KINGMAN Early Thursday morning, a call went out for paramedics. A 59-year-old Kingman resident was having chest pains. The defibrillator under his skin had activated after his pacemaker failed to slow his heart rate.
When Kingman Fire Department paramedic Capt. Bob Casson arrived, the man was resting on his couch and said he felt normal.
Casson hooked up one of the department's new cardiac monitors to see if everything actually was normal. While the man was being loaded into the ambulance, his heart rate became erratic for a second time.
"He said he could feel it something was not right," Casson said.
The machine agreed with the patient and began beeping to alert Casson that something was indeed wrong. While the paramedics were loading the gurney into the ambulance, a few but valuable seconds to respond would have been lost if the monitor had not warned them.
An audio alarm may not seem like a hi-tech leap for cardiac monitor defibrillators, but before the KFD received the new machines, paramedics would have needed to keep a constant eye on the old monitors to know if the patient's condition suddenly changed.
"We have other things to do. We can't stare at the monitors," firefighter and EMT Tanner Miller said.
The call was the first chance for the KFD to use its new Philips Heartsmart MRx cardiac monitor defibrillators, which arrived this week. Although Casson didn't need to use the defibrillator to jump-start a heart in this case, the devices proved they were worth the investment. Approximately 85-percent of the department's calls are of a medical nature.
Battalion Chief Bill Johnston said the six new defibrillators cost $125,000 but the department was able to save about $30,000 by teaming with Tempe's fire department on a joint contract.
Technology in the medical field advances so quickly that the new monitors will probably only be useful for about four or five years. But they include the best available technology as of today, Johnston said.
"These monitors increase our capability of medical response in the field both in diagnosis and treatment," he said.
The new monitors offer paramedics the ability to receive more information about the patient's heart condition and make a more accurate diagnosis. A patient may be having a heart attack or simply chest pains. A quick diagnosis by first responders can make the difference in life or death situations.
The American Heart Association reports 460,000 Americans die each year from sudden cardiac arrest. Most die before reaching the hospital. That's why early defibrillation is the key procedure for paramedics.
In most cases when cardiac problems strike, the heart 'fibrillates,' meaning that it shivers rather than effectively beats and pumps blood to the rest of the body.
Defibrillation is a process in which an electronic device delivers an electric shock to the heart to help reestablish normal rhythms.
The monitor analyzes and displays the heart's rhythm. Based on certain characteristics, the machine determines whether or not a shock is needed.
If a shock is required, the monitor will alert the user to either press a button or to stand back to deliver the shock automatically. The monitor re-analyzes the heart rhythm to determine if another shock is needed.
Most people are familiar with defibrillators from television shows or movies in which actors rub two paddles together and yell, "clear" before shocking a person. But paddles are ancient technology in the real world.
In reality, paramedics apply two sticky pads to the victim that deliver the charge. One reason for the change was the safety of the paramedics. If there was contact with the victim's body while an electrical charge was surging through it, the paramedic could be shocked too. The pads provide hands-off safety.
The new defibrillators send 150 joules of electricity to the heart. In the older models, the intensity of the charge would progressively increase to around 360 joules depending on how much resistance the body created. The new monitors adjust to the body's impedance while maintaining a consistent charge.
The lower charge is aided by a modern defibrillation process called biphasic therapy. Numerous medical studies showed biphasic, in which the current flows both positively and negatively, was just as successful as monophasic therapy (one direction) but required less energy and caused less damage to the heart.
The new monitors can read the blood-oxygen level as well as blood pressure. Previously, paramedics needed separate devices to take these readings. They also contain a carbon dioxide monitor that helps the paramedics diagnose why a patient might not be breathing.
"It tells us if there is a blockage; it tells us if (the patients) are maintaining too much carbon dioxide; it gives us the ability to see how fast to bag (pump air into the lungs) the patient," Casson said. "It also shows the (carbon dioxide) wave form. That's one thing the doctor wants to see."
The machines also record the exact time each function occurs allowing the paramedics to focus more on treating the patient rather than keeping notes. The machines print an incident summary, which emergency room doctors rely upon.
Paramedics can switch the monitors to parameters for children with the push of a button and adjust the monitor to be clear in bright light or in no light just a few more things the old monitors could not do.
While the department is excited about the new technology, Casson said it still could never replace the human touch.
"It has all the bells and whistles, but we still have to treat the patient," he said.