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Research Assessment #2

Date:​ September 11, 2018

Subject:​ Innovations in Emergency Medicine

MLA or APA citation:

“The Future of Emergency Medicine: Innovations Making Patients The Point-of-Care.” ​The

Medical Futurist​, 8 Aug. 2018,

medicalfuturist.com/future-emergency-medicine-innovations-making-patients-point-care.

Analysis:

In today’s society, the digital world is taking over everything including technology

in the healthcare field. However, this article from ​The Medical Futurist ​reveals many of

the benefits that technology can bring into the medical that can improve patient care

and recover. This proficient article first brings to light that crucial fact that time is

everything in an emergency. Even just a few can be the difference between being able to

save the patient or not. Technology can be one of the ways that doctors can battle time

and be successful.

After reading this article, I learned about the use of new technology in the form of

an app called Pulsara. This innovative app actually has the ability to make

communication in the emergency much easier. The paramedics can actually inform the

Emergency Room before arriving with a patient at the hospital. Another ability this app

has is to display the estimated time of the patient's arrival based on the GPS to make

sure it accurate. Incredibly enough, the Paramedic have the option of taking pictures of

the situation or emergency and send it to the doctors and nurses that will be taking care
of the patient. This allows the doctors to be more prepared leading them to deliver

improved care to the patient. Another tool in Pulsara is being able to alert other

specialties that could help the case like a cardiologist making the treatment much more

efficient and reliable. The creation of this app has the power to heavily improve ER care.

There also many other apps that are similar to this that are created to improve the

medical field in so many in different ways.

I also discovered an amazing technology that is usually used for other purposes

but is not utilized to help the medical field better equip its doctors and nurses. There is

a video game called Airway EX that can help in real life emergency situations. This video

game gives a medical professional the ability to perform stimulates airway procedures,

which provides a realistic situation for doctors to practice their skills. This helps them

learn how to handle their stress in an emergency situation so it won't affect their

performance. It also gives them the chance to continuously improve their skills leading

them to be more comfortable and prepared for real-life situations. The game allows

them also to work on their speed which is a crucial component in the ER where seconds

can mean life or death.

Through this article, I was able to uncover numerous ways technology can be

utilized to benefit healthcare workers and patients. It is incredible how we have

technology at the tip of our finger that can better the world at the simple push of a

button. I was enlightened by the many different functions that technology can have for

us in this modern world.

(Article starts on 3 and ends on 9)


The Future of Emergency Medicine: Innovations
Making Patients The Point-of-Care
The Medical Futurist | 12 minute read
28 November 2017

Every minute spent without treatment could reduce the chance of survival in case of medical

emergency and trauma patients. Digital health innovations making patients the point-of-care could

become a great help for first responders and emergency units in the battle against time. Here, we

collected what trends and technologies will have an impact on the future of emergency medicine.

Six minutes before brain damage


Car crashes, home injuries, fires, natural disasters. The difference between life and death often

depends on the speed and efficiency of emergency care services. The work of doctors, paramedics,

and nurses being in the first line of the battle against early and meaningless death or paralyzation is

extremely difficult and inspirational at the same time. Sometimes there are only seconds left to save
a patient’s life. In case of high-risk patients, each minute waiting for treatment ​significantly

reduces​their chance of surviving. This includes cardiac arrest patients, where brain damage

typically starts within ​four to six minutes​.

No wonder that millions of people (including The Medical Futurist team) jittered through more

than 300 episodes of ​Chicago County General Hospital’s ER starting from the 1990s, and that the

gig ensured a standing place for George Clooney among the biggest stars. The suggestive power of

doctors and nurses saving lives also gave a rise to medical documentaries, such as the BBC’s ​An

Hour To Save Your Life​, the American docudrama entitled ​Untold Stories of the ER with

re-enactments of real-life medical stories or the more recent incarnation of ER, entitled ​Chicago

Med​.
Patients to the hospital or hospital to the patient?
In spite of the impression through the television screens that the emergency department is one of

the most important medical specialties, the field is relatively new and it is mostly the product of the

accelerated, globalized world we live in. Some experts ​say that modern emergency medicine

services were first developed in the United States in the 1960s; as a response to the increased

number of traffic accidents due to the boom of cars on the newly built American highways. Later

one, the United Kingdom, Australia, Canada, Hong Kong, and Singapore followed shortly

thereafter, developing their respective emergency medical systems in the 1970s and 1980s.

While ​the aim of emergency care is the same in every country – providing timely care to victims of

sudden and life-threatening injuries or emergencies in order to prevent needless mortality or

long-term morbidity –; ​two different approaches emerged​. The Anglo-American model represents

the “patient to the hospital” practice, while the Franco-German model means the “hospital to the

patient” way of thinking.

The latter is used in most European countries, and it means that medical doctors supported by

paramedics treat more patients on the scene of an accident or in their homes before bringing them

to the hospital, thus emergency care happens on the scene or en route to the hospital. In the case of

the Anglo-American model, fewer patients are treated on the spot, and they rather transport the

injured to the emergency room as fast as possible for treatment. Currently, countries in the

developed world use some practices from both models, but the latest digital technologies will rather
push emergency medicine in the direction of the “hospital to the patient” approach. Let me show

you how!

We collected the latest innovations making it possible to treat medical and trauma emergencies

faster and more efficiently than ever before. Dávid Márkus, first aid expert and medical student at

Semmelweis Medical School, helped us a lot with finding the relevant directions. He is also the

developer of a ​chatbot on Messenger​ that teaches people how to do proper CPR in Hungary.

1) Apps simplifying communication, administration and


in-flight emergency care
Pulsara is a Montana-based U.S. start-up whose app simplifies communication in emergency care.

It allows paramedics to alert an emergency department before arrival with the patient. It does so not

only by calculating the estimated time of arrival based on GPS, but users are able to attach pictures

of the ECG, the injury, the medicine list of the patient, send the personal data and the parameters of

the patient, etc. Alerting the stroke team/cardiologists or anyone else who might be involved in the
treatment of the patient this way allows the ED workers to prepare much better and faster for the

arrival of the critically ill patient.

On their website, the team said they got the idea when a group of physicians, fed up with the

pitfalls of their current acute care protocols, posed the question at a dinner table “How can we

improve patient care in our facilities?” I hope in the future, they’ll have more fruitful dinners like

this one.

Full Code Pro is a free and easy-to-use app developed by the American Heart Association. It makes

it easy to document critical interventions, a „code” during critical events such as CPR or cardiac

arrest resuscitation. It not only allows the worker to record events (e.g. shock) with only one tap,

measures times, counts down according to the protocol but also helps the team by having a

metronome built in to optimize chest compression rhythm. Full Code Pro makes it easy to

administer cardiac arrests, and also gives an opportunity to debrief the case so that the team can

learn from the collected data as well. Thus, you can fully focus on the patient without sacrificing

proper documentation. A win-win situation!

Dr. Ray Bertino, Clinical Professor of Radiology and Surgery at the University of Illinois College

of Medicine, ​worked with a team of aviation experts to develop ​airRx​, the world’s only smartphone

app that’s designed to help physicians deal with some of the most common in-flight medical

emergencies. The app contains the 23 most common medical emergency situations that could be

encountered during a flight, various flight and cabin crew roles, as well as the medico-legal

implications for volunteering to assist. It could give a piece of mind for doctors traveling on board

of an airplane as well as passengers fearing that something might happen to them while going from

San Francisco to Beijing.


2) Video game for practice & 911 chatbot for real situations
Airway EX is a professional video game developed by ​Level Ex​, a Chicago-based start-up applying

video game technology to healthcare. The app allows practicing anesthesiologists, CRNAs, and

medical professionals to simulate the performance of airway procedures. It provides realistic

endotracheal intubation scenarios so that the doctors and paramedics can better prepare for difficult

airway management. The app scores the worker’s speed, the caused damage, bleeding and also

monitors the virtual patient’s vital signs while the procedure takes place. Moreover, it can be used

anywhere – on the subway, at home or on the Bahamas during holidays (but we don’t recommend

that).

The 911bot, a messenger-based chatbot was ​developed during a Disrupt Hackathon in New York

with the aim to help users in emergency situations. It lets anyone report emergencies to the

authorities through a quick image-based interface, which might be a lot faster than making a phone

call. And as your report is sent through the system, it offers options to send extra information and

pictures or video footage. As most people are frozen when a lethal or serious accident happens, the

app gives advice on how to handle the situation well and how not to cause even more harm to the

injured or bystanders.

3) Portable ultrasound, ECG & other point-of-care devices


The appearance of pocket-sized, user-friendly and portable diagnostic devices make it easier and

faster to treat a patient on the spot. No matter whether it iss ultrasound, ECG or laboratory testing,

behemoth machines are things of the past.


While some years ago ultrasound diagnosis was the privilege of radiologists, nowadays emergency

medical specialists have an opportunity to use bedside point-of-care ultrasound devices (PoCUS) to

answer some yes-or-no questions (e.g. intraabdominal bleeding). Ultrasound machines such as

SonoSite​’s or ​Clarius​’ hand-held products allow any doctor to use them easily while working on a

code or a critically ill patient.

Yet, we all know it’s not only about the size. Not so long ago, it was a huge innovation that a

smartphone was able to make a one-lead ECG. However, even if it showed the rhythm, it wasn’t

able to replace standard 12-lead ECG. In many cases, if the doctor does not see all the 12 leads, a

possible heart attack might be easily mistaken. Now, ​Smart Heart Pro allows users to make a

12-lead ECG with a smartphone or tablet wirelessly, which is as accurate as a similar standard

bedside exam.

Luckily, the long-hours waiting for laboratory blood test results will also be over soon with

hand-held, lightweight point-of-care testing (PoCT) devices, such as the ​i-STAT testing equipment​.

Abbott’s fast and accurate blood analyzer allows doctors to evaluate the patient’s blood sample on

the spot and wirelessly transmit the results or the data to colleagues. Invaluable time gain during

emergency situations!

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