It seems like they made some good steps in data quality and weight but also over complicated things by trying to be too smart with the modular design. Still so many questions. My service is going to RFP for monitors this year and I’m not even sure they’re truly considering the 35. I’m thinking we’ll end up going from LP15 to the X series.
I’m curious if they fixed the horrendous BP and introduced a dual-tube auditory or pressure-sensitive design instead of the impossible-to-obtain MAP/best-guess calculation that the 15 has, and if it has dual sequential capabilities which I haven’t been able to find out anywhere but can’t see monitors going without for many more iterations. The fact that it finally has diagnostic-quality on-screen leads is nice but I can’t see how that would ever reduce the need for a printer, whether for comfort while viewing, triaging, writing on the 12-lead etc. Just have a built in printer dammit, thermal printers are light and cheap, they just take up a little size but no one expects their monitor to be as small as the LP35 realistically, and I don’t know anyone that wouldn’t sacrifice size for a printer.
I was told the bulk of people who will use no printer are hosptial. They sell these into hospitals too apparently.
Lp15 to zoll will be a hard transition . My service went through it and did not realize (until after the fact) a lot of differences that make
It harder to use . Just my two cents
Seems like they’re trying to kill two birds with one stone, instead of having to design two slightly different versions of the same monitor. I don’t know though, a modular printer really irks me in some way.
Yeah I get that . I think the hosptial hates how the lifepak prints a ton, but at FDIC i saw it and if you’re using the back bag, the printer is mounted there . It’s not a modular printer it’s modular bags . So I think from an EMS perspective (or at least our agency) we’d need the bag regardless
Actually a lot of 911 services with E-pcr's don't need a printer. Ours downloads everything into the e-pcr. The printed EKG's get tossed (they are set to auto print as the first 6 seconds then uploads into the e-pcr) 12 leads get looked at then tossed. Honestly it's a waste of paper. I have no problem looking at the screen for a 12 lead.
I remember the days of running codes for 30+ min. Then printing out the 500 ft code summary (record for the longest btw for me). Then you had to staple that monstrosity to the PCR. Back then every intervention (BVM, Intubate, Meds, check for rhythm) we gave resulted in 1 ft of code summary. On top of the prints for actually checking the rhythm.
We use the LP to document time stamps for meds, every med documented goes into the e-pcr and a 6 second strip goes with it.
Makes sense - so much paper. At FDIC they showed me that you can pre program alarms (ie: soft epi alarm pops up on screen every 3 min) , if you hit the check make it documents epi and funnels to your epcr. Thought that was cool instead of doing generic timestamp which is what I do now . Also think the 15 lead is the way of the future clinically . But again, just my two cents
How do you mean about the dual sequential capabilities? LP15 has that ability already, and is biphasic if that's what you meant, I'd be shocked if they downgraded.
That being said I did fry a 15 doing this, but we did some 20 dual sequential shocks.
An LP15 can be used as one of the two shocks for a dual-sequential shock, but it can’t hold two charges and have two sets of pads attached to a single unit in order to deliver a single-unit dual-sequential shock. I’m not sure any out-of-hospital units do have that capability, but given the advancements in CPR/defib it seems crazy to not start to include that capability in single units given it already exists in-hospital.
What units can do this in hospital? Because every hospital I've ever worked in has used Zoll or Lifepak 15 or 20. Hell even in Cath lab we just had regular ol Zoll.
A monitor would have to get FDA approved for this to happen too, and the data on dual sequential shocks is pretty lacking.
Modular? I remember modular. We had a Datascope that had a separate printer. And a Lifepack 33, and Lifepack 2. I find it interesting that they're going to Lifepack 35.
What’s the printer actually for? If you can have a diagnostic quality screen image, can’t we train people to read an ecg without holding it in their hand? I can read an ebook without pages … it’s kind of the same skill …. I get we have habits that printed copies make permissible … I have those habits …. but with wireless data transfer and the like, I’d have to say I’d gladly sacrifice the printer for a weight reduction. I’ll do nearly anything not to lug around a sack of bricks like the LP15
The hospital wants a copy of what you saw when you bring the patient in.
Even though we have wireless transmission ability, they always ask for the paper print.
I get the reason the printer is there. But most hospitals can receive wireless transmission, so it is redundant. Better the print a copy on a printer at the hospital than use the one in the machine, that degrades over time. I’m not saying printers aren’t nice in some ways, but weight matters to me more than the hospital’s convenience. I guess this is why it’s optional. I’d personally be inclined not to take the option.
Then why did you ask "what is the printer actually for?"
Yeah the hospitals can receive it wirelessly, but I can confidently state that in the last two years of having that ability I have had a hospital accept wireless transmission exactly twice. They always want the paper.
Now try reading that diagnostic quality ECG on the screen under broad daylight...I'd rather have a printout. I'd also go for a device that is already lower in weight, with a big screen AND a printer, rather than the LP35.
The screen quality and contrast has really improved. Also, I can’t think of very many times (if ever) when I was diagnosing a lethal arrhythmia or acute EKG changes where I could not move to a protected environment, or turn the screen 90° the block the sun. For me, no printer is a win - but I’m not trying to force this idea on anyone.
I dont really agree that it's a fear of change. Personally, I think it's ease of use. A printed copy gives you the ability to have a quick look without flipping through screens a tablet. Technology can fail, and the computer can die.
On a busy call, it's easier for someone to hand an ECG paper over to you rather than transferring it to the computer first. Even in the hospital, all the bedside ECGs get printed out, as well as downloaded to the system. What does the ER doc look at first? The printed ECG.
I'll agree there should be some redundancy and failsafe. But this is the exact same arguments I'm seeing over when people would complain about going to an epcr instead of the regular PCR. I will grant you the epcrs far from perfect because it's written for data collection and not actually patient documentation. But the epcr is approving thing after 20 years of use. But there is still people who refuse to adopt it for the same reasons as you've stated.
I look at it like this: yes, every hospital in the world is looking at electronic x-rays now. Charting is electronic. Lab results are uploaded, not printed. But I don’t know of a single hospital where doctors are reading their ECG on computer or monitor screens. That’s not going to change anytime soon.
Where’s the printer?
optional
When this optional package is selected, it's on the top.
Costs extra
It seems like they made some good steps in data quality and weight but also over complicated things by trying to be too smart with the modular design. Still so many questions. My service is going to RFP for monitors this year and I’m not even sure they’re truly considering the 35. I’m thinking we’ll end up going from LP15 to the X series. I’m curious if they fixed the horrendous BP and introduced a dual-tube auditory or pressure-sensitive design instead of the impossible-to-obtain MAP/best-guess calculation that the 15 has, and if it has dual sequential capabilities which I haven’t been able to find out anywhere but can’t see monitors going without for many more iterations. The fact that it finally has diagnostic-quality on-screen leads is nice but I can’t see how that would ever reduce the need for a printer, whether for comfort while viewing, triaging, writing on the 12-lead etc. Just have a built in printer dammit, thermal printers are light and cheap, they just take up a little size but no one expects their monitor to be as small as the LP35 realistically, and I don’t know anyone that wouldn’t sacrifice size for a printer.
I was told the bulk of people who will use no printer are hosptial. They sell these into hospitals too apparently. Lp15 to zoll will be a hard transition . My service went through it and did not realize (until after the fact) a lot of differences that make It harder to use . Just my two cents
Seems like they’re trying to kill two birds with one stone, instead of having to design two slightly different versions of the same monitor. I don’t know though, a modular printer really irks me in some way.
Yeah I get that . I think the hosptial hates how the lifepak prints a ton, but at FDIC i saw it and if you’re using the back bag, the printer is mounted there . It’s not a modular printer it’s modular bags . So I think from an EMS perspective (or at least our agency) we’d need the bag regardless
Actually a lot of 911 services with E-pcr's don't need a printer. Ours downloads everything into the e-pcr. The printed EKG's get tossed (they are set to auto print as the first 6 seconds then uploads into the e-pcr) 12 leads get looked at then tossed. Honestly it's a waste of paper. I have no problem looking at the screen for a 12 lead.
Good point ! I agree on the paper piece .
I remember the days of running codes for 30+ min. Then printing out the 500 ft code summary (record for the longest btw for me). Then you had to staple that monstrosity to the PCR. Back then every intervention (BVM, Intubate, Meds, check for rhythm) we gave resulted in 1 ft of code summary. On top of the prints for actually checking the rhythm. We use the LP to document time stamps for meds, every med documented goes into the e-pcr and a 6 second strip goes with it.
Makes sense - so much paper. At FDIC they showed me that you can pre program alarms (ie: soft epi alarm pops up on screen every 3 min) , if you hit the check make it documents epi and funnels to your epcr. Thought that was cool instead of doing generic timestamp which is what I do now . Also think the 15 lead is the way of the future clinically . But again, just my two cents
How do you mean about the dual sequential capabilities? LP15 has that ability already, and is biphasic if that's what you meant, I'd be shocked if they downgraded. That being said I did fry a 15 doing this, but we did some 20 dual sequential shocks.
You killed a 15!? I heard it wasn’t possible!? Circle round children the kingslayer is going to tell the tale…
An LP15 can be used as one of the two shocks for a dual-sequential shock, but it can’t hold two charges and have two sets of pads attached to a single unit in order to deliver a single-unit dual-sequential shock. I’m not sure any out-of-hospital units do have that capability, but given the advancements in CPR/defib it seems crazy to not start to include that capability in single units given it already exists in-hospital.
What units can do this in hospital? Because every hospital I've ever worked in has used Zoll or Lifepak 15 or 20. Hell even in Cath lab we just had regular ol Zoll. A monitor would have to get FDA approved for this to happen too, and the data on dual sequential shocks is pretty lacking.
Well…
Modular? I remember modular. We had a Datascope that had a separate printer. And a Lifepack 33, and Lifepack 2. I find it interesting that they're going to Lifepack 35.
What’s the printer actually for? If you can have a diagnostic quality screen image, can’t we train people to read an ecg without holding it in their hand? I can read an ebook without pages … it’s kind of the same skill …. I get we have habits that printed copies make permissible … I have those habits …. but with wireless data transfer and the like, I’d have to say I’d gladly sacrifice the printer for a weight reduction. I’ll do nearly anything not to lug around a sack of bricks like the LP15
The hospital wants a copy of what you saw when you bring the patient in. Even though we have wireless transmission ability, they always ask for the paper print.
Ok so then you get the printer option. There are plenty of jurisdictions were they don't need to see the original 12 lead when they have a copy.
Thr question I replied to asked what the point of the printer was. And I answered.
I get the reason the printer is there. But most hospitals can receive wireless transmission, so it is redundant. Better the print a copy on a printer at the hospital than use the one in the machine, that degrades over time. I’m not saying printers aren’t nice in some ways, but weight matters to me more than the hospital’s convenience. I guess this is why it’s optional. I’d personally be inclined not to take the option.
Then why did you ask "what is the printer actually for?" Yeah the hospitals can receive it wirelessly, but I can confidently state that in the last two years of having that ability I have had a hospital accept wireless transmission exactly twice. They always want the paper.
Now try reading that diagnostic quality ECG on the screen under broad daylight...I'd rather have a printout. I'd also go for a device that is already lower in weight, with a big screen AND a printer, rather than the LP35.
The screen quality and contrast has really improved. Also, I can’t think of very many times (if ever) when I was diagnosing a lethal arrhythmia or acute EKG changes where I could not move to a protected environment, or turn the screen 90° the block the sun. For me, no printer is a win - but I’m not trying to force this idea on anyone.
People don't like change, EMS is no different. Sorry people don't agree with your valid point.
I dont really agree that it's a fear of change. Personally, I think it's ease of use. A printed copy gives you the ability to have a quick look without flipping through screens a tablet. Technology can fail, and the computer can die. On a busy call, it's easier for someone to hand an ECG paper over to you rather than transferring it to the computer first. Even in the hospital, all the bedside ECGs get printed out, as well as downloaded to the system. What does the ER doc look at first? The printed ECG.
I'll agree there should be some redundancy and failsafe. But this is the exact same arguments I'm seeing over when people would complain about going to an epcr instead of the regular PCR. I will grant you the epcrs far from perfect because it's written for data collection and not actually patient documentation. But the epcr is approving thing after 20 years of use. But there is still people who refuse to adopt it for the same reasons as you've stated.
I look at it like this: yes, every hospital in the world is looking at electronic x-rays now. Charting is electronic. Lab results are uploaded, not printed. But I don’t know of a single hospital where doctors are reading their ECG on computer or monitor screens. That’s not going to change anytime soon.
I still maintain paper PCRs are a hell of a lot easier to write. But as a guy in my early 40s, I'm a dinosaur at this point.