Many picture a Defibrillator being those two paddles that jolt you back to life. While those still exist in many different forms, the more common unit is much more simple, yet much more complex. They’ve replaced the paddles with a set of pads that stick to your skin. Just slap them on and free your hands for other use.
Another misconception is that the jolt the Defibrillator magically starts your heart. It actually does the opposite. When you have what’s called a “shock-able heart rhythm” your heart is actually beating too shallow, too fast, randomly, or out of sequence. The shock delivered actually stops your heart so it can reset itself. It’s kind of like when the power goes out on a server and then automatically turns back on when the power comes back on.
It used to be that shocking you would literally cook part of your heart and surrounding tissue because it was such an overpowered and inefficient power surge. They’ve since then fixed that automatically tuning the power output and frequency to be the most efficient and least damaging as possible.
But outside of adding a computer to regulate the shock and changing out the paddles the concept has pretty much stayed the same. It’s a proven way to save a person’s life with specific and deadly cardiac issues.
What has changed is what’s considered the STEMI (ST segment elevation myocardial infarction) Alert. When you have a blocked artery providing the necessary blood flow to the heart every second counts. Each second that passes means more heart muscle that dies. In this case the national goal is to get you into surgery within 90-minutes of onset.
Lets say you are having chest pain and an ambulance arrives. There is the possibility that you may get the attention of either an EMT such as myself or a Paramedic. EMT’s will use the automated features of the Defibrillator. If you are going into cardiac arrest we place the two pads on you and let the computer take over advising us when to shock or to perform CPR. We can also place additional leads to get an all-around picture of your heart. However we are not trained to read or interpret the wave segments that those leads produce.
Technology now steps in. Either via a wireless modem or a Bluetooth connection to a cell phone we can transmit your EKG readout to the hospital we are headed to. There they can interpret your readout and prepare further if needed. The hospital can now advise a cardiologist or get the Cath Lab ready to receive you.
Now if you have a Paramedic respond to your situation they are trained to interpret your EKG readout and take additional actions. Not only can they inject potentially life saving drugs but they can activate the STEMI alert. At this point they alert the hospital of the elevated ST segment on your EKG and then also send the EKG readout wirelessly to the hospital for a team to confirm the STEMI. This essentially bypasses the emergency department upon arrival and sends you directly to the Cath Lab.
In a recent case a man had a life-saving balloon in his artery within 26 minutes of onset. That’s 1/3 the time of the 90 minutes national goal. This is thanks to the remote view the hosptial had of the patients heart while en-route to the hospital. Some departments have gone a little further and provide a direct audio/visual link between the patient/responder and the hospital staff.
We will continue to see remote technological innovation in the health care industry from an emergency response to in-home care. Doctors already have the ability to use their smartphone to bring up a hospital patient’s live EKG and vitals from anywhere in the world reducing response time to a potentially life-threatening or life-diminishing situation.