Cheap ECG Monitors

Be aware that You Get What you Pay For.

If you are using the ECG for anything other than to just say "oh I have an ECG", then you need to be using a 12 lead ECG. Prices for 12 Lead Monitors are not cheap.

No person would consider administering any form of Drug Therapy based soley on a 3 - lead ECG.

Check also the clinical governance issues surrounding the ecg i.e. maintenance calibration etc.

an example of price ranges for 12 lead is anything from £4,000.00 upwards
 
Phecta said:
Be aware that You Get What you Pay For.

If you are using the ECG for anything other than to just say "oh I have an ECG", then you need to be using a 12 lead ECG. Prices for 12 Lead Monitors are not cheap.

No person would consider administering any form of Drug Therapy based soley on a 3 - lead ECG.

Check also the clinical governance issues surrounding the ecg i.e. maintenance calibration etc.

an example of price ranges for 12 lead is anything from £4,000.00 upwards
Click to expand...

No person would consider administering any form of drug therapy based soley on a 3 lead ECG, is that true?

Hate to say bullsh*t and be pedantic but arn't ALL pre-hospital cardiac arrest drugs administered on the basis of a rhythm strip?

Have you got a copy of the clinical governance ECG machine calibration document I think I've lost mine

Anyway, depending what your going to use them for, there may be a couple of machines, small and light, that members may find of interest.

NN
 
All ECG Machines should be callabrated regularly, Cardiac arrest is different as the drugs would not be given unless the Defibrillator had monitoring capabilities, if it did not have such capabilities, then who is using the machine?

Sorry i was meaning diagnostic use for treatment of myocardial Infarction. Once you move to pre-hospital thrombolisis, then 12 lead ecg monitoring is required.

If a person is to administer cariac arrest drugs (Epinephrine, Amiodarone, Atropine), then they should already be issued with the defibrillator and ECG by their employer as there are serious clinical governance issues with people using any machine as the employer wont have any control over callibrtation and safety checks.
 
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Hi Neuralnet sorry matey i was trying to rush the posts as i was sat in a car on standby as i wrote, and wrote in haste, as each time i was writing, i had a job.
 
Thanks everyone


The other thing I’m looking at is the large limb ECG electrodes.

They seem expensive for what they are, £30.

Anyone know a better price?

Anyone have any experience of them?

Do they always need gel?


NN
 
I spoke to the bloke that services the LP12 macines for the LAS, he stated that when he "services" them the only thing that is checked is that it is able to deliver a shock.
The LP12 cost in the region of £12000 when boght back in 2003/4, with the LP15 which is replacing the LP12 believed to be costing in the region of £18000.
It is standard observation an ECG, I certainly wouldn't be happy only having access to a 3 lead ecg, they were phased out in London when the LP12 was introduced.

NN there is nobody that I know that would thrombolise on the sole evidence of a rhythm strip, most 3 leads that I have seen tend to display lead 2 as a default.

We are now supposed to do have a patient attached to a 12lead asap, if clinically indicated, SOB, DIB, Syncope, Hypertension, Hypotension, Chest Pain, Chest Tightness, Nausea and Dizzyness are all conditions or symptoms that may indicate a full ecg.

A cardiac arrest is just one of many reasons why an ECG would be done, also depends on what kind of equipment is available and the level of the person using it, in other words are they able to differentiate between fine VF and Asytole, a Defib won't shock fine VF unless you put it in manual mode, also things like pulseless VT, to the poorly trained they might think that is a bradycardic rhythm.
 
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From a doctors point of view...

If you need an ECG to determine prehospitally whether a patient has cardiac arrest or not.......you failed BLS, ALS, every bloody LS course there is.

Patients, that are unconscious and dont breathe have cardiac arrest and BLS procedures should be started immideately... See European Resus Council website.

In-hospital the anaesthetist uses a 5-lead ecg to monitor patient during surgery. In case of symptoms as stated in the previous post we run 2 12-leads, a short and a long one.

LP-12 and 15 or Zolls cct (that are somewhat cheaper than LPs) are great tools for the skilled user in the prehospital environment, but they can never be better than your clinical observations. They are tools, that helps YOU (or the person you transfer the ECG to) decide what to do. I totally agree with bigjl on the indications for doing a 12-lead, but dont rely on the machine, use it as a decision aid, together with SAMPLE and clinical observations.

best regs and be safe

Mike
 
DrMikeM said:
From a doctors point of view...

If you need an ECG to determine prehospitally whether a patient has cardiac arrest or not.......you failed BLS, ALS, every bloody LS course there is.

Patients, that are unconscious and dont breathe have cardiac arrest and BLS procedures should be started immideately... See European Resus Council website.

In-hospital the anaesthetist uses a 5-lead ecg to monitor patient during surgery. In case of symptoms as stated in the previous post we run 2 12-leads, a short and a long one.

LP-12 and 15 or Zolls cct (that are somewhat cheaper than LPs) are great tools for the skilled user in the prehospital environment, but they can never be better than your clinical observations. They are tools, that helps YOU (or the person you transfer the ECG to) decide what to do. I totally agree with bigjl on the indications for doing a 12-lead, but dont rely on the machine, use it as a decision aid, together with SAMPLE and clinical observations.

best regs and be safe

Mike
Click to expand...

Mike,

WELL SAID
 
We will be using our LPs for pacing within the next year in London, though the I haven't been trained to treat a non breathing patient as in cardiac arrest, but it is fairly normal for Ambulance Trusts to do things different to hospitals, such as protocol C as used in Kent, we started using different oxygen guidelines , no oxygen for for cva's unless hypoxic the same for cardiac chest pain. I have posted before about how ambulance services resuscitation, BLS is defib, bvm. ALS is IV access aswell. Though staff in hospitals are doing ILS courses now, possibly to allow for good resuscitation before the crash team gets there.
After every resus the memory card from the FR2 is downloaded. Or if a LP is used you would print off a code summary. This information is all collated and used by the resus council to change and improve the way resusitation is performed in the UK.
 
Thanks all,
Thoroughly enjoyed this debate so far, some really interesting points i thought, Dr M, love the comment "If you need an ECG to determine prehospitally whether a patient has cardiac arrest or not.......you failed BLS, ALS" made me have a right chuckle to myself.

Couple of interesting points, just curious really as its been a number of years since i worked the Ambulances after joining the gravy train in the middle east.

When i worked A&E we used the Zoll M series with both 3 leads and 12 leads used dependant on the job, great piece of equipment...the telemetry option was just coming into practice when i left which connected your monitor to the CMU and a cardiologist who could make the final decision on administering thrombolitics. bigjl, just wondering ref the comment you made "a Defib won't shock fine VF unless you put it in manual mode"... is this the normal now for the first line Ambulances to carry semi auto Defibs?...obviously when i worked on the roads it was down to the individual at the time to make the decision and not the machine!.

Another interesting point that has been brought up, as Dr M states, a monitor/Defib is a tool but the decision is down to the individual administering the treatment, this comes about with a good history (clinical observations) and experience and not just solely on what you see on the monitor, however interestingly enough when i completed my first ACLS course with the AHA they were completely monitor orientated.

I carry a FRED easy port with inbuilt monitor, great little machine which still gives me the ability to monitor patients that i suspect to have a cardiac issue, obviously only 2 leads but enough to allow me to enforce my decision, again all this based on a good history and clinical Obs.

Like i said good thread.

All the best

Mac
 
They brought in the FR2 just after I joined, best part of ten years now. Up until then we had the 710, and the criticare for BP, pulse and spo2. Also pulse pressure if I remember correctly. We now do BM, Temp and ETCO2.

Only experienced Techs, 3 years post millars, and Paras can shock in manual mode.

From memory only Paras where allowed to shock on the LP12.

The LP15 has an AED function, but again only Paras shock paeds using the LP15 in manual mode, but as the FR2 is such a good piece of kit, crews have grown to rely on it, after a review of data the meddirector decided to allow us to operate it in manual for fine VF, on the basis that some fine VF arrests might have been deemed non shockable by the FR2.

In London we don't use telemetry, we also don't thrombolise, all STEMI's go to the cathlab, as does chest pain with LBBB. The interpretation is done by the crew on scene.

Some other services are going down the cathlab route, as it has been proved to work over the last 4/5 years in London.
 
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As a paramedic I feel the more information you have the better so I would always prefer a 12 lead ECG. However in remote hostile environments then the amount of kit you can carry is some what restricted. I have seen some extremely small ECG / defibrillators designed for use in the climbing community. I have never used one so I can't comment on there effectiveness but they would seem to me to be better than nothing and as for drugs being administered, if it was a life or death situation in the middle of a desert and no help is coming then a 3 lead ECG would be a useful resource in diagnosis if used and taking into consideration all other observations with a view to the interventions of treatment to administer.
 
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