Let's Talk Monitors!

[Epi-do]

What cardiac monitor does your service use? What do you like about it? What do you dislike about it? Would you recommend it?

We are looking at getting new monitors for our trucks. We currently have Lifepack 12's. I know they are looking at the Phillips and the LP15. We have been asked to give our input/make suggestions if we have any. However, I don't work anywhere else on the side, so I can't really make any sort of firsthand suggestions. But, if I can take opinions back from people that actually use the various monitors that are out there, it would be helpful in narrowing down which ones to consider more seriously.

 

[TransportJockey]

My old service in NM used Zoll M and then E series. I loved them. Simple to use, pretty reliable and battery life was awesome. Different joule settings than anythign else though.

Service I did internship with in ABQ used LP12s. Easy to use as well. Reliable and tough. Battery life seemed to suck though.

Service I just got hired on with up here uses LP12s as well with talk of going to the LP15.

I have used Phillips in class and thought they were ok. My personal ranking is Zoll, Phillips, LP.

 

[NomadicMedic]

I'd been using LP12s and I liked 'em. The 12 leads were clean and that was important to me.

However... I am now currently using a Phillips and I'm not a fan. The 12 lead is ALWAYS full of artifact, the SpO2 sensor sucks, the NIBP cuff is always inaccurate, plugging in the capnography is a PITA... I could go on and on, but let me say, if it were up to me, I'd be tossing that Phillips POS and we'd be back with the LP12.

And, I know the Phillips reps will give you one or two to try and evaluate... I'd do it, and watch for the issues I mentioned.

 

[exodus]

We use Zoll M CCT monitors. And they're pretty nice, only one I've ever used though. Problem with them that I don't like though, is it's very awkward to handle with the stand if the stand doesn't fit on the gurney, ala bariatric calls. It would be amazing if there was a quick release latch to hold it to the stand instead of straps. But as far as the monitor goes. It's alright and it filters out artifact pretty well most of the time. Never used Defib / Pace on it though.

 

[Smash]

I'd been using LP12s and I liked 'em. The 12 leads were clean and that was important to me.

However... I am now currently using a Phillips and I'm not a fan. The 12 lead is ALWAYS full of artifact, the SpO2 sensor sucks, the NIBP cuff is always inaccurate, plugging in the capnography is a PITA... I could go on and on, but let me say, if it were up to me, I'd be tossing that Phillips POS and we'd be back with the LP12.

And, I know the Phillips reps will give you one or two to try and evaluate... I'd do it, and watch for the issues I mentioned.

I agree, we currently have Philips and they are nothing more than ballast. Biggest load of garbage I've seen. Battery life is great though. LP12 had terrible battery life, haven't seen the 15 to know what they are like. Personally would love to have a Schiller Argus ProLife 2, gorgeous machines. Apparently they cost money though, and money is not to be spent (except on managers bonuses).

 

[Shishkabob]

LP11s are the most prevalent monitors at my current gig.. friggin dinosaurs.


I used LP12s in my internship. HATED the extremely short battery life. I couldn't get through an average 911 call without a battery dying, let alone working a code. God forbid we get sent to another call before getting back to get fresh batteries... we always kept 2-3 extra on the rig.

As far as performance, it was ok. I never really liked it though. We have a couple at my current job too. Beats the 11s, but that's not saying much.



I learned / trained on the Phillips in class. I love those monitors. Everything just seems fluid when working with them. Can't really describe it... just liked them.

 

[lightsandsirens5]

I'd say the Zoll M (or E) is far and away the best out there. I have seen it put through more abuse.........

I really like how there is no way to confuse any of the buttons with the on off switch too. As for batt life, I cannot comment on the Phillips as I have never even laid eyes on one. The LP has terrible batt life according to another local servce I work with quite a bit. That and the button confusion thing. The Zoll have unbeleivable batt life. I have personally run a code with one in which we did 7 or 8 shocks in addition to a 45 minuter transport of said code pt. The battery never once started giving the low alarm.

Another thing I like about the Zoll is that it will connect to bystader type AED pads made by Zoll. Impretty sure the lifepacs don't do that. I sure Phillips will do that as there are quite a few Phillips AEDs. But it is a Phillips then. Apparently they make great boat anchors. :-/

I would defiantly reccomend the Zolls over anything else out there.

Good luck and consider yourself honored to have actuallly been asked for your input on an issue like this.

 

[Veneficus]

I agree, we currently have Philips and they are nothing more than ballast. Biggest load of garbage I've seen. Battery life is great though. LP12 had terrible battery life, haven't seen the 15 to know what they are like. Personally would love to have a Schiller Argus ProLife 2, gorgeous machines. Apparently they cost money though, and money is not to be spent (except on managers bonuses).

I was at testing site for phillips. They took nothing of what we suggested, customer service was nonexistant, the leads broke all the time, pulse ox cord not long enough, alarms too sensitive, it goes through paper like it was free.

we referred to it as the perfect anchor but ballast sounds better

 

[fma08]

We have the Phillips. I haven't run into any issues personally once we switched to the "grabber" style leads. But then again, we haven't had them for too long yet.

Edit: We switched from the LP12's with pretty much no bells and whistles on it. The service I rode with while in medic school had the LP12's with some additional features and I did like them. Haven't tried the Zolls yet.

 

[reaper]

You will get 1000 different opinions on them. It is all what the person uses daily.

I personally hate the Zolls with a passion, biggest peice of garbage ever made.

The phillips are ok, but I dont like them. Used them for 3 years when they first came out and learned to not like them.

LP12 has been the golden standard. It preforms it's job well and can handle the abuse that is put to it. It can be picky and needs to be setup just right.

LP15 has pushed it over the top. If you do the resaerch on it, you will learn that it has the most state of the art software ever developed for a monitor. No other machine can even compare to it. They have designed them to be even more rugged then the LP12.

Battery life in a LP has always been issues with people. But, you need to realize what those monitors are preforming. They will eat up a battery. As battery technology becomes better, they will make them even better. I have no problem getting through a code or long transport on a LP12 batteries. A lot of it is how they are taken care of and conditioned.

When talking boat anchors, you have to include the HP Code master on that list!

 

[Smash]

I was at testing site for phillips. They took nothing of what we suggested, customer service was nonexistant, the leads broke all the time, pulse ox cord not long enough, alarms too sensitive, it goes through paper like it was free.

we referred to it as the perfect anchor but ballast sounds better

Oh yes alarms are great! A stray breeze wafts through the window and it starts screaming, which results in 2 things: first, it spews out enough paper to jot down War and Peace on and second, we all spend 90% of the job pushng the silence alarms button.

We now have an extension cord for the pulse ox, which results in it now being too long and gettng tangled in everything, but fortunately they make up for that by keeping the EtCO2 too short, so you can't move too far without pulling your tube out. I guess that evens it out... Leads still break on what seems like a weekly basis and we had some that liked to keep us on our toes by turning themselves off when you push the charge button during a code. Great fun!

I would love to get my hands on a 15 to try, but my money would still be with the Schiller.

 

[ceej]

You think the LP11 is a dinosaur, the LP10 is a shockasaurus .

I've always liked the LP series. The LP 15 battery life is far superior to the LP 12 in my experiences. I have done an entire 24 with multiple codes without changing the batteries.

 

[Veneficus]

You think the LP11 is a dinosaur, the LP10 is a shockasaurus .

I've always liked the LP series. The LP 15 battery life is far superior to the LP 12 in my experiences. I have done an entire 24 with multiple codes without changing the batteries.

Thanks, having used a LP 5 where you could separate the monitor and defibrilator (no idea why) I feel rather old.

 

[MrBrown]

I love the LP10 not so much for the cardiac intervention capability but because I can sling it over my shoulder, stow it practically anywhere (unlike the oddly shaped LP12) and it looks really damn awesome in that red case, and it has paddles!

No NIBP or SPO2 on that thing, you had to manually count respirations and blood pressure!

I have only used LP12 and it's good, but the screen colours (that funny brown/orange/yellowish colour) and the damn scrolly trigger wheely thing is a PITA.

We're getting the MRx, havent used it yet but it looks weird

 

[fortsmithman]

My service just purchased a Lifepak 12. We were looking at the Lifepak 15 but were told there were problems with charging it in the rig.

 

[ah2388]

i rly like the zoll e series

 

[Epi-do]

Thanks for all of the comments! I am somewhat surprised about the comments regarding the phillips monitors. While I haven't truly used one, I have been able to look at one and liked it what little bit I was able to mess with it. One of our neighboring departments recently switched from Zolls to Phillips, so it will be interesting to hear their feedback about them as well.

 

[lightsandsirens5]

talking boat anchors, you have to include the HP Code master on that list!

Well duh!

The inkjet printer turned heart monitor..........

And the one I used had a terrible strip printer. For a company that makes printers too, you would think that they could make a defib that would actually print a decent strip.

 

[EMSLaw]

I have only limited experience with monitors, all of it with LifePaks (5, 10, 12...). I suspect that like many things, you develop a preference based on what you're used to, and everything else seems different. Different is strange and wrong.

 

[redcrossemt]

I personally love the "ergonomics" of the LP12/15. It's easy to use, layout makes sense, cables and hoses route easy. Rolls of paper may be annoying, but the printer feeds good. Battery performance has always been ridiculous, but is supposed to be better with the new batteries for the 15.

Honestly though, I've had the best performance from Zoll and would call them the overall best solution. Filtering is the best with the least artifact. The 12-lead analysis (if you use it) is the best. The CCT monitor is very impressive, if heavy. 120-volt charging on the monitor is nice. We use the E series for our rescue trucks and I enjoy the "filtering" of CPR out of my ECG as well as the real-time CPR help. Anecdotally, I am sure we get capture much more often with pacing, and I'll venture out there and say that we have had a few more cases of successful defibrillation. Of course, that's comparing Zoll biphasic posterior-anterior to Lifepak monophasic anterior-anterior, along with many CPR changes.

As far as downsides to the Zoll, the ergonomics aren't there. The M has always been hard to carry. We now use the E and I've seen the R. Both are better for carrying, but the buttons and layout still don't make sense. The external EtCO2 detector isn't my favorite. Hope you don't ever lose or break that cable! Z-fold paper isn't my ideal solution, but our newer ones have less problems than ever.

Phillips, while a cool concept, has yet to be proven. The MRx hasn't really made a stand for itself as far as reliability and quality. You can read the issues above. Phillips AEDs rock my world though... With your medical director's approval you can tune the specificity and sensitivity of the defib protocols, as well as let the AED decide whether to instruct shock or CPR first based on amplitude of the ECG. Very cool for lay persons and trained rescuers alike.

As far as using AED pads, the LifePaks, Phillips, and Zoll all attach to their own AED pads. You can buy converters if you are using one brand of AED and another monitor brand. At my first responder agency we use Phillips AEDs, but the responding ALS service uses LifePak. We just purchased adapters for all the AEDs ($30 each) so we don't have to change pads.