The salt Lake Tribune

Salt Lake County paramedics are being equipped with new devices to speed treatment of heart attack sufferers - and South Jordan is leading the way.

On July 15, South Jordan City Fire Department and Jordan Valley Medical Center piloted cell phone technology that allows paramedics to transmit full 12-lead electrocardiograms to hospitals, placing doctors on alert and giving them data they need to diagnose and prepare treatments.

The system has been used on a dozen emergency calls, and is being adopted by other cities, including Midvale and West Valley, said Wayne Edginton, South Jordan battalion fire chief.
The fire department purchased the EKG equipment - costing $25,000 per ambulance - as part of a push to create a "heart-safe community," said Edginton.

The department also has offered free cardiopulmonary resuscitation training to hundreds of residents and is encouraging businesses and public buildings to stock automated external defibrillators.

Heart disease is America's No. 1 killer, claiming the lives of 36 percent of the more than 2.4 million people who die each year, according to the American Heart Association.
But timely care can save lives, said Edginton. "Time is muscle as far as heart attacks are concerned."

The new EKG technology frees patients to bypass testing in the emergency room, shaving by 30 to 40 minutes the time it takes to get them into a catheterization lab, where doctors can perform a balloon angioplasty to open clogged coronary arteries and restore blood flow to the heart.
"We call that 'door to balloon time,' " said Jordan Valley emergency physician Bart Johansen. Restoring oxygen to the heart prevents damage to the muscle and improves outcomes, he said.
Also, a 12-lead EKG is more accurate than the single-lead systems in most ambulances, said Edginton, who says it takes about two minutes to hook up a patient and get a reading.
The information is sent via Bluetooth wireless to a PDA and then to a server in Denver. In less than a minute, the server alerts the receiving hospital and spits out an EKG.

Johansen said the technology pairs with less-invasive procedures developed by cardiologists in recent years.

But, Johansen cautions, patients who ignore symptoms or drive themselves to the hospital deprive themselves of such life-saving innovations.
kstewart@sltrib.com

Medical News Today

With better quality sound, reproducibility potential for computer analysis, file-sharing and verification, this new approach offers many benefits, as two Canadian researchers tell the ERS annual Congress in Stockholm.

The traditional stethoscope, fast approaching its second centenary, could soon have to give way to new digital technologies, which are undergoing spectacular development. Even the latest electronic stethoscopes cannot rival MP3 players, used today mainly for leisure purposes. So explained Neil Skjodt, of the Department of Medicine at the University of Alberta (Edmonton, Canada), in his presentation to the annual Congress of the European Respiratory Society (ERS) in Stockholm.

Working with an audiologist colleague, Bill Hodgetts, Skjodt based his analysis on the conclusions of several recent studies, which had demonstrated that health care staff generally had mediocre auditory faculties, especially when using stethoscopes. In particular, a Danish study had shown two years earlier that medical staff at all levels had difficulty distinguishing most heart and lung sounds, and that their performance barely improved when they used an electronic stethoscope.

Two more recent studies had found that medical students sometimes had to listen to certain clinical sounds up to five hundred times before they could recognise them accurately. Yet there are few electronic instruments that make it possible easily to record, reproduce or store the sounds heard during a medical consultation. Not to mention the possibility of transmitting such sounds to databanks so that other doctors may refer to them later.

Better than a stethoscope

At the same time, the increasingly popular portable MP3 recorder/players, used primarily for music, are selling in vast numbers and becoming a major presence on the market. This gave Skjodt and Hodgetts the idea of studying whether the classical stethoscope could be replaced by a cheap off-the-shelf MP3 recorder/player.

By pressing its microphone directly to the chest, they were able to record a whole range of respiratory sounds with different patterns. Different baseline breath sounds with or without added wheezing were studied. "The quality, clarity and purity of the loud sounds were better than I have ever heard with a stethoscope", Skjodt told the Stockholm audience. The MP3 files were later transferred to a computer and converted into frequency curves. Computer analysis of the stored sounds showed that each had a distinct signature. The computer - like the human ear - did, however, sometimes have difficulty in processing complex or quiet breathing sounds.

Skjodt then tested the trainee respiratory specialists to identify the MP3 recordings of breath sounds- with mixed but promising results. Wheezing noises were recognized much better than in similar historic studies, but differences in baseline breath sounds and in recognizing combinations were still not better than chance. Skjodt and Hodgetts plan to see if brief training and ability to use reference recordings could improve auditory recognition.

Unequalled multi-tasking potential

"The improved quality is only one of the benefits", Skjodt emphasised, "and there would be many other advantages to using an MP3 device instead of a stethoscope." Indeed, the recorded breathing sounds can be included in the patient's file for future reference. They can also be sent to a specialist, or processed with more sophisticated software for particularly detailed analysis. In addition, the MP3 recorder can, of course, be used to replace an ordinary dictaphone for medical reports, or to register conferences, as well as patient interviews. And, naturally, to listen to music out of hours…

The Canadian researchers will now continue their study, examining other clinical sounds and assessing the impact of more highly developed audio techniques on sound recognition by the human ear. Doctors could find this particularly useful at patients' bedsides.

European Respiratory Society

Mobile phones should come no closer than one meter to hospital beds and equipment, according Dutch research published in the online open access journal, Critical Care. Scientists demonstrated that incidents of electromagnetic interference (EMI) from second and third generation mobile phones occurred at a mere three-centimeter distance.

In this particular study, the research team examined the effects of General Packet Radio Service (GPRS) and Universal Mobile Telecommunications System (UMTS) signals on critical care equipment such as ventilators and pacemakers. Almost 50 EMI incidents were recorded; 75% were significant or hazardous. Hazardous incidents varied from a total switch off and restart of mechanical ventilator and complete stops without alarms in syringe pumps to incorrect pulsing by an external pacemaker.

The second generation (2.5G) GPRS signal caused the highest number of EMI incidents at over 60% whereas the third generation (3G) UMTS signal was responsible for just 13%. EMI incidents also occurred a greater distance with GPRS with a hazardous incident even at three meters.

While first generation mobile phones are used mainly for voice transmission, 2.5G and 3G phones enable internet access, sending and receiving data. They entered the market, however, with little proof regarding their safe use in the medical environment.

Dr Erik van Lieshout, lead researcher from the Academic Medical Center, University of Amsterdam, said; "Our work has real implications for present hospital restrictions of mobile phone use in patient areas."

"It is unlikely that mobile phone induced EMI in hospitals will be eradicated in the near future so the one meter rule currently in place should continue, as it is relatively safe," commented Dr van Lieshout.