Half way through a flight from Mumbai to London, a male passenger complained of a swollen right hand and an inability to bend his fingers. The flight attendants were uncertain about what to do and hooked the passenger up to a small device which took and transmitted vital signs, including his pulse, blood pressure and a picture of his hand, to a ground-based medical team.
As the passenger’s condition worsened, the device was also used to transmit an electrocardiographic (ECG) trace. The resulting information was used to rule out heart problems, and the passenger was stabilised and monitored with the assistance of a doctor on the flight. The decision was made to continue the journey rather than divert to the nearest airport.
Medical emergencies like this often occur on aircraft, and there are not always doctors on board. But in this particular case the doctor says she would have asked for the flight to be diverted, had it not been for the ability of the portable vital-signs monitor being carried on the aircraft to rule out a heart attack. Such remote health monitors are becoming even more sophisticated and are also capable of being used in some of the most extreme conditions.
The device used on the Mumbai flight was a Tempus telemedicine monitor made by RDT, a British company based near Basingstoke. It supplies the devices for use on ships and at remote locations like oil wells, as well as on aircraft. The Tempus is similar to a high-end portable monitor used by some ambulance crews, except that it is small, extremely rugged and capable of simultaneously transmitting the data for vital signs, including ECG, blood-sugar and blood-oxygen levels, along with voice and video pictures. Moreover, it can do this in multiple ways, with built-in Wi-Fi, mobile, satellite and Bluetooth communication links. It is also designed to be simple to operate using a touch-screen and pictorial instructions, which means that the need for training is minimal.
Now RDT has come up with an even tougher version, which has just gone into trials with America’s special forces. It is waterproof, soundproof (so as not to give a unit’s position away) and will operate over military radio systems. Because it will be used by trained combat medics, new features are being added. These include a small ultrasonic probe that can be used to scan for internal injuries, such as fluid in the abdomen or internal bleeding, and a video laryngoscope, which can be used to view and open a patient’s airway by inserting a tube—a tricky and potentially dangerous procedure. A miniature video camera on the laryngoscope’s tip relays a picture to the screen on the device to help its correct insertion. The monitor can also be preprogrammed with medical details of individual members of a unit, or automatically obtain them from “smart” dog tags, which are being considered by some armed forces.
Just as the crew of an aircraft or ship can use such monitors to connect to remote medical centres in order to help make a diagnosis, obtain treatment advice and determine whether to divert for help or not, the idea is that a commander in the field will be better informed about the need to evacuate a casualty—which might mean calling off an operation. And if the trials with the special forces go well, says Graham Murphy, RDT’s chief executive, versions of the new device could be provided for civilian paramedic use.
Future capabilities, Mr Murphy hopes, might include a digital stethoscope to analyse breathing sounds and a haematoma scanner to look for a brain haemorrhage. And in both civilian and military use, the vital signs recorded by the monitor could provide doctors attending a casualty who arrives at a hospital with a history of the patient’s condition and any treatment administered—something which is not always readily available. This could be sent remotely, or carried with the patient and transferred via a memory stick. Medical emergency-room dramas may never be the same again.
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Quelle/Source: The Economist, 02.09.2010
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