i just started at a busy inner city agency that uses the MRL (pic 40 i believe). it's biphasic, but i've been told conflicting info about energy settings. i was told once that you use the monophasic setting and the machine converts it to the proper energy, but i've also been told to use the standard 200 for biphasic. i've been searching for info on the net about it, maybe a user manual or something like that with no luck. if anyone knows anything about this monitor or where i could find this info, i'd appreciate it.
anyone familiar with the MRL monitor?
- Thread starter nsom9ac
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Just for the record, is this the Welch Allyn (MRL) PIC 40?
JPINFV
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Yes. Welch Allyn bought out Medical Research Labs. I can't really comment on them, though, because they we only used on the RN CCT calls (BLS service outside of RN or RT calls). As such, I've never been on a call where the capibilities were used outside of a monitor, pulse ox, and NIBP machine (almost had a call that needed pacing though).
MSDeltaFlt
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Just dial it up as you normally would. We use them and we have had no problems with the Joules settings.
what do you mean "as you normally would"? i've been told conflicting information ranging from using the monophasic energy settings to using standard biphasic settings. so which do you use with this machine?
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Don't you think that's a question you should be asking at work? I'd hate to break protocol with such a procedure. Using 12 LPM instead of 15 isn't the end of the world, but hitting the wrong button on a defibrillator very well could be.
You really need to be discussing this with the service/company or your field training officer. You can't be expected to know how to operate every piece equipment when you first start.
Yes I do, and I have ... 3 times now! Like I mentioned before, I've been told 1) to shock using the standard 200J biphasic setting 2) to set the machine to the monophasic setting of 360J and the machine will convert it to the correct output and now 3) i have a i don't know answer from someone who's been using this machine for several years.
So back to my original question, is anyone familiar with this machine (MRL pic 50) or know of where i find a user guide online?
JPINFV
Gadfly
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http://www.welchallyn.com/documents...ual_20070324_PIC4050_defibrillatormonitor.pdf
User manual from Welch Allyn for the PIC50 (Welch Allyn owns MRL now).
Note: The manual is 18 megabytes, so "right click ->save as" works better than opening up directly.
User manual from Welch Allyn for the PIC50 (Welch Allyn owns MRL now).
Note: The manual is 18 megabytes, so "right click ->save as" works better than opening up directly.
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What about your Medical Director or ALS coordinator?
Nsom9ac... I'm not trying to slam you, but this is a BIG deal.
If you use the wrong setting, and it is documented somewhere that you were taught the right way to use it, the company will probably NOT get in a lot of trouble, and you will. I'd be really concerned about a service that doesn't adequately train its new hires, and leaves you having to resort to the internet to find help in operating a piece of equipment that you should know how to operate in your sleep.
You REALLY need to reach out within your service for help... and, if I were in your position, it would REALLY concern me that providers didn't know how to operate the defib!
Nsom9ac... I'm not trying to slam you, but this is a BIG deal.
If you use the wrong setting, and it is documented somewhere that you were taught the right way to use it, the company will probably NOT get in a lot of trouble, and you will. I'd be really concerned about a service that doesn't adequately train its new hires, and leaves you having to resort to the internet to find help in operating a piece of equipment that you should know how to operate in your sleep.
You REALLY need to reach out within your service for help... and, if I were in your position, it would REALLY concern me that providers didn't know how to operate the defib!
paramedix
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I agree with Jon...
It is something we lack in some EMS companies. How many of the people get "new" equipment for their vehicles and they don't know or are unsure how they work!?
It happens quite often that you are trained on a certain piece of equipment during your training as EMT or whatever your qualification might be and when you start working on the road, it differs. It happened to me a lot of times, not all of our stations use the same type or make of equipment.
The lack of confidence and skill in your equipment can be detrimental to you and your patient if used incorrectly. It would be wise if you can try to get hold of a rep for that specific piece of equipment to "show you the ropes" and the safety precautions around it.
This way you will receive the correct information and you can ask questions regarding that equipment with an "expert" answering them for you.
Just an opinion...
It is something we lack in some EMS companies. How many of the people get "new" equipment for their vehicles and they don't know or are unsure how they work!?
It happens quite often that you are trained on a certain piece of equipment during your training as EMT or whatever your qualification might be and when you start working on the road, it differs. It happened to me a lot of times, not all of our stations use the same type or make of equipment.
The lack of confidence and skill in your equipment can be detrimental to you and your patient if used incorrectly. It would be wise if you can try to get hold of a rep for that specific piece of equipment to "show you the ropes" and the safety precautions around it.
This way you will receive the correct information and you can ask questions regarding that equipment with an "expert" answering them for you.
Just an opinion...
Oh so sorry people, but this should not even be a topic that's worth discussing. Even though it has come up here before in the past.
If you have a piece of equipment on your ambulance that you are expected to know how to use, and you don't know that, the blame rests soley on you. Period. Not to mention the fact that it is completely and utterly inexscusable to allow yourself to be in that situation.
I don't care what equipment was used in your intial training in the classroom...or at your service...if you start practising in the field without the ability to use each and and every piece of equipment at your disposal, then you should not be there in the first place. Step back and get yourself trained.
If that sounds harsh, that's just to bad. This is not something that should be looked at as a hobby, or a job that has no consequences. Either do your job right, or go home and let someone else do it.
The fact that this keeps coming up is just another sign of how worthless EMS is becoming in America.
If you have a piece of equipment on your ambulance that you are expected to know how to use, and you don't know that, the blame rests soley on you. Period. Not to mention the fact that it is completely and utterly inexscusable to allow yourself to be in that situation.
I don't care what equipment was used in your intial training in the classroom...or at your service...if you start practising in the field without the ability to use each and and every piece of equipment at your disposal, then you should not be there in the first place. Step back and get yourself trained.
If that sounds harsh, that's just to bad. This is not something that should be looked at as a hobby, or a job that has no consequences. Either do your job right, or go home and let someone else do it.
The fact that this keeps coming up is just another sign of how worthless EMS is becoming in America.
JPINFV
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^
I agree with the above with a slight addendum. Regardless of how well or not you are trained, I completely endore going to the manual for additional information. That's how I learned about Wheelen's silent test function.
I agree with the above with a slight addendum. Regardless of how well or not you are trained, I completely endore going to the manual for additional information. That's how I learned about Wheelen's silent test function.
man you people! so quick to sit on your high horse and point your finger. just like all the other monkeys out there that simply agree with whatever the first person says, not actually contributing anything else to the conversation. unless it's a poll, who cares how many people agree with whom. when i posed the question, i was looking for further information because i was getting crap info from those training me (yes imagine that, a burned out inner city medic). this is not a common piece of equipment, at least not around here, and i thought i might be able to find someone on here that might know the proper energy setting for defib. yes that is the only thing i don't understand about this machine yet and i have asked all i have trained under so far with all different answers. i thought i could get semi non judgemental info but apparently i was sorely mistaken.
as far as the energy setting being protocols, every place i have worked has followed acls guidelines. same drugs and doses, and same energy settings. have you actually sat through an acls class. quoting from the acls book directly ... "select energy level at 360J for monophasic defibrillator. select DEVICE-SPECIFIC energy level for biphasic manual defibrillator, TYPICALLY 120 to 200 J; IF UNKNOWN SELECT 200 J.
as i said in the original post and other times as well, i was told multiple different things about this device specific (mrl pic50) setting. you slam over and over again, yet essentially provide no useful information to this situation. yes i agree it's crap i'm having this much trouble getting someone to give me a straight answer about this, and yes i will continue to ask the next crew chief i'm with and the next after that one until i get an answer i'm comfortable accepting.
i have seen conversations on here where you guys are quick to slam and cut people down who are reaching out for advice. obviously those people are much less likely to reach out again for advice. now do any of you want someone that might one day be treating your grandmother, your child or god forbid yourself to be afraid of asking questions because they'll be slammed to no end and not be answered anyway. i have to say that due to this, i'm not very likely to post here anymore. ya'll can have your forum. i'll get my advice and info through other sources.
with that said, i want to thank JPINFV for the link to the user guide. you're the only one that provided any kind of helpful information. that guide (like i suspected) states the proper energy setting for that device. thanks again.
as far as the energy setting being protocols, every place i have worked has followed acls guidelines. same drugs and doses, and same energy settings. have you actually sat through an acls class. quoting from the acls book directly ... "select energy level at 360J for monophasic defibrillator. select DEVICE-SPECIFIC energy level for biphasic manual defibrillator, TYPICALLY 120 to 200 J; IF UNKNOWN SELECT 200 J.
as i said in the original post and other times as well, i was told multiple different things about this device specific (mrl pic50) setting. you slam over and over again, yet essentially provide no useful information to this situation. yes i agree it's crap i'm having this much trouble getting someone to give me a straight answer about this, and yes i will continue to ask the next crew chief i'm with and the next after that one until i get an answer i'm comfortable accepting.
i have seen conversations on here where you guys are quick to slam and cut people down who are reaching out for advice. obviously those people are much less likely to reach out again for advice. now do any of you want someone that might one day be treating your grandmother, your child or god forbid yourself to be afraid of asking questions because they'll be slammed to no end and not be answered anyway. i have to say that due to this, i'm not very likely to post here anymore. ya'll can have your forum. i'll get my advice and info through other sources.
with that said, i want to thank JPINFV for the link to the user guide. you're the only one that provided any kind of helpful information. that guide (like i suspected) states the proper energy setting for that device. thanks again.
Ridryder911
EMS Guru
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Here's an idea. instead of whining ask your director of education or supervisor as you should had in orientation. Burned out, surely they have a boss. No answer, then ask administration and your medical director, or call the rep in your area. You are going to base the answers based upon a bunch of basics? It is your responsibility as others described. Sorry, I have no problem asking the appropriate people, and if need be work my way up the food chain, until I get an appropriate answer.
Okay, last resort go to AHA ACLS, which describes to place on 200 joules. Again, I refer you to your local operation education and manager, in which should have the manual and possibly a video to watch. Forums are great for information, but nothing replaces getting straight from the source, in this case I would consider essential before using any of the equipment.
R/r 911
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nsom,
In reading through this thread, I don't see were people were on their high horse and pointing fingers. They were bringing up valid points, but they weren't necessarily what you wanted.
That being said, I'm glad that you got the information that you were looking for. I'm also glad that the other information was presented because it COULD answer another person's question in the future.
FYI, our protocols have us using a different energy setting for our biphasic AED than the mfg setting. So it can be a local issue, as well as a device specific issue.
In reading through this thread, I don't see were people were on their high horse and pointing fingers. They were bringing up valid points, but they weren't necessarily what you wanted.
That being said, I'm glad that you got the information that you were looking for. I'm also glad that the other information was presented because it COULD answer another person's question in the future.
FYI, our protocols have us using a different energy setting for our biphasic AED than the mfg setting. So it can be a local issue, as well as a device specific issue.
So because your own flaws, short-comings and lack of professionalism are pointed out, you get upset. Nice one on that. You'll fit in just fine around here.
I do like it that you'll only ask a question until you get the answer that you like; very telling.
Honestly, what upset you so much? That somebody wasn't willing to hold your hand, pat you on the head and tell you everything is ok? That I told you you were screwing up? Better get used to it pal, it's gonna happen again.
Learn from your mistakes, move on, and don't make them again.
No, you're getting it because allowing the problem to continue is unacceptable, for the reasons I listed, and a whole lot more besides. If you weren't able to get any answers from your partner's in the field, where else do you think you should have gone? A supe? Medical director? The manual for the monitor (and I gaurentee that your service has one of those)? Did you do this? Apparently not, you just let the problem go without resolving it.
Yes, and? What is your point with this? That the MRL may have a specific setting that other monitors don't have? Ok, why is that surprising to you? What do you think you should have done if this is the case? Why didn't you do it?
I have never used an MRL so I really can't help with that problem. But I do know that before I ever went and used it in the field I would be comfortable using it and know how to use it, even if that meant I had to talk with someone other than my partner, or heavens forbid, read a manual. Nobody has slammed you over and over again, I simply pointed out that using a piece of equipment that you don't know how to use, and allowing that situation to occur is wrong. Do you disagree?
I do like it that you'll only ask a question until you get the answer that you like; very telling.
Honestly, what upset you so much? That somebody wasn't willing to hold your hand, pat you on the head and tell you everything is ok? That I told you you were screwing up? Better get used to it pal, it's gonna happen again.
Learn from your mistakes, move on, and don't make them again.
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That's enough of this one...it can only go downhill from here.
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