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Emergency Medical Services: What`s Coming Next?

We all know that technology is advancing at an astonishing pace, and it's certainly changing how we do business. Stop and think about what type of computer you were using when Y2K occurred. The iPad2, which is now becoming outdated, was as fast as the original Cray 2 supercomputer. We put a man on the moon with computers that don't have the power that an iPod or our cardiac monitors currently have. And everyone has heard that "there's an app for that."

Generally speaking, we have embraced technology as it has made our jobs easier while improving the level of patient care we provide. In the field, we're using pulse oximeters to determine oxygen saturations, glucometers to determine blood-sugar levels and cardiac monitors and AEDs that can interpret the rhythm and even tell us when we need to provide an electric shock to defibrillate the heart. We even use endotracheal tubes with cameras on the end so we have a better view when we attempt to intubate a patient.

Some providers have moved to the next level by using portable ultrasounds, testing blood samples in the field, and using mechanical CPR devices to ensure correct compression depths and rate, thus alleviating the need for two or more providers to do hands-on CPR. These advances have transcended into emergency departments and hospitals as well, with full body scanners, wireless monitoring devices, respirators, infusion pumps, etc.

With all of this, one might wonder what's next. Two articles sent to me provide a glimpse of what might be next. And believe it or not, neither was published in a fire, EMS or medical journal or magazine.

The first article was published in the July 2, 2012, edition of the Marine Corps Times. It discusses the development of a portable brain scanner that's hand-held, battery-operated and about the size of a Nintendo Wii controller. It was developed to "help identify specific types of brain bleeds that could result in death or serious brain damage."

This device is small enough to be carried in a jump kit, is water resistant and is mil-spec tested. The device uses infrared light and fiber optics to look at different areas of the brain, and the Marine Corps has successfully tested it.

The intent is that a corpsman can make a rapid assessment of a number of casualties involved in a blast or explosion to determine who has the potential for a bleed. This enhanced field triage improves upon the standard triage model and only takes approximately two minutes longer to complete. The cost: $18,000 per device. That doesn't seem to be exorbitant, and we know that many items developed and used by the military eventually are made into civilian equivalents and the cost normally comes down. Thermal-imaging cameras are just one example of this technology transfer.

The second article I read was published in the July 30, 2012, edition of Bloomberg Businessweek. A medical student in Australia developed a stethoscope that can help diagnose respiratory illnesses in children in areas where there is limited medical care. The stethoscope "can plug into a smartphone and doesn't require medical training to use."

While the student developed the hardware for about $20, he had programmers develop the app and build the algorithms. The app asks for specific information about the patient, instructs the provider on what to look for and what to record, and after the data is uploaded to the app, a diagnosis is made and the app provides treatment instructions. The student believes the stethoscope will become as "ubiquitous as a thermometer at home."

This device is now being tested and modified, and it's one more example of how technology is changing our profession.

The moral of this article is that we need to read beyond our standard EMS and medical journals to see what else is going on in the world. Don't get tunnel vision and only look to what we know to predict our future. Staying informed equates to improving our knowledge, and this means stepping outside our comfort zone to see what others are doing. How else are we going to find out what's coming next?

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