project, find a way to make the electrodes wireless and reliable (Bluetooth perhaps?). If I could monitor patients without 28 separate wires constantly turning into Lifepak spaghetti it would be awesome. I'll tolerate cables to provide electrical therapy, but it sure would be great to be able to acquire EKGs without the wires.


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## Summit (Nov 8, 2015)

Ewok Jerky said:


> The product you have in mind already exists on some level.
> 
> https://en.m.wikipedia.org/wiki/Holter_monitor
> 
> Generally these devices are interrogated by cardiologists in the outpatient setting not paramedics in the field.


This. Now go make a better cheaper less clumsy holter... But first you should understand your market at a basic level before polling the audience.


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## Brandon O (Nov 8, 2015)

It sounds like you're imagining a Holter monitor that records other parameters in addition to heart rhythm, such as blood pressure, serum glucose, etc.

Truth be told, if a patient is so high-risk that there's a real chance they'll drop dead of a miscellaneous cause while wearing the device, they are proooobably too high-risk to be walking around at home. ("Should we discharge this guy? He might die any moment." "Eh, just make sure we're recording it if he does.") There may be a niche, but I'm having a hard time thinking of it. (Perhaps capturing certain transient physiological parameters associated with ephemeral, hard-to-diagnose metabolic conditions...)

The future may be houses or cell phone tricorders that can unobtrusively monitor us in this way regardless of risk, but I'm not sure we're there yet.


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## Adam Wallace (Nov 9, 2015)

Hi All,

Thank you for your responses they have been really useful and given me food for thought.
I appreciate I have more questions than answers at this stage, that is why I am conducting research before starting any design work and thought this forum would be a good place to get the opinions of people with real experience and provide me with real insights.

If anybody else has any thoughts about my project, paramedic cardiac monitors in general, or are happy to offer suggested improvements please feel free to respond.

Thanks!


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