Click, Beep, Eject, Reboot...
The ECG machine has its roots of development in the late 19th century, with Willem Einthoven earning a Nobel Prize in Medicine after assigning the PQRST designations to the various deflections of the cardiac rhythm. Fast forward a few years and those devices are now capable of resting in our pockets for bedside exams. As paper charts fall by the wayside, technology continues to radically affect our ability to deliver care to patients. Our new colleague, Dr. Google, has readily become a second-opinion consultant for our patients. Along with patients emailing their providers through the EMR system, recent technologies continue to evolve how we interact with patients.
If any of you reading this article were privy to the moderately viral video of a flying automatic defibrillator (above), you can appreciate that the fast pace of technology in the development of medical devices is quite impressive. Robotic Flat Panel Robots now make possible the interactions of neurosurgical consultations for potential stroke patients and, theoretically, similar actions could be accomplished through the delivery of these applications to drone/unmanned air systems (UAS). Even the simplest capabilities of Bluetooth communication are now allowing for remote vital assessment in confined spaces. When the Palm Pilot of the late 1990s first made it into the lab coat, it did not seem fathomable that it would someday have a distance cousin (aka the smartphone) who would offer a handheld portable ultrasound as a resource in patient assessment.
Considering these changes, the potential applications of new technologies in a wilderness environment are not only massive in volume but are also constantly evolving at a rapid pace. How do these resources handle the anticipated extremes of a remote setting? Where do these tools fit in the desert, aquatic, or high altitude environments? In a harsh wilderness setting, where human health and life are at potential risk, are the current and evolving technologies robust enough to reliably deliver on their intended application?
Among the various fields of application, ranging from patient search and assessment to treatment and intervention, sorting through the long and growing list of technologies is a seemingly daunting process. Understanding the limitations of the technology in durability and capability is also a shifting target as new releases of software upgrades compel a conscientious effort by providers to be mindful of these changes. Finally, implementation of new technologies into wilderness medicine protocols for EMS personnel, SAR teams, guide services, and remote medical groups demands scrupulous efforts in training personnel and maintaining equipment. The intention of this new column by WMS magazine is to expose the growing resource of technologies through reviews, field trials, and feedback of the society. Journey with us as we consider the resource of new technologies in the backcountry and how they further enable the wilderness medicine provider to facilitate patient care.
Published on August 4, 2015