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Home > Topics > Technology
March 11, 2014
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EMS News in Focus
by Arthur Hsieh

Google Glass won't solve EMS problems (but it can help)

With all respect to the physician community, please think bigger

By Arthur Hsieh

Evolving technology has made EMS more sophisticated in its ability to assess patients in the field.

Equipment such as pulse oximetry, glucometry, capnography, multi-lead electrocardiograms, and portable labs have increased the diagnostic capability of EMS providers. It’s just too bad that the rest of the medical profession has had difficulty understanding the increasing sophistication of those in the field.

A recent article points to a Rhode Island ER being the first to test Google Glass on medical conditions — and envisions “...an ambulance crew someday responding to a stroke victim, using the eyeglass technology to provide real-time video and audio to a neurologist back at the hospital who could then order a clot-busting, brain-saving drug immediately.”

Um, couldn’t we do that now, sans glasses? Education standards require  paramedics to understand essential functions of the brain, how and why strokes occur, and how to identify them early. EMS providers have been shown to be fairly accurate in identifying strokes using standardized assessments. We perform a limited set of tests to rule out hypoxia and hypoglycemia. We assist in identifying who is a candidate for therapy and who is not. With all respect to the physician community, please think bigger than this.

Remote sensing technology will help extend the reach of the medical field. We are moving toward a decentralized approach to health care in this country; it’s simply cheaper and just as effective to receive medical attention in clinics and health centers, compared to hospitals. Greater preventive efforts will go even further in reducing the overall cost.

Telemedicine will allow fewer physicians to effectively oversee a web of health care professionals who are prepared to function interdependently, as a team, to better care for patients. 

Using a piece of equipment as an electronic leash is counterproductive to that approach. I’ve seen these quotes before, from physicians who mean well, but don't realize how they denigrate the industry in making such comments. Yes, EMS will have to continue to do its housecleaning and improve the consistency of its educational model. But many parts of the country are already there, and doing some amazing things in improving overall community health.

Technology like Google Glass should augment and enhance that function, not restrict and limit it. Have some trust in the human component of the system.

About the author

EMS1 Editor in Chief Art Hsieh, MA, NREMT-P currently teaches at the Public Safety Training Center, Santa Rosa Junior College in the Emergency Care Program. Since 1982, Art has worked as a line medic and chief officer in the private, third service and fire-based EMS. He has directed both primary and EMS continuing education programs. Art is a textbook author, has presented at conferences nationwide, and continues to provide patient care at an EMS service in Northern California. Contact Art at Art.Hsieh@ems1.com.
Comments
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Greg Friese Greg Friese Tuesday, March 11, 2014 6:22:05 PM Well said comments about Google Glass and stroke assessment
Jon Drake Jon Drake Tuesday, March 11, 2014 6:53:08 PM Unfortunately, the RI prehospital medicine is significantly behind the rest of the country when it comes to providing advanced life support. The majority of ALS providers are licensed to the "Cardiac" level, which at best provides a perfunctory understanding of stroke, so in turn the ER physicians are accustomed to field providers who don't have the same level of knowledge and assessment skills as true paramedics. The ER docs comments are illustrative of the overall lack of evolution in the Rhode Island EMS system.
Delya Stoltz Delya Stoltz Tuesday, March 11, 2014 7:42:40 PM Thank you, Art Hsieh! And you can have an, "Amen!" with that as well! Our colleagues in the UK and in many other places have the ability to work more aggressively. And, in places where it is not yet mandated that it's a four year degree position, they still trust well trained medics to accurately characterize what they are visualizing before their own eyes (in order to administer thrombolytics for instance). I fail to see how the picture transmitted by glasses would be any more true a description than the one that I can convey. My impression is replete with the patient's environment, smell, grooming, temperature and my first hand experience. I'm not saying that this is a bad idea. More tools tend to be better for all parties. But in a world of finite funding, I can think of a hundred other things that we could put on under-stocked ambulances that would make the lives of medics and their patients better in easily quantifiable ways.
Skip Kirkwood Skip Kirkwood Sunday, March 16, 2014 9:30:57 AM One of the reasons that on-line medical direction died off in much of the United States is that there were not enough docs to come to the radio and talk to the medics. Where OLMD was extensively used, it wasted time and helped to "dumb down" the profession. How are we going to deal with these issues when it comes to "seeing" as opposed to just listening? Where are we going to find the docs to sit around and wait for several hundred thousand video conferences per day? Not a fan.....
Skip Kirkwood Skip Kirkwood Sunday, March 16, 2014 9:31:26 AM One of the reasons that on-line medical direction died off in much of the United States is that there were not enough docs to come to the radio and talk to the medics. Where OLMD was extensively used, it wasted time and helped to "dumb down" the profession. How are we going to deal with these issues when it comes to "seeing" as opposed to just listening? Where are we going to find the docs to sit around and wait for several hundred thousand video conferences per day? Not a fan.....just because you "can" do something doesn't mean that you "should"!!!
Tom Bouthillet Tom Bouthillet Sunday, March 16, 2014 9:43:25 AM Now if we could do away with the radio report other than age, gender, chief complaint, and level of stability. I love how the nurses say, "No questions or orders." I think to myself, "Your questions can wait and I have standing orders." Or my favorite. "Did you start an IV?"
Mike Smertka Mike Smertka Monday, March 17, 2014 10:34:04 AM Tom Bouthillet, truthfully you could do without that too. People walk through the front door of EDs all the time with life threatening problems. They don't call ahead. Emergency physicians and department staff are more than capable of handling any patient the few minutes it takes for various teams to arrive.

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