In this roundtable article, TechNation asked members of the HTM community to share the scoop on defibrillators (including AEDs). Our panel shares their tips regarding the latest advances for these devices as well as their unique individual insights.
Participating in the roundtable article are David Braeutigam, System Director, Healthcare Technology Management, Baylor Scott & White Health; Ashish Dhammam, Sales Director, Soma Technology Inc.; RepairMED CEO Diane Geddes; and Juan Ortiz from Tenacore Holdings Inc.
Q: What are the latest advances or features in regards to defibrillators?
David Braeutigam, System Director, Healthcare Technology Management, Baylor Scott & White Health
Braeutigam:Many of the newest defibrillators now have wireless capability. This is used for recording events during codes and can be used to create reports of the actions taken during a code event. Most of the defibrillators now do automatic internal diagnostics usually once a day to ensure the defibrillator is working properly. Some also test the battery and report the status back to a central computer. Many can be used as a full-fledged patient monitor with some having 12 lead ECG, pulse oximetry and CO2 monitoring.
Dhammam: CPR Feedback is a new advancement that most manufacturers are adopting and SpCO (Carbon Monoxide) measurement for pre-hospital models is also becoming popular. Along with ETCO2, I expect wireless data transmission and daily self-test function to be features in the near future.
Geddes: Newer models have the capability to transmit ECG via WiFi or cellular connection to the health care facility before the patient arrives. Some models have improved CPR coaching and/or real-time feedback. Newer systems indicate when there is an issue with a lead or if it is not capturing pacing data which are often missed in an emergency. Aside from ECG, SPO2 and etCO2 are also added features.
Ortiz: The latest advances include, but are not limited to, having a more consistent shock with a higher confidence level. Another advancement is the ability to deliver more current. These are important because it is a matter of life and death and these devices need to be reliable.
Jumper: Target controlled, low-flow anesthesia systems have been around for a few years now, but these machines can automatically adjust flow and vaporizer settings based on end values preset by the anesthesiologist. Also, new technology for the Co2 absorbers such as the spiralith which is a lithium-based absorber that does not generate the dust that traditional soda lime canisters do. Soda lime dust is a huge issue in maintenance.
Juan Ortiz, Tenacore Holdings Inc.
Q: Why are defibrillators (AEDs) so important for health care facilities?
Braeutigam: Defibrillators are so important not only because they can save lives with defibrillation but also can be used as a transport monitor. Most defibrillators are configured with ECG, most have external pacing capability, pulse oximetry and even CO2 monitoring. They are one of the most important and versatile devices in the hospital. Automatic External Defibrillators (AEDs) are also important outside a nursing floor. They can be found in an office area, cafeteria, at your child’s school or even at an auto dealership. AEDs allow the non-clinical person to perform defibrillation with no training. They are truly life-saving devices.
Dhammam: A defibrillator is a crash cart/patient safety item used to resuscitate patients from cardiac arrest, and is also a requirement of state and accrediting organizations.
Geddes: Defibrillators are essential equipment used to respond to life-threatening cardiac arrest. Defibrillators also provide physiologic information while caring for sick patients.
Ortiz: Defibrillators (AEDs) are crucial to any health care facility because they increase the chances of survival from a sudden cardiac arrest. These devices need to be readily available and easily accessible because they are only effective when administered within the first few minutes of a sudden cardiac arrest.
RepairMED CEO Diane Geddes
Q: What are the most important things to look for in a defibrillators (AED)?
Braeutigam: You must have buy-in from the critical care doctors and nurses on the type of defibrillator you will want to purchase. A committee should be formed with doctors, nurses, HTM and supply chain to evaluate the features everyone would like to have. The doctors and nurses will be interested in the ease of use, type of output and the options available. HTM will be interested in the reliability and the cost of maintenance. Remember if you are purchasing the wireless options to get the IT department involved if it requires a server, IP addresses, etc. Also don’t forget to calculate the additional annual cost of any servers, software, licenses and support costs for the wireless add-ons. Supply chain will be interested in standardization, supply cost and capital costs during the evaluation.
Dhammam: As with all equipment, timely PMs help extend the life of units and avoid unforeseen failures. More specifically for AEDs, maintaining a log for changing batteries is helpful.
Geddes: Biomed technicians need to be trained on the proper use and maintenance of defibrillators. Performing preventive maintenance as recommended by the manufacturer is vital in extending the service life of a defibrillator.
Ortiz: Biomeds can extend the life of defibrillators by doing a routine inspection and sending the unit in for a preventative maintenance check. At Tenacore we recommend defibrillators be inspected monthly, and sent in for preventative maintenance every six months. This will ensure that the device is always functioning.
Ashish Dhammam, Sales Director, Soma Technology Inc.
Q: What else would you like to add or do you think is important for biomeds to know about defibrillators (AEDs)?
Braeutigam: Defibrillators are a very easy device to look at when rounding. You can easily look at the defibrillator to see if the charging light is on so it is plugged in. You can also stop and check the expiration date on the electrodes and the defibrillator pads. You don’t want these to be expired. AEDs will usually have a check mark or a visual indicator to say if the last automated test passed. That is a real easy check. Don’t forget about AEDs in public areas or your doctor’s office also.
Dhammam: For defibrillators, I would recommend always keeping a battery charger in the shop and maintaining a good stock of back-up batteries, pads and other essential accessories as they do go on a back order from time to time from the manufacturer.
Geddes: Biomed technicians are charged with maintaining these devices. Training is essential on providing proper repair and maintenance.
Ortiz: Always remember to do a thorough check of the defibrillators. We all have a common goal and that is to keep our patients safe. Tenacore is always here to help answer any questions you may have.
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