# "do it all" monitor in the form of a laptop



## roovy (Nov 13, 2010)

Does anyone know where I can get a 'do it all' laptop monitor. I would be looking at connecting a USB unit with all the cables for BP, ECG, Spo2, as well as 12 lead ECG monitoring with the option of web transmission. I would then mount the laptop in the ambulance, as have the vitals recorded directly to my electronic pateitn report form. Does such a thing exist?

Reuven


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## clibb (Nov 13, 2010)

roovy said:


> Does anyone know where I can get a 'do it all' laptop monitor. I would be looking at connecting a USB unit with all the cables for BP, ECG, Spo2, as well as 12 lead ECG monitoring with the option of web transmission. I would then mount the laptop in the ambulance, as have the vitals recorded directly to my electronic pateitn report form. Does such a thing exist?
> 
> Reuven



That would be a pretty easy software to make. Problem is how to connect the cables into the computer. Are the 12 leads USB cables?....


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## EMSLaw (Nov 13, 2010)

Not as far as I know, because the monitor also does other things, like pacing and defibrillation, that you couldn't easily make a laptop do.  What you can do is hook up your lifepak or other monitor to your laptop and download the information directly onto the PCR.  I know EMSCharts mobile has that capability, and I'm pretty sure that since Zoll makes monitors, ePCR does the same.


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## JPINFV (Nov 13, 2010)

I'm sure they're out there. When I was doing EEGs for undergrad research, we used a desktop as our data collector. However, as EMSLaw pointed out, with a laptop you're going to lose the ability to do interventions.


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## EMSLaw (Nov 13, 2010)

JPINFV said:


> I'm sure they're out there. When I was doing EEGs for undergrad research, we used a desktop as our data collector. However, as EMSLaw pointed out, with a laptop you're going to lose the ability to do interventions.



Right.  At the hospital, the ECG cart is just a laptop, a printer, and a gizmo that the leads plug into (I know, I'm grossly oversimplifying, probably, but hey, it's not where I work).  But they still have lifepaks around for when they actually need an intervention.


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## JPINFV (Nov 13, 2010)

True, but it's also a different situation

I'll take the emergency room at the hospital I used to volunteer at. The ER had something around 30 rooms, but only 1-2 12 lead machines and 4-5 crash carts (guestimating, and not counting the one peds or the carts in the code room). Every bed was a monitored bed though, so every patient who needed it could be put on a 5 lead continuous monitor. 

In the ambulance, there's 1 patient, so if you can have one machine provide continuous monitoring, 12 lead acquisition, and electrical intervention, why have multiple machines?


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## EMSLaw (Nov 13, 2010)

JPINFV said:


> True, but it's also a different situation
> 
> I'll take the emergency room at the hospital I used to volunteer at. The ER had something around 30 rooms, but only 1-2 12 lead machines and 4-5 crash carts (guestimating, and not counting the one peds or the carts in the code room). Every bed was a monitored bed though, so every patient who needed it could be put on a 5 lead continuous monitor.
> 
> In the ambulance, there's 1 patient, so if you can have one machine provide continuous monitoring, 12 lead acquisition, and electrical intervention, why have multiple machines?



I agree.  I was just saying that the machine the OP is looking for obviously exists, because hospitals have them.  But they're not suitable for EMS work for the reasons you mentioned.


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## MrBrown (Nov 13, 2010)

A Lifepak 12 or Heartstart MRx will provide all of what you are looking for; ie ECG, SPO2, NIBP, ETCO2 etc


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## roovy (Nov 14, 2010)

*"do it all monitor" to laptop*

A Lifepak 12 or Heartstart MRx will provide all of what you are looking for; ie ECG, SPO2, NIBP, ETCO2 etc 

Thanks for your reply above. I appreciate that those units can do all of what you mentioned, but I specifically am looking for a laptop/netbook based one. This way I can automatically get the vitals onto electronic forms, ECG's onto these forms etc. Also, if I want to add modules later (e.g. invasive monitoring etc), it can added at minimal cost, and without needing to replace the entire unit.


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## 18G (Nov 14, 2010)

I've never seen anything like your describing. The concept sounds like a cool one but not sure how practical it would be. If you put your patient on the monitor in a patient's house, you will have to then disconnect the monitor cables and plug it into your laptop in the ambulance. How would you import the initial EKG strip into your report? You would prob still end up taping it and copying manually.

Also, you do not want to be monitoring an EKG with a laptop and then have to fumble with re-attaching the "regular" monitor because you now have to cardiovert, pace, or defib. Again, in that situation... you will still have to tape and copy your strips recorded  by the "regular" monitor. 

As someone else said.... downloading all the patient data from the LP12 or other monitor would prob be easier and most efficient (and cheaper).


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## usalsfyre (Nov 14, 2010)

Nearly all of the leading ePCR programs have the option of downloading your strips and vitals to the program from the monitor via Bluetooth or USB cable. Much cheaper, FDA approved and you don't lose the ability to defib, pace, ect. In addition, invasive monitoring ect can be added to your monitor by an approved service center. Much, much better option really.


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## medic417 (Nov 14, 2010)

http://www.dremed.com/catalog/product_info.php/products_id/1662


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## Scout (Nov 14, 2010)

Sounds like there is an opening for a pcr on the lifepac


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## Cameron (Nov 14, 2010)

Not sure if this is useful or not, but I'm giving it a shot.

As you all can tell, I am a student. I'm in my freshman year at my high school. I'm currently taking a elective called Biomedical. In class we learn about blood pressure, EKGs the heart, etc.  There is a program on our laptops we use called LabVIEW. In this program we had to make programs (and have some created for us already) that take blood pressure and data from EKGs. I'm not sure that its 100% reliable but it seems pretty useful. It all gets connected to a computer by a USB cable, and all the equipment (Blood pressure cuff, Wires for the EKG) get connected into ports through a piece of hardware called a SensorDAQ. 

Might be something you want to try out, if you have any question I'll try my best to answer them!

-- Cameron


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## ffemt8978 (Nov 14, 2010)

roovy said:


> I would be looking at connecting a USB unit with all the cables for BP, ECG, Spo2, as well as 12 lead ECG monitoring *with the option of web transmission.*



That opens up a whole can of worms that would have to be addressed first, namely in HIPAA compliance and security aspects.


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## gicts (Nov 15, 2010)

ffemt8978 said:


> That opens up a whole can of worms that would have to be addressed first, namely in HIPAA compliance and security aspects.



In a way it is a reality.

http://ems12lead.com/2010/11/15/phy...m-5-0-partnership-with-airstrip-technologies/

To the OP: I know that a Lifepak does all that you are asking, and can connect to a USB and upload all of the data to a laptop. I am not too sure that it would be practical in the near future for a laptop to run and power a B/P cuff, SPO2, and EKG. You would need an external source to inflate the cuff regardless, so it wouldn't be just a cord going to the laptop (and I doubt a reasonable battery life would be sustainable) . Most importantly is the practicality. Why? If you are wanting a EKG and vitals, the Lifepak (and competitors) offer that as well as up the ante with the shocky stuff, something I can't imagine a laptop being able to ever do.


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## ffemt8978 (Nov 15, 2010)

gicts said:


> In a way it is a reality.
> 
> http://ems12lead.com/2010/11/15/phy...m-5-0-partnership-with-airstrip-technologies/
> 
> To the OP: I know that a Lifepak does all that you are asking, and can connect to a USB and upload all of the data to a laptop. I am not too sure that it would be practical in the near future for a laptop to run and power a B/P cuff, SPO2, and EKG. You would need an external source to inflate the cuff regardless, so it wouldn't be just a cord going to the laptop (and I doubt a reasonable battery life would be sustainable) . Most importantly is the practicality. Why? If you are wanting a EKG and vitals, the Lifepak (and competitors) offer that as well as up the ante with the shocky stuff, something I can't imagine a laptop being able to ever do.


Maybe so, but I have serious concerns about how the data is protected during transit from the mobile device to the destination.  It would have to be an encrypted link the entire distance in order to ensure that eavesdropping attacks wouldn't obtain any PHI.

And lets face it...most users now days either don't install encryption, use easy to guess decryption keys (passwords), or use an encryption scheme that is easy to break.


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## JPINFV (Nov 15, 2010)

ffemt8978 said:


> That opens up a whole can of worms that would have to be addressed first, namely in HIPAA compliance and security aspects.



Would there need to be any HPI in that specific data stream? If all it says is "Unit 75" and the hospital knows via a secured means (e.g. phone, encrypted radio, etc) that Unit 75 has Jane Doe on it, then it *might* (I only know the basics of HIPAA) not have issues as identifying data isn't included. Heck, just some sort of code number instead of a blantant "Unit 75." Transmitter ID 123456, and have a table at the receiver saying transmitter 123456 is Unit 75.


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## ffemt8978 (Nov 15, 2010)

JPINFV said:


> Would there need to be any HPI in that specific data stream? If all it says is "Unit 75" and the hospital knows via a secured means (e.g. phone, encrypted radio, etc) that Unit 75 has Jane Doe on it, then it *might* (I only know the basics of HIPAA) not have issues as identifying data isn't included. Heck, just some sort of code number instead of a blantant "Unit 75." Transmitter ID 123456, and have a table at the receiver saying transmitter 123456 is Unit 75.



There wouldn't have to be, but there most likely will be simply because EMS personnel would type in patient info instead of leaving it anonymous.  Besides, the OP stated he wanted to record vitals directly to his ePCR, along with being able to transmit said vitals so there's a possibility of the information being transmitted in that aspect also.

That brings up another question, and maybe I'm way off base on this.  It sounds like the OP wants to use the laptop to take and record his vitals directly on his ePCR instead of manually doing vitals and filling in his PCR based upon those results.  I'm not comfortable letting any of my EMT's use a machine to take their vitals for them, for a whole slew of reasons.


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## reaper (Nov 15, 2010)

Yes, Lifenet transmit 12 leads with encryption. 

Also, Emscharts is a widely used epcr program and the entire report and all info is transmitted via the internet. This is not something new. 

Almost all monitors do what the OP is talking about, so I see no need for his design of a laptop.


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## socalmedic (Nov 20, 2010)

i know for a fact that the zoll m can be blue tooth connected to the ePCR for real time vitals/12lead/monitor integration into the PCR on the toughbook. it would not be hard to have it show all the info on a nice 27" flat screen in the ambulance, i have seen it done at the shows. just costs money. i dont know that i want the laptop to be able to control the defib or the pacer. right now for the nice price of (IIRC) $55,000 you can have a zoll m, 12lead, spo2, spco, etco2, nibp, an invasive monitoring port, pacer, defib, with bluetooth tethering to your toughbook/ambulance computer.

the technology is there, budgets are not. i myself an content with an LP12, spo2, etco2, pacer, defib. i am not tech savy and would get lost with all the other features. i also perfer manual BP.


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## HappyParamedicRN (Dec 12, 2010)

clibb said:


> That would be a pretty easy software to make. Problem is how to connect the cables into the computer. Are the 12 leads USB cables?....



And how would you get it to do defib and pacing??

We use Zoll monitors and PCR software and our monitors link to the lap top via bluetooth and upload our EKGS and vitals..


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