I'm sensing a new thread...How many gadgets and how dependent?

[mikie]

So with the new technology giving us more 'vitals' (I don't know what you would consider them), then yes we will need more training.

Kinda win-lose situation?

 

[VentMedic]

So with the new technology giving us more 'vitals' (I don't know what you would consider them), then yes we will need more training.

Kinda win-lose situation?

No, if used correctly and with some extra education, it opens up new possibilities for a more thorough assessment and even research.

 

[BossyCow]

One of the hardest things I've found to teach my students is to document why they felt the monitor was not the best, latest greatest source of info. Writing into the report. SPO2 was 86 per monitor but pt was breathing normally, had good color, lungs sounds clear and equal bilaterally. But to write on the report that the pt's o2 sat was low and then to not show treatment worthy of the number looks bad on a report later.

We are always going to have pts who have an odd monitor stat of some kind. And we can't use cookbook treatments in every case. There will always be differences. But we need to document what made this one different and what you saw that made you choose the treatment you did.

 

[VentMedic]

In some of the hospital computer SpO2 charting pathways, there are at least 8 pre-listed things commonly known to skew the number that can be checked as well as a type in if one feels the number is not going with the clinical assessment. Bad form to type a low value (or high value if O2 titration check) without an explanation as to why a change or intervention was or was not made.

 

[mycrofft]

Vent..."Knobologist"? Did you coin that!? Cool!

Oh, and in my last comment I really meant that we were on "annual", not "annal", training!:blush:

 

[ErinCooley]

the only thing we "rely" on is the EKG on the lifepak, and I guess the glucometer. We pretty much always do manual v/s... at least 1 time.

 

[rjz]

I have to agree with everyone that feels that technology is bringing us down. There is one problem that seems to continue to rear its ugly head....the hospital. (At least in my area). I am always being asked for pulse ox readings, what the EKG machine said about the 12 lead, etc. Our protocol for acute MI is even based on the machine giving you the ***acute mi suspected*** printout. We are trained to read the strip, make a decision, and treat the pt. However if I feel like I am seeing ST elevation and the monitor disagrees guess who wins...the monitor. Myself I rarely use a pulse ox, if asked for a reading I like to say I could not gain capture. It is the truth, and most of the time there is so much ambient light around that it really doesn't work. This of course goes back to the comment already said. Many times we as providers are not trained on how to use these gadgets. It then becomes ones own prerogative to go out and find the information. The hospitals rely on these machines to give them all their readings and when you don't provide them those readings they get testy with you. I guess I just have to continue marching to my own old school drummer....

 

[Ridryder911]

I have to agree with everyone that feels that technology is bringing us down. ....

I disagree it is NOT the technology rather the individuals using or misusing the technology. Such technology such as EtCo2 and even the Spo2 are great tools. Do they change my assessment or my treatment? NO but they aid in additional qualifiers that I have as documentation and a base line reading. Again, I should had already had a preliminary diagnosis prior to even attaching such equipment.

Let's not blame technology on our laziness or poor assessment techniques and failure to appropriately diagnose.

R/r 911

 

[John E]

another round of applause...

for Rid...

If it's all technology's fault, stop communicating with computers.

John E.

 

[reaper]

You need to read the posts! He said it is not the technologies fault!!!!!!!!!!!!!!!!!

 

[John E]

I read his posts...

I've read all of them, hell, I wrote one of them. And I agree with what Mr. Ryder is saying which is why I wrote "another round of applause for Rid..."

The majority of the posts in this thread are trying to blame nuts, bolts, microchips and electricity for human errors.

My point was and remains, it's hypocritical to lay the blame for inaccurate diagnosis' on the machines when it's the people operating the machines who are most often making the mistakes. Coupled with the fact that the technology isn't going to magically stop itself, the modern medical field is wholly reliant on technology. Complaining about technology while using a computer is just silly.

John E.

 

[mycrofft]

Not silly, just a sign of unintegrated values...like mine.

I'm not giving up gadgets that work, those are "tools". I'm avoiding a blind reliance on their results.
As a kicker, my admin has decided, despite my relaying the Welch Allyn rep's message about +/- 10 mmHg variance in BP, to buy a new vital sign monitor for every exam room. They are using these to replace a LVN or RN or even a real med tech to assist the MD and going for untrained clerks. I told the doc any VS he sees from me other than a POx is NOT from the monitor.
Now, the thermometers...what temp are you supposed to keep the probe covers? Unless you are on "monitor", a little heater in the probe brings it to a preset temp, then measures the rate of rise for a set length of time and CALCULATES the temp by rate of rise, not the actual temp. I can take any four of ours , put them into a cup of hot water, and not get the same reading on most of them, and a couple will be off by as much as a degree and a fraction; if I compare them to my trusty elecronic lab probe thermometer, they are all wrong by as little as a couple precentages, or, again, over a degree. If I use all new probes..pretty close.

 

[rjz]

Wow I didn't know that about the probes. That kind of explains a lot..and once again points out a need to read and learn about your equipment.

And for the record I didn't say that it is technologies fault that we rely on it, it is the human factor that makes someone rely on it. Many of you may not rely on it and use your own brains, I do too. However as more and more technology weaves into our day to day care I seem to see more and more people relying on it. Just seems like a problem that I see. It then seems to be further encouraged by the hospitals and becomes perpetual.