Cardiac Monitor/Defibrillators- what are you using or wish you were using?

[antiquefirelt 994]

We're gearing up to replace our Lifepack 10's and most of our people were pretty confident they only liked Physio until actually putting their hands on the Zoll X series. The only other unit on the market appears to be a Phillips which they say FDNY EMS is using. Can anyone elaborate on their experiences with the latest generation of monitor/defibs?

We're looking at the full deal with 12 lead, SPCO, end tidal CO2, automatic BP, etc. We have no experience with Zoll or Phillips and no one near us uses Phillips so we've never even touched one. We do know our service with Physio went down the toilet when our local rep left their employ.

Thanks.

[SteveC7010 58]

We've got a fully loaded Zoll X on our unit. It's great and not terribly difficult to learn to use. We just had a confirmed save with it late last week. Never got to the CPR stage. The 12 lead in the house showed a STEMI so we had the patient airlifted out. He came home today.

Life-Net (Air Methods) uses them exclusively up here and may nation wide. I'm not 100% on that.

If you get one (or more), get the full saddlebag accessory and the right mount to place it in your unit safely.

[antiquefirelt 994]

We've got a fully loaded Zoll X on our unit. It's great and not terribly difficult to learn to use. We just had a confirmed save with it late last week. Never got to the CPR stage. The 12 lead in the house showed a STEMI so we had the patient airlifted out. He came home today.

Life-Net (Air Methods) uses them exclusively up here and may nation wide. I'm not 100% on that.

If you get one (or more), get the full saddlebag accessory and the right mount to place it in your unit safely.

Thanks. We did find that learning to use it wasn't too bad, as I said we've got one demo in service and most have found it pretty easy to use, the only things that's more complicated is printing summaries and such, but the functional things were easy enough that I can do it, and I haven't ridden in the back of a bus in over a decade. We too liked the saddlebags, they're a must for the way we use them.

A few local EMS units around us also have Zoll, but the older M series (?) so they reports don't align with the X's. I do know that Lifeflight of Maine also uses them as well as Portland FD and Northeast Mobile Health both are likely the busiest service in the state.

[sympathomedic 383]

I use the Zoll at Empress and I really like it. It is WAAY lighter and the batteries last a long time. Being an EMS guy, I can always find something to c/o. The hooks that let you hang it on the cot can be very tough to unhook. I guess they wanted to make sure it never unhooked itself and fell.

Zoll has a very good online training video. I find the auto cuff better than most, but I must emphasize, AUTO CUFFS CAN RARELY BE TRUSTED. I had a very shocky pt, with every sign of shock in the book, and the Zoll gave me a normal BP. I had it try again and got the 70/50 I knew it must be.

If you sync EKG's to a PCR program, one cool thing about the Zoll is that it can sync WHILE still monitoring the pt. So as I approach the ER, I have it send the calls worth of vitals and EKG to the tablet, and I walk in with all that stuff done.

All tha being said, I have never used a Philips, so it may very well be better.

[SRS131EMTFF 471]

Zoll X-series. We just got 2 X-series with medic level features and 7 all new Zoll smartCPR AEDs for <~$50,000. We were sold on Lifepack until we saw the X series demo, we did not consider Philips. Between the weight, software and hardware it was a no brainer.

Even if you only use it to take vitals it is the only EKG/AED with military grade technology built in. Between the welch-allyn BP cuff taking BPs in 5 seconds and the EKG leads allowing respiration rate determination, vitals take themselves.

The CPR feedback allows you to track your CPR performance though-out and ensure proper perfusion competent, it will yell at you if you do not. It really makes effective CPR idiot proof.

Hopefully you got the full demo from both, and Ian, the smooth-talking Zoll rep. was able to show you exactly why the X-series is superior.

Edited July 3, 2014 by SRS131EMTFF

[antiquefirelt 994]

Thanks for the replies. Seems like we're all finding the Zoll to be pretty nice compared to what we've used in the past. It's nice to hear real world experience such as the BP cuff not being quite the best thing since sliced bread. Our EMSer's thought it was awesome, then when it was slightly problematic is the filed wondered if it was a problem or just hyper-sensitive. With our LP's we required at least one manual BP before using the auto cuff due to the quality of the readings. Sounds like that might still be a good idea. No doubt it's fast when your sitting in a classroom.

SRS131EMTFF: We did get the full demo along with Ian for three days of ride along (one for each shift). It was great, the first demo one of our guys thought Ian's last name was Zollman and that he and his father owned Zoll. He's still taking a good beating on that. We had some fun with Ian and that as well. We'll have to see how the pricing comes out, but we were looking at about $100-105K for three X series with all the bells and whistles.

Anyone had any experience with the Phillips. Local skepticism is even higher than we had with Zoll, as we can't find anyone in our state using them on an ambulance. Of course before the Zoll, our personnel were convinced the LP 15 was the next greatest thing, sight unseen. Now they've had their eyes opened. Amazing what we'll convince ourselves of without looking any further.

Normally I have next to nothing to do with EMS procurement, but a temporary shift in duties requires that I approve this purchase, so any tidbits help.

Edited July 3, 2014 by antiquefirelt

[sympathomedic 383]

I mean no harm, but I would rather not know a BP than have the machine give me a wrong one. I would rather not know, and know that I don't know, than think I know and have it be that what I know turns out to be wrong. The respiratory rate counter is so innacurate as to be useless. The 5 second BP works about 1/5 of the time (it only works if the machne catches the BP during inflation, rather than having to fully inflate then slowly deflate.) Most of the time it needs to fully cycle.

I love the device, but it just isn't gonna happen that I base a treatment decision on a BP taken by any machine. JEMS did a study showing how innacurate ALL machine vitals are, and it showed that the shockier the patient, the more innacurate the vitals. When the Zoll is right, it is pretty accurate, but it can be WAAAY off. It is very easy to not be bothered taking real vitals and just roboticly documenting machine vitals, but it is at best = quality care compared to REAL vitals, and at worst it can lead you to perform an improper intervention- fluid challenge, lasix, nitro, trendelenburg etc.

The CPR feedback seems a real advance. Like all things medical, a study will need to be done to see if it makes us do better CPR and if that = better outcomes.

[SRS131EMTFF 471]

I mean no harm, but I would rather not know a BP than have the machine give me a wrong one. I would rather not know, and know that I don't know, than think I know and have it be that what I know turns out to be wrong. The respiratory rate counter is so innacurate as to be useless. The 5 second BP works about 1/5 of the time (it only works if the machne catches the BP during inflation, rather than having to fully inflate then slowly deflate.) Most of the time it needs to fully cycle.

I love the device, but it just isn't gonna happen that I base a treatment decision on a BP taken by any machine. JEMS did a study showing how innacurate ALL machine vitals are, and it showed that the shockier the patient, the more innacurate the vitals. When the Zoll is right, it is pretty accurate, but it can be WAAAY off. It is very easy to not be bothered taking real vitals and just roboticly documenting machine vitals, but it is at best = quality care compared to REAL vitals, and at worst it can lead you to perform an improper intervention- fluid challenge, lasix, nitro, trendelenburg etc.

The CPR feedback seems a real advance. Like all things medical, a study will need to be done to see if it makes us do better CPR and if that = better outcomes.

Delete

Edited July 3, 2014 by SRS131EMTFF

[Jybehofd 85]

ive used the philips its not bad but the print-out on the 12 lead is a little weird... just takes getting used too but seeing a dynamic 12 lead is cool. where i work we started with the lifepack 12s not a bad machine but heavy, and short battery life.. i had to carry 4-6 batteries working a 16 hr tour. also because of limited chances of getting back to the station to change out dead ones. then they changed over to the 15s.. very nice a little lighter but still heavy compared to the zoll but the battery life is longer. and easy to use just like the 12.

good luck

[WAS967 97]

There are agencies still using LP10s? Can they be retrofitted to be biphasic?

I'd love to play with a Zoll X series. I've heard so many good things. The idea of something lighter than the boat anchor of an LP15 seems a huge plus.

[antiquefirelt 994]

There are agencies still using LP10s? Can they be retrofitted to be biphasic?

I'd love to play with a Zoll X series. I've heard so many good things. The idea of something lighter than the boat anchor of an LP15 seems a huge plus.

We did just get the Phillips in for a demo and are using one for two weeks. It too appears to be a significant improvement over the current monitors (now that you mention it, they might be LP12's). The Phillips is not as small or light as the Zoll X, but the screen size is larger and it appears that some of the secondary functions (printing summaries, trends,etc) are simpler. They too can push the info into the ePCR quickly using wireless or a cellular connection. After the crews using the Zoll X for two weeks, most if not all are certainly no long in the tank for Physio. In the end, while not everyone will be happy (ever), any new unit appears that it will work and be a significant improvement on many fronts. Still waiting for Physio to send us up a demo, they wanted 4-6 weeks to get us one, which appears to mirror how our service with them has been, which certainly doesn't help the sales force.

[EMT-7035 4]

We just took delivery of 4 LifePak 15s for our fleet about 2 months ago which replaced our LifePak 12s. We didn't demo Phillips at all, but we had the Zoll X and the LifePak 15 for about a month, while taking a poll from the agency, the BLS providers were split between the Zoll and LifePak, but every single ALS provider we have voted for the LifePak. For BLS, the cuff does seem to have some nice features, and as several others have pointed out it's much, much lighter and more compact. It seemed to be more intuitive to use, but some felt it seemed like a toy. One of the biggest complaints from the medics were that the printer is in the back, and analyzing anything or even printing strips to show the ER became a challenge, especially if the monitor is on the back of the stretcher or on a self in the rig.

We use ImageTrend for our PCR service, and both worked well with the system so that didn't really affect anything for us. We put the quotes against each other and got both vendors down considerably, and by the end, they were within a thousand dollars of each other (for the 4 monitor quote) so price wasn't a big factor for us in the decision. However, a potentially big contributing factor is that the majority of our medics are employed or volunteer elsewhere in the almost exclusively LifePak filled region. Most other agencies still have LifePak 12s, something I'm sure is soon to change, but people certainly are used to the Physio layout.

[paratrooper75 41]

I use the Zoll in the air and on the ground. I've also used the LP12 and LP15. The Zoll X-series/Propaq wins hands down.

[Ladder44 73]

At AMR we use life pak 12s, there old and rundown and behind in technology. Id like to get 15s, more options, color code screen, not as senstive to movememnt and can blue tooth your vitlas/ekgs to laptop.

[WAS967 97]

Too bad Physio doesn't have a monitor the size of the LP20 that we can use in the field. The LP12/15 is heavy compared to what I would expect in this day of electronic miniaturization.