Comment by goodells | Hacker News Reader

Comment by goodells | Hacker News Reader

Paramedic here - I could see this being useful in the emergency medicine world, if it ever gets to market. Lots of cool things are starting to get included in our cardiac monitors (LifePak 15, Zoll X Series, etc.). And guess what ... almost every single patient already gets 4-10 stickers put on them :).

Recent-ish advancements in tech here have made it possible to continuously measure the amount of exhaled CO2 from a patient's breath, transmit EKGs wirelessly for review by a physician in a hospital, and automatically cycle a blood pressure cuff at any interval we want. All in a patient's living room with equipment carried in one hand. In the very near future these devices will widely incorporate video laryngoscopy using their screens to assist in endotracheal intubations. Video laryngoscopes are already everywhere in the field, but they use their own screen/tablet and require extra work to get recordings out of for documentation purposes.

Ultrasound (the traditional kind - nothing like this article's stickers) is already on board some ambulances. Mostly used for locating deeper veins on people that are otherwise tough/impossible to get IV access on, checking for pneumothorax, or verifying death by confirming there's no heart wall movement.

It's not out of the realm of possibility for the cardiac monitors to gobble up the ultrasound functionality next, and incorporate that into the EKG lead stickers.

> Recent-ish advancements in tech here have made it possible to continuously measure the amount of exhaled CO2 from a patient's breath, transmit EKGs wirelessly for review by a physician in a hospital, and automatically cycle a blood pressure cuff at any interval we want.

None of these things mentioned require any recent tech advances. This could literally be done in the 80s.

It’s more a testament to how slow meaningful progress has been made in healthcare tech for economic, political and scientific reasons - the non cynical aspect is that for a lot of the cost involved the benefits in outcomes are not necessarily there.

I agree with you in principle but I think you're missing the magic that makes this all possible.

That magic is the cheap and ubiquitous GSM wireless network which is something that wasn't possible in the 80s.

I agree that we should have cheaper innovations in medicine, that we're held back by entrenched interests, and that we could have had cheaper elecommuncation network access a decade or so ago, but some of this simply wasn't possible in the time frame that you're talking about.

No I am fully aware. We used to process credit cards over the AMPS (analog) mobile phone network - and this is also how EKGs were sent by EMTs in that timeframe - prior to that in the 1970s they used a dedicated chunk of 70cm spectrum. The items listed are a seriously small amount of data. Sure it’s a bit cheaper now - but we were integrating GPRS modules into embedded hardware in the 90s, it wasn’t that expensive.

What was the coverage map of something like AMPS? Was it ubiquitously available like GSM more or less is now?

It was ubiquitous enough in urban and suburban areas in the US and Canada. The coverage of AMPS was solid, what was limited was the bandwidth and capacity - but there were far fewer users. Coverage in remote rural areas was poorer but still - in the late 80s it was being used for EMT transmittal of telemetry. And as stated using dedicated spectrum this is a 1970s tech. On rereading the OP I am more puzzled what they are talking about because it seems like they are talking about EMT monitoring as opposed to continuous home monitoring - the former we have been doing for 50 years.

> verifying death by confirming there's no heart wall movement

Is that something you can use for verifying death? It was my impression that people can still be revived in that state (not easily, but…). Is this just popular misconceptions speaking?

> people can still be revived in that state

Yes, via the American Heart Association:

> Conclusion: Resuscitation efforts to achieve ROSC, contributing to neurologically intact survival, are needed for at least 38.5 minutes in patients with witnessed OHCA.

OHCA: Out of Hospital Cardiac Arrest

https://www.ahajournals.org/doi/abs/10.1161/circ.128.suppl_2...

Worries me that in a lot of hospitals, esp in developing countries, the heart rate is still taken as the default indicator for life.

Some cultures and individuals don’t cling to life at all costs.

Out of inability due to missing tech or out of other reasons like culture or belief systems?

The commenters you’re replying to have no idea what they’re talking about. There’s virtually no where on earth where basic and advanced cardiac life support isn’t performed, especially in hospitals.

“In a lot of hospitals, esp in developing countries, the heart rate is still taken as the default indicator for life.”

That’s just nonsense on multiple levels. A person in Vfib or pulseless electrical activity has a “heart rate” but they are inevitably going to die without intervention - they are just as dead as someone with asystole. So nowhere in the world is a heart rate an indicator for life - that isn’t a cultural issue that’s a basic physiology one.

A lack of heart rate is not a necessary nor sufficient indication of death!

The medical indications for basic and advanced cardiac life support are clearly understood throughout the world at this point.

Cultural attitudes towards CPR vary - some of that has to do with education as well. It’s a complicated subject, but Hacker News comments don’t seem to be the most fruitful place to have that discussion.

Reducing CPR to “clinging to life at all costs” is not coming from an informed point of view. CPR performed on a 25 year old otherwise healthy trauma victim and a 95 year old with heart failure are not comparable.

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