From the May 2017 issue of HealthCare Business News magazine
By James Laskaris and Julie Andrews, MD Buyline Analysts
Patient safety is always paramount in defibrillators, patient monitoring and biomedical testing equipment, but cost is always a factor.
Latest innovations in Defibrillators
The 2015 American Heart Association (AHA) Guidelines Update for advanced cardiac life support (ACLS) showed that a low end-tidal carbon dioxide (EtCO2) level in intubated patients was linked to a very low success rate for resuscitation. As a result, the ability to monitor EtCO2 during resuscitation efforts became a priority.
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In response to this, all major defibrillator manufacturers have now added the ability to monitor EtCO2 to their manual equipment for both the acute care and EMS settings. The health care team can now assess the EtCO2 along with other vital signs during resuscitation and adjust the plan of care in real time.
The emphasis in any level of CPR training, from community-based to advanced, is on the rescuer performing high-quality CPR. Manufacturers have begun incorporating software into their professional devices that gives immediate feedback to the rescuer regarding the quality of compressions. If an automatic external defibrillator (AED) is in use, the feedback may be as simple as a digital message that reads “Push Harder” or “Good Compressions” or a visual meter that gives color feedback as compressions are performed.
Software is also available for manual defibrillators that can provide feedback during resuscitative efforts, and provide information that can be directly transferred to the electronic medical record (EMR) after the event. This can allow for vital quality review for the resuscitation team, and real-time accurate documentation in the patient’s medical record. This real-time documentation not only has an impact on the patient’s plan of care, but also on hospital coding and billing information.
Defibrillators, both manual and automated, use biphasic waveforms that come in three different forms: biphasic truncated; rectilinear biphasic; and pulsed biphasic. They all deliver peak energy at the same programmed settings, but differ in how they adjust energy output in relation to physical impedance. Mounting evidence shows a greater effectiveness for the biphasic truncated and rectilinear biphasic over that of the pulsed biphasic waveform. This information should be considered when purchasing either automated or manual defibrillation devices.