Cardiac & Resuscitation, Equipment & Gear, Patient Care

How to Spec a Prehospital Monitor/Defibrillator

Issue 11 and Volume 37.

The task of selecting a monitor/defibrillator device can be challenging. The competition among the various manufacturers of these devices is strong. All tout the latest bells and whistles, which can present those seeking to move into the next generation of electro-cardiac patient care technology with some serious and considerably complex decisions.

This type of decision should not be made in haste or without enlisting the help of a team of stakeholders who will have some point of interest in the use of—or byproducts of the use of—the technology selected. Largely, the team should consist of the following members:

  • Education and training representative;
  • Quality assurance representative;
  • Prehospital care representatives from all levels, including EMT, paramedic, critical care registered nurses and physicians;
  • First responder representatives;
  • Local medical control or base station representatives;
  • Logistical or supply and inventory representatives;
  • Management; and
  • Information technology representatives.

The team should meet often and investigate its respective needs with regard to clinical technological requirements, logistical support and ease of data management. These investigative efforts could include actual site visits of other systems currently using the technology and the experiences these users have with the various vendors of the technology. It could also include actual reviews from frontline users and support personnel.

Make a list of what you want, and compare the various options to make the best possible match to the available technology.

Have vendors actually demonstrate the use of the technology specific to your intended uses, and be careful (and wary) of vendor promises or “vaporware” claims. Be careful of claims that plans are for future technology meeting your spec if current technology is purchased now. Have your checklist handy and demand specific answers.

Technology is changing rapidly, so be sure you select a product that has a service life that includes the ability to accept both hardware and software upgrades. Barter for top-of-the-line warranty plans, including locking in any extended warranty costs.

Do not buy what you do not need. This highlights the need for local medical control and base station involvement. Be clear of the path your system is headed down and the technology requirements anticipated to meet those expectations.

Clearly, environmental considerations are important. Aeromedical devices should be lightweight with screens that can be easy to read, and alarm systems that provide exceptional visual cues.

Critical care transport devices should be easy to use, durable and ergonomically fitting. EMS and first responder devices should be similarly built and equipped, as well as having the ability to be easily supported by the vendor.

Data management, including the movement of data, should be easily accomplished—with little user interface necessary to accomplish this task. Data analysis should be seamless—shareable where needed yet safe and secure. Local support should be readily available and accessible.

Lowest bidder economics is often the method for procuring this technology, thus a thoroughly researched, organized and comprehensive spec is necessary.

Current economics associated with high-pressure sales tactics in an extremely competitive market demand the highest level of preparedness when considering purchasing cardiac electrotherapeutic and associated technology.