Recording paper, think twice

There are many after market suppliers of recording paper that claim to save you “big dollars” on your consumables purchases. These may be short -term savings but in the long run can cost you a lot of money.

We often receive calls from customers who are experiencing a problem associated with the printing function on their ECG machine. They tell us, “The machine will not print an ECG” or “Every time I press the print button the machine feeds extra sheets of paper after the ECG has been printed”

Both of these problems are consistently related to the use of cheap recording paper that is badly manufactured. Usually the paper registration mark is in the wrong place or commonly is too small. The black registration mark is very important because it is used to correctly position each sheet of paper so that the next ECG printed is in the correct position. The registration mark is recognized by a sensor that is positioned close to the print head. If it is too small or in the wrong position is will either be missed completely or will incorrectly position the recording paper.

We make dozens of service calls each month to fix print problems that are related to the use of cheap recording paper. As this is not covered under the machine’s warranty the customer always ends up with a service charge that far exceeds any savings they have made. So think twice when someone offers you a cheap price. In the long run it can actually cost you a lot of money.

FRED easy, Power for Life!

The clinic for cardiology of the Zurich University Hospital launched the project ‘Power for Life’ in May together with partners. 13 telephone booths on the famous Bahnhofstrasse in Zurich were equipped with SCHILLER FRED easy defibrillators.

In addition to a SCHILLER FRED easy type defibrillator, the resuscitation boxes installed contain an integrated GSM unit. When the first-aid box is removed, the emergency number 144 is dialled automatically, connecting the first aider directly to the Zurich rescue service via a mobile handsfree telephone. In this way, the dispatcher can help the non-professional rescuer on the phone until the paramedics arrive and take over.

More information about the FRED easy defibrillator can be found here.

Tasers, likely preventing deaths

Currently, there is a great deal of attention being paid to the use of Tasers by police forces around the world. In the USA, we have two very divided camps. One side says that there have been no proven detrimental effects from the use of Tasers to subdue violent people and the other side says that every week a death is recorded that is attributable to the use of Tasers.

Closer to home, we have the NSW Police Service currently conducting a twelve month trial. The New South Wales Government is refusing to commit to key recommendation’s made in a report by the NSW Ombudsman. The report advocates a two-year ban on any further distribution of the stun gun to police and recommends another independent review of the weapon’s dangers.

So, what are the dangers? Sabin Russell from the San Francisco Chronicle writes:

When 50,000 volts of electricity from a Taser surge across the body, it can instantly incapacitate a person — more safely than a blow from a police baton or a blast of pepper spray, its manufacturer contends.

But cardiologists are concerned that, in certain cases, the device might also interrupt the rhythm of the human heart, throwing it into a potentially fatal chaotic state known as ventricular fibrillation. Rather than pump blood in sequence through its four chambers, a heart in ventricular fibrillation writhes uncontrollably. It is a common cause of sudden death.

Dr. Zian Tseng, a cardiologist at the University of California, believes Tasers are potentially dangerous because a jolt of electricity, at just the right moment in the heartbeat cycle, can trigger ventricular fibrillation.

He ought to know. He uses a precisely timed jolt to throw the hearts of his patients into ventricular fibrillation on a regular basis.

Tseng installs implantable electric defibrillators into the chests of heart patients who are at risk of sudden cardiac arrest. The devices are miniature versions of the electric paddles used to jolt a stalled heart back into its proper rhythm. Vice President Dick Cheney is the most prominent American with such a device implanted in his chest.

Before Tseng can wheel a patient out of the operating room, he must test the new defibrillator by stopping the heart, and watching to see if the life-saving implant does its job.

“There are vulnerable periods in the cardiac cycle, when shocks can cause dangerous arrhythmias,” Tseng said. Known as a T-wave on the heart monitor, the brief pause in pumping takes up about 3 percent of a heartbeat’s cycle. Tseng times his jolt of electricity for that moment, to stop a heart, so the defibrillator can automatically start it again.

People using Tasers, he said, risk jolting a person at precisely the wrong instant. “I think they are dangerous,” he said. “If you are shocking someone repeatedly, it becomes a bit like Russian roulette. At some point, you may hit that vulnerable period.”

Cardiologists also know that the window in which a jolt of electricity can halt a heart expands significantly when a patient is treated with certain drugs, or when the body is flooded with the fear hormone, adrenaline. Patients with heart problems are also more vulnerable to the condition.

Executives at Taser International are aware of the heart’s vulnerability to ventricular fibrillation, but they insist their device is safe. The electrical current used in an operating room to stop a heart is 30 times higher than that produced by a Taser, said Mark Kroll, an electrical engineer and board member of the Scottsdale, Ariz., firm. Medically induced fibrillation involves applying a current directly to the inside of the heart, he added, while a Taser’s current is applied to the clothing and skin.

“The current delivered by a Taser is too weak to induce ventricular fibrillation,” he said. Ventricular fibrillation (VF) is the most common cause of so called Cardiac Arrest in the general population. In fact, 85% of Cardiac Arrests are VF. The only way to return a persons heart rhythm to its normal rhythm is by using a defibrillator.

These days’ defibrillators are appearing in all sorts of places. Airports, Railway Stations Gyms, Health Clubs, many public places and even at your local watering hole. So why can’t police officers carry a defibrillator, either in there patrol car or carried on the same belt as the Taser. A defibrillator is currently available that weighs 495 grams and is 133mm x 126mm x 35 mm. The defibrillator is called Easyport and is currently used by bicycle paramedics in Victoria and South Australia.

There is obviously a lot of argument from both sides going around at the moment and I guess that the jury will be out for some time on this issue. Is it better to use a Taser or a gun to subdue a dangerous person? Personally, I think so but not at the cost of a life. If the risk can be mitigated by a police officer carrying a miniature defibrillator as well as the Taser I think it will go a long way to helping both sides of the argument.

http://seattlepi.nwsource.com/health/207168_tasers10.html

ICD ‘hacking’ being researched

It is now possible to hack implanted devices such as pacemakers to obtain patient information or even make them lethal, a study has warned.

Implanted devices are used to keep the heart beating regularly, to shock a heart that is beating chaotically, to stimulate parts of the brain or to deliver drugs. Millions are in use worldwide.

The implants are increasingly equipped with wireless technology, allowing for remote device checks and freeing patients from repeated doctor visits.

But this convenience may come with unanticipated risks, warns a team of researchers in the US.

The researchers, from three American universities, have demonstrated how to use a radio to hack a combination heart defibrillator and pacemaker, suggesting it could be possible to remotely control someone’s heart.

The team reports that it is possible to extract private medical information and reprogram the devices without a patient realising it.

They were able to reprogram the devices to shut down and to deliver jolts of electricity that would potentially be fatal had they been inside a person.

However, the researchers stressed that there had never been a reported case of a patient with an implantable cardiac defibrillator or pacemaker being targeted by hackers.

Their efforts cost $30,000 and the study was designed to identify and prevent future problems.

The research was led by two computer scientists - Tadayoshi Kohno of the University of Washington and Kevin Fu of the University of Massachusetts Amherst - with cardiologist Dr William Maisel of the Beth Israel Deaconess Medical Centre and Harvard Medical School.

The report, to published at www.secure-medicine.org, will be presented and published at the Institute of Electrical and Electronic Engineers Symposium on Security and Privacy in Oakland, California in May, though it omits key details to prevent abuse.

Dr Maisel said one aim of the research was “to encourage the medical device industry to think more carefully”.

“Fortunately, there are some safeguards already in place, but device manufacturers can do better,” he said.

“We hope our research is a wake-up call,” added Dr Kohno, an assistant professor of computer science and engineering at the University of Washington, who fears that this kind of hacking could soon be attempted.

“In the 1970s, the Bionic Woman was a dream, but modern technology is making it a reality. People will have sophisticated computers with wireless capabilities in their bodies. Our goal is to make sure those devices are secure, private, safe and effective.”

The team has set out three defence mechanisms that require no battery power, making them potentially easy to incorporate in the devices without extensive redesigning: a device that audibly alerts patients of security breaches, one that authenticates requests for access from outside devices and a vibrating device that patients can sense.

The researchers’ hacking experiments used an implantable cardiac defibrillator, a sophisticated device that automatically regulates the heart beat by sending small corrective electrical signals to the heart or by delivering a large shock to restore a potentially fatal heart rhythm back to normal.

The model they tested contained computers and radios that allow health care practitioners to diagnose patients, read and write private medical information, and adjust the device’s therapy settings wirelessly.

In computer laboratory bench tests, the research team used an inexpensive software radio to intercept and capture signals sent from the implantable device. They were able to obtain detailed information about a hypothetical patient, including name, diagnosis, date of birth and medical ID number.

Researchers could determine the make and model of the device and access real-time electrocardiogram results, as well as data on the hypothetical patient’s heart rate and cardiac activity.

The team then mounted attacks. They were able to turn off the therapy settings stored in the implantable device, rendering it incapable of responding to dangerous cardiac events. Additional commands were delivered, resulting in the delivery of a shock that could induce ventricular fibrillation, a potentially lethal arrhythmia.

Bruce Lindsay, an electrophysiologist at the Cleveland Clinic and president of the Heart Rhythm Society, said defibrillator transmissions were “not designed to withstand terrorist attacks”.

“But I don’t think the findings have any great clinical significance,” he added. “To hack the system, you have to get the programmer right up against the patient’s chest. It’s not as if somebody could do this from down the street.”

Key defibrillator makers are Medtronic Inc, Boston Scientific Corp and St Jude Medical Inc. It was Medtronic’s Maximo defibrillator that Maisel’s team studied.

Medtronic spokesman Rob Clark said the risk of any “deliberate, malicious or unauthorised manipulation of a device is extremely low.”

Future versions capable of transmitting signals as far as 30 feet from a patient will incorporate stronger security, he said.

Boston Scientific said its defibrillators “incorporate encryption and security technologies designed to mitigate these risks,” including measures to prevent unauthorized reprogramming.

St Jude said: “As the study points out, the likelihood of unauthorised or illegal manipulation of an implantable device is extremely remote, and St Jude Medical is not aware of such an event with our devices.”

The Food and Drug Administration said it was working on standards to raise the security of medical devices that receive instructions over radio waves but had not finalised them.

“The chance of an ICD being reprogrammed by a computer hacker is extremely remote,” said a spokeswoman, using the abbreviation for implanted defibrillator.

Prof Tipu Aziz of Oxford University, who does brain implants, comments: “This is a very interesting report,” but adds: “It is unlikely at present that this will be a risk to my patients. It is also even more unlikely to be of interest to hackers in general and very few terrorists.”

A British spokesman for the manufacturer Medtronic adds: “There has not been a single reported incident of such an event in more than 30 years of device telemetry use, which includes millions of implanted patients worldwide.”

The Medicines and Healthcare products Regulatory Agency, the UK government agency which is responsible for ensuring that medical are acceptably safe says it will investigate: “Despite an extensive database of adverse incidents, the Agency has never received any reports of hacking associated with implantable medical devices such as pacemakers or ICDs (implantable Cardioverter defibrillators).

“Nevertheless, as part of our adverse incident investigation process this we will look into this further, in consultation with the relevant device manufacturers.”

Pre-hospital ECGs critical for heart attack patients

Lifesaving procedures to open blocked heart arteries could begin much sooner for heart attack patients if electrocardiograms (ECGs) were recorded before they arrive at the hospital and used to put treatment teams into action, according to a scientific statement in Circulation: Journal of the American Heart Association.

Each year, about 920,000 people in the U.S. have a new or recurrent heart attack, also called myocardial infarction (MI). ST-segment elevation myocardial infarction (STEMI) is a common and especially severe type of heart attack. While there are no exact statistics for STEMI, the number has been estimated between 200,000 and 400,000.

Rapid treatment to reopen the blocked artery is vital because more heart muscle dies the longer it’s deprived of blood flow.

Current criteria for evaluating quality of care includes elapsed “door-to-balloon” or “door-to-drug” time — the time span from the moment a patient enters a hospital emergency room until blocked arteries are re-opened either by angioplasty or a clot-busting drug.

However, “the clock starts ticking from the moment a person develops symptoms of a heart attack,” said Henry H. Ting, M.D., lead author of the statement and a cardiologist at the Mayo Clinic in Rochester, Minn. “The pertinent measure of system performance is from the time of first medical contact with paramedics or other emergency medical personnel to reperfusion therapy (reestablishing blood flow to the heart muscle).”

Ting and colleagues evaluated progress since STEMI guidelines were first issued by the American Heart Association and the American College of Cardiology in 2004. They were updated last year. The guidelines recommend that all emergency medical services acquire and use pre-hospital electrocardiograms to evaluate patients with suspected acute coronary syndromes.

“If pre-hospital ECGs were more widely used and integrated with systems of care, the time from first medical contact to balloon reperfusion could be reduced to less than 60 minutes,” Ting said. The recommended goal is 90 minutes or less.

Delays from the time a person has heart attack symptoms to when they receive artery-opening treatment can be divided into four time intervals: (1) symptom onset-to-EMS arrival; (2) EMS arrival-to-hospital arrival; (3) hospital arrival-to-ECG; and (4) ECG-to-reperfusion. Pre-hospital ECG programs, if effectively implemented and coordinated with comprehensive systems of care, have the potential to decrease the latter three time intervals – and eliminate the third one.

The statement presents examples of using pre-hospital ECGs, including systems of care with door-to-balloon times approaching 30 minutes or less. In these systems, pre-hospital ECGs are used to activate the cardiac catheterization laboratory while the patient is en route to the hospital, and the patient is transported directly to the cath lab (bypassing the emergency room evaluation).

Despite the recent recommendations, fewer than 10 percent of EMS systems have adopted the use of pre-hospital ECGs, and the rate has not substantially changed since the mid-1990s.

“Furthermore, even when a pre-hospital ECG is acquired, the information is often not translated into effective action to decrease delays in treatment,” Ting said. “It is a lost opportunity to improve the quality of care for STEMI patients if the information from a prehospital ECG is not used to change downstream processes of care.”

The reluctance of patients with acute coronary syndromes to call 9-1-1 is a major obstacle to realizing the full public health benefits of pre-hospital ECGs and organizing systems of care. Studies show that more than half of STEMI patients take themselves to the hospital rather than use EMS. In addition, recent studies have shown that the longest delay for STEMI patients – two hours on average – is from the time of symptom onset to hospital arrival, said Ting.

Other barriers include:

• ensuring EMS and emergency rooms have the capacity to meet demand for services;
• developing standards for education and quality assurance for EMS providers;
• improving collaboration among EMS, emergency medicine physicians and cardiologists;
• co-ordinating hospital networks to provide the ideal patient care;
• overcoming insurance reimbursement issues for prehospital care;
• studying unintended consequences from implementing pre-hospital ECG programs.

Widespread implementation of pre-hospital ECGs is being addressed by the American Heart Association’s Mission: Lifeline, a national initiative launched in 2007 to improve regional systems of care for patients with STEMI. Mission: Lifeline’s initial phase includes emergency medical services system assessment and improvement.

Co-authors are Harlan M. Krumholz, M.D.; Elizabeth H. Bradley, Ph.D.; David C. Cone, M.D.; Jeptha P. Curtis, M.D.; Barbara J. Drew, R.N., Ph.D.; John M. Field, M.D.; William J. French, M.D.; W. Brian Gibler, M.D.; David C. Goff, M.D., Ph.D.; Alice K. Jacobs, M.D.; Brahmajee K. Nallamothu, M.D.; Robert E. O’Connor, M.D.; and Jeremiah D. Schuur, M.D. Author disclosures are available on the manuscript.

Sonic Healthcare

SCHILLER Australia has been the major supplier of ECG machines and Data Management software to Sonic Healthcare for almost twenty years. Sonic uses a range of ECG machine models and SEMA, (SCHILLER ECG Management and Archiving) software.

Over this period of time many changes have taken place, both with Sonic and SCHILLER. For example, the first ECG machine model to be installed was AT-6 and it used an old DOS based version of SEMA software. Now, after three generations of ECG machine and several software upgrades Sonic now has the most advanced ECG data management system in Australia.

Sonic’s pathology companies right across Australia use the combination of SCHILLER software and machines. They include, Melbourne Pathology, VIC. Douglass Hanly Moir Pathology, NSW, Capital Pathology ACT, Southern IML Pathology, NSW, Barratt and Smith Pathology, NSW and Clinpath, S.A.

AHA and Google, attacking heart disease

To use the American Heart Association heart attack risk assessment, go to the AHA’s risk assessment website http://www.americanheart.org/riskassessment or to the new Google Health website http://www.google.com/health. There, you enter your blood pressure and cholesterol levels, weight, age and other risk factors. You can then export data into your personal health record (PHR) on Google Health.

While taking the heart attack risk assessment, you can also find out if you have metabolic syndrome, a group of risk factors that greatly increases the chances of developing cardiovascular disease, including stroke and diabetes.

Those who haven’t taken the risk assessment, but have a PHR on Google Health, can also import data about their risk factors directly into the risk assessment tool and evaluate their risk without re-entering the data.

Personal health information entered into the American Heart Association’s Heart Attack Risk Assessment tool is collected, maintained and disclosed in accordance with the American Heart Association Privacy Policy, which is available here.

Joining forces with Google is one more way for the American Heart Association to reach out and help Americans live longer, healthier lives, free of heart disease and stroke.

ARGUS Pro Transport

Experience the New Freedom in Intensive Care Monitoring!

The ARGUS PRO Transport II is an intensive care monitor which meets the specific needs of clinics and rescue services. The unit provides full performance for bedside and transport, without restrictions regarding the measured parameters. Suitable for Intensive Care Units, Operating theatres, Recovery rooms, Emergency wards, Ground-, and especially Air Rescue Services.

Features:

• Small size and low weight
• Full functionality of the highest capacity Intensive Care Monitoring Systems
• Intuitive user interface via touch screen
• Direct access to all important settings of the shown parameters
• Unlimited number of display configurations can be saved so the display can be adapted to the needs of any monitoring situation
• As a part of the ARGUS PRO System, the ARGUS PRO Transport II can display the data of any other ARGUS PRO monitor within the clinic network

Options:

• Resting ECG and FAX
• Graphical ST analysis
• Systolic blood pressure variation
• Cardiac Output

NRMA Careflight & SCHILLER Australia, saving lives together

The world’s most lightweight emergency patient monitoring system is now aboard the planes and helicopters of NRMA Careflight to better help its staff to save lives.

NRMA Careflight has taken delivery of five of SCHILLER’s mobile ARGUS PRO Lifecare units. Three will be used by Careflight International medical retrieval teams operating across the world from bases in Sydney, Darwin and Perth. Two others are being used on board the helicopters participating in Careflight’s HIRT trial.

SCHILLER Australia managing director Harry Packer said the Argus PRO Life Care unit combines an intensive care patient monitor, defibrillator and transcutaneous pacemaker. It weighs just 2.1kg making it highly portable.

“This unique, lightweight yet powerful device opens up many new horizons in emergency care as well as inter-hospital or in-house patient transfers ,” Mr Packer said.

The unit has already been put to the test by Careflight International on a rescue mission last month involving a man who sustained severe head trauma in Bali.

Careflight’s chief medical officer Dr Alan Garner said there is nothing on the market that compares with it for size, weight and capability.

Dr Garner said savings in weight and size are critical in medical emergencies, particularly for pre-hospital trauma.

“The Schiller Argus Pro Lifecare unit replaces a defibrillator, Capnograph and Propack monitor, saving us valuable space and around 6.5kg,” Dr Garner said.

“Added features such as the alarm functions, 12 lead ECG, Masimo Pulse Oximetry and hot swappable batteries means no other unit gets anywhere near it,” he said.

He said he had received very good feedback from Austrian counterparts who had been using the unit extensively.

Mr Packer said that the Westpac Rescue Helicopter Service and Hawkes Bay Rescue Service in New Zealand and Careflight Queensland had also expressed interest in the system.

NRMA CareFlight, a registered charity, is conducting the world’s first randomised clinical trial (HIRT) to evaluate the benefits of rapid response physician care to head injury patients. CareFlight International, the commercial branch of the organisation, provides medical retrieval services anywhere in the world.

SCHILLER Australia supplies a wide range medical equipment including electrocardiographs, long-term ECG and blood pressure recorders, spirometers, medical IT solutions, patient monitors and external defibrillators. It has offices in Newcastle, NSW and Melbourne, Victoria.

ARGUS Pro LifeCare

ARGUS Pro LifeCare, enjoy the power of lightweight patient monitoring in emergency care.

One of the most powerful intensive care patient monitors goes mobile - with defibrillator and transcutaneous pacemaker!

Whatever the requirement - emergency care, inter-hospital or in-house patient transfer. The ARGUS Pro LifeCare assists you without compromise. All this power in a unique, compact 2.1 kg package.

The ARGUS Pro LifeCare covers:

• Full diagnostic ECG (I, II, III, aVR, aVL, aVF, V1-V6)
• NIBP
• SpO2 with plethysmogram
• etCO2 with capnogram
• 2 temperatures
• 2 invasive blood pressures
• Defibrillator with AED and MANUAL mode
• Extremely gentle defibrillation energy using Multipulse Biowave® (biphasic pulsed defibrillation impulse, patented)
• Transcutaneous pacemaker

The bright, clear 4.8″ screen can display 3 waveforms with 7 parameter measurements providing a complete patient overview. All acquired data, including voice recording, is stored by the ARGUS Pro LifeCare for later external review or case analysis. The combination of SCHILLER Multipulse Biowave® AED/manual defibrillator, pacemaker and monitoring functions is unique and opens many new horizons in emergency care and hospital applications.

ARGUS PRO LifeCare can additionally be used in combination with the ARGUS Pro Transport monitor to provide the full range of patient monitoring.

Optional:

• Shock frame with rescue bag and handle
• etCO2 mainstream sensor
• External thermal 3-channel printer
• ARGUS PRO LifeCare charging unit
• Full range patient monitoring with ARGUS PRO Transport

CPR / AED Awareness Week

Out-of-Hospital Cardiac Arrest

Each year, about 310,000 coronary heart disease deaths occur out-of-hospital or in emergency departments in the United States. Of those deaths, about 166,200 are due to sudden cardiac arrest – nearly 450 per day.

• Sudden cardiac arrest can happen to anyone at any time. Many victims appear healthy with no known heart disease or other risk factors.
• Sudden cardiac arrest is not the same as a heart attack. Sudden cardiac arrest occurs when electrical impulses in the heart become rapid or chaotic, which causes the heart to suddenly stop beating. A heart attack occurs when the blood supply to part of the heart muscle is blocked. A heart attack may cause cardiac arrest.

Cardiopulmonary Resuscitation (CPR)

• Less than one-third of out-of-hospital sudden cardiac arrest victims receive bystander CPR.
• Effective bystander CPR, provided immediately after sudden cardiac arrest, can double or triple a victim’s chance of survival.
• The American Heart Association trains more than 10 million people in CPR annually, including health professionals and members of the general public.
• The most effective rate for chest compressions is 100 compressions per minute – the same rhythm as the beat of the BeeGee’s song, “Stayin’ Alive.”

Automated External Defibrillators (AEDs)

• Unless CPR and defibrillation are provided within minutes of collapse, few attempts at resuscitation are successful.
• Even if CPR is performed, defibrillation with an AED is required to stop the abnormal rhythm and restore a normal heart rhythm.
• New technology has made AEDs simple and user-friendly. Clear audio and visual cues tell users what to do when using an AED and coach people through CPR. A shock is delivered only if the victim needs it.
• AEDs are now widely available in public places such as schools, airports and workplaces.

CPR/AED Awareness Survey

• Eighty-nine percent of respondents said they were willing and able to do something to help if they witnessed a medical emergency.
• Few Americans (12%-20%) are confident that they would know when it is appropriate to perform CPR or use an AED.
• At most, roughly four in ten are extremely or very likely to perform CPR on an adult (39%) or child (37%) they know personally.
• Less than 17 percent of Americans believe they are at risk for sudden cardiac arrest.
• The survey was conducted online within the United States by Harris Interactive on behalf of the American Heart Association between January 8, 2008 and January 21, 2008 among 1,132 U.S. residents aged 18 and older.

Public Policy for CPR/AEDs

The American Heart Association supports state public policy initiatives that:

• Promote the access and use of AEDs and establish quality AED programs in high-risk locations
• Encourage bystander CPR and CPR training for professionals who may need to respond to medical emergencies
• Promote increased quality and appropriate use of 9-1-1 systems
• Extend Good Samaritan legal liability protection to all users of AEDs

The American Heart Association also supports increased funding for the Rural and Community Access to Emergency Devices Program, which gives communities funding to place automated external defibrillators (AEDs) in rural areas and trains lay rescuers and first responders to use AEDs.

How’s your CPR?

Most Americans don’t believe they could perform cardiopulmonary resuscitation (CPR) and use an automated external defibrillator (AED) to help save a life in a cardiac emergency, according to a recent American Heart Association survey.

In an online survey of more than 1,100 adults, 89 percent said they were willing and able to do something to help if they witnessed a medical emergency. Yet only 21 percent were confident they could perform CPR, and only 15 percent believed they could use an AED in an emergency. More than half of those surveyed didn’t recognize an AED in a typical setting. Survey respondents reported lack of confidence, concern about legal consequences and fear of hurting a victim as reasons they would not take action in a cardiac emergency.

The American Heart Association released the survey results as part of the inaugural National CPR/AED Awareness Week, June 1-7. The intent of the week is to encourage the public to get CPR training and learn how to use an AED to reduce death and disability from sudden cardiac arrest (SCA).

Unfortunately, only about six percent of out-of-hospital SCA victims survive. Without immediate, effective CPR, the chance of surviving out-of-hospital SCA decreases seven to 10 percent per minute. Even if CPR is performed, defibrillation with an AED is required to stop the abnormal rhythm and restore a normal heart rhythm.

“We think it’s critical for people to get CPR training and learn how to use an AED,” said Lance Becker, M.D., professor of emergency medicine at the University of Pennsylvania in Philadelphia and spokesperson for the American Heart Association. “CPR and AED use are inextricably linked in the SCA survival chain, and it’s crucial that bystanders take rapid action. If more people are trained and respond, we can save thousands more lives.”

The American Heart Association provides classroom CPR and AED instruction, as well as a self-paced CPR Anytime Kit that includes an inflatable manikin and instructional DVD. The association’s adult Hands-OnlyTM CPR educates untrained people to call 9-1-1 and push hard and fast on the center of an adult SCA victim’s chest until help arrives.

Designed to be simple and intuitive, AEDs are available in many public places such as schools, airports and workplaces and will guide the user through the process with clear, calm voice cues. The devices are strategically deployed and maintained to ensure that they are ready in a medical emergency, and will not deliver a shock unless a shockable rhythm is detected.

“There’s no reason for people to be afraid to act,” Becker said. “We want people to feel confident that whatever action they choose — whether using an AED or performing conventional CPR or adult Hands-Only CPR — they are doing something to help, which could be a lifesaving decision.”

SCA survivor Jenifer Fergusson knows first hand about the importance of people taking action. The New York native suffered an SCA at work when two coworkers immediately came to her aid. Due to their quick actions, Jenifer survived her cardiac event.

“My coworkers are true heroes,” she said. “I’m so grateful they had the skills and courage to perform CPR and use a defibrillator when I went into cardiac arrest. Thankfully, my company had an AED onsite. If my colleagues hadn’t acted or the AED was not available, I might not be here today.”

Other results from the survey include:

High BP? AHA says monitor it!

People with hypertension should routinely monitor their blood pressure at home to help manage the disease, according to a new joint scientific statement from the American Heart Association, American Society of Hypertension and the Preventive Cardiovascular Nurses’ Association.

The statement is published online in Hypertension: Journal of the American Heart Association, the Journal of the American Society of Hypertension and the Journal of Clinical Hypertension and printed in the June issue of Journal of Cardiovascular Nursing.

“High blood pressure is notoriously difficult to treat to goal – many patients fail to reach target levels despite treatment, and studies show home monitoring can help,” said Thomas G. Pickering, M.D., D.Phil., chair of the statement writing group. “Blood pressure measurement and tracking could be improved with home monitoring by the patients themselves, in much the way people with diabetes monitor their blood sugar levels with home glucose monitors.”

He said there is strong evidence that the traditional way of measuring blood pressure in adults can be misleading. Studies indicate that between 10 percent and 20 percent of people diagnosed with high blood pressure in the doctor’s office actually have the ‘white coat effect,’ meaning that their pressures are normal under other conditions, but rise in the medical setting.

“It is also believed that some people with normal blood pressures in their doctors’ offices have pressures that spike to potentially dangerous levels in other situations,” said Pickering, director of the Center for Behavioral Cardiovascular Health at Columbia Presbyterian Medical Center in New York, N.Y.

According to the statement, home monitoring is particularly useful in the elderly, in whom both blood pressure variability and the white coat effect are increased, as well as in patients with diabetes, patients with kidney disease and in pregnant women.

Pickering noted that because everyone’s blood pressure is highly variable during the day, taking one reading at a doctor’s office every few months doesn’t give a complete picture of a person’s condition. Home monitors can take multiple measurements during each session, and can be used at different times of day. Many monitors also store and average blood pressure readings over time, providing crucial data for patients to take to their physicians so they can work as a team to diagnose and treat the condition. Many types of home monitors are relatively inexpensive at less than $100.

“Home blood pressure monitoring also gives patients the physiologic feedback they need to see regarding blood pressure,” says Nancy Houston Miller, R.N., co-author and former president of the Preventive Cardiovascular Nurses Association. “Rather than three to four office blood pressure checks per year, if they measure blood pressure at home in addition to following up with their healthcare provider, patients are likely to achieve goals more quickly and be confident that medicines are working for them.” She also states that nurses and nurse practitioners have a significant role to play in interpreting data from blood pressure devices and educating patients about needed lifestyle interventions and medications.

“We’re encouraged by this joint statement on the value of home blood pressure monitoring and confident it will be helpful in reducing the incidence of heart attack, stroke and kidney disease,” said Suzanne Oparil, M.D., president of the American Society of Hypertension.

Hypertension increases the risk of heart attack and stroke and controlling it is essential to reducing that risk. The statement writing group said home blood pressure monitoring is evidence-based healthcare that can improve the quality and lower the cost of caring for the 73 million people with hypertension.

Although earlier American Heart Association guidelines have included home monitors, this is the first statement to have detailed recommendations on their use.

• Patients should purchase oscillometric monitors with cuffs that fit on the upper arm. They should use a proper fitting cuff, and ask a healthcare provider the proper way to use the monitors.

• Wrist monitors are NOT recommended.

• Patients should take two or three readings at a time, one minute apart, while resting in a seated position. The arm should be supported, with the upper arm at heart level, and feet on the floor (back supported, legs uncrossed). It’s important to take the readings at the same time each day, such as morning and evening, or as a healthcare professional recommends.

• Use of a home monitor can confirm suspected or newly diagnosed hypertension and rule out diagnosis for patients whose readings at the doctor’s office don’t reflect their actual pressures over time.

• Home monitoring can be used to evaluate the response to any type of antihypertensive treatment, and to motivate patients to take their medications regularly.

• The target goal for treatment with a home monitor is less than 135/85 millimeters of mercury (mmHg), or less than 130/80 in high-risk patients.

“I hope this leads to a new era in patient-doctor partnerships,” Pickering said. “I think this is a very healthy trend and with a condition like high blood pressure, it really does depend on the patients remembering to change their lifestyles or remembering to take their pills.”

Only a few of the home blood pressure devices on the market have been subjected to proper validation tests such as the Association for the Advancement of Medical Instrumentation (AAMI) and British Hypertension Society (BHS) protocols. Several devices have failed the tests. An up-to-date list of validated monitors is available on the BHS Web site, http://www.bhsoc.org/default.stm.

Co-authors include Gbenga Ogedegbe, M.D., M.P.H.; Lawrence R. Krakoff, M.D.; Nancy T. Artinian, Ph.D., R.N.; and David Goff, M.D., Ph.D.

SCHILLER and Ortivus, co-marketing

Ortivus AB and SCHILLER AG join forces within the EMS sector; launches combined product offer and a market co-operation

Baar, 15. Mai 2008, Ortivus AB and Schiller AG have signed a co-marketing agreement to jointly address the EMS (Emergency Medical Service) market. The basis for the agreement is a mutually developed wireless interface between Ortivus pre-hospital information system MobiMed and SCHILLER’s ARGUS PRO LifeCare defibrillator. The combined offer represents a hitherto unparalleled combination of functionality, low weight and flexibility within the EMS sector.

The product offering will be demonstrated at SCHILLER’s booth 1121 G at RettMobil in Fulda, Germany, May 15 -17, 2008.

There is a constantly growing need of ICT solutions including telemedicine, documentation (e.g. DIVI) and information management within the EMS sector. Today Ortivus MobiMed is one of the most comprehensive solutions available addressing these needs. At the same time EMS users also need qualified vital signs monitoring and defibrillation capabilities; functionalities that must be fulfilled without adding unnecessary extra weight on the EMS personnel for instance when working outside the ambulance. Bundled together with MobiMed, and making use of the new mutually developed Bluetooth interface, the SCHILLER ARGUS PRO LifeCare defibrillator will in real-time transfer vital signs to the MobiMed ambulance tablet PC. This unit will in turn analyse, display and transmit the vitals together with for instance electronic patient record data (e.g. DIVI) to hospitals and emergency centres included in the MobiMed network. The defibrillator, including its monitoring facilities, thus becomes a fully integrated part of MobiMed.

To fully leverage on the opportunities brought forward by the combined offering Ortivus and SCHILLER have entered into a co-marketing agreement under which the parties will promote each other’s solutions.

“The interface and the combined offering will bring us into a paradigm shift within EMS. We are combining two state-of-the-art products into one very strong solution. Biphasic defibrillation with external pacing, monitoring, continuous transfer of monitored data, electronic patient record and information management, all at a total weight of less than 4,5 kilos is indeed a very compelling solution. Backed up by the co-marketing agreement we will now be able to address the market even more efficiently ” says Johan Folkunger, VP Sales and Marketing at Ortivus.

”This interface will enable us to offer to customers the complete change of resucitation with seamless integration of inovative products thus providing key benefits for our customers” says Dominik Doppler, VP Sales and Marketing & Business Development at Schiller AG.

About Ortivus :

Ortivus AB is a Healthcare IT company that offers information and decision-making support systems for Healthcare, Emergency Medical Services and Public Safety in Europe and North America. Ortivus AB is listed on the OMX Nordic Exchange Small Cap list and was established in 1985. Ortivus has approximately 150 employees and subsidiaries in Germany, Great Britain, Canada, and the US. Also visit www.ortivus.com

About SCHILLER :

SCHILLER is a leading international manufacturer and supplier of electrocardiographs, long-term ECG and blood pressure recorders, spirometers, medical IT solutions, patient monitors and external defibrillators. The company was founded by Alfred E. Schiller in 1974. More than 700 employees work for the SCHILLER group in 28 subsidiaries around the world. SCHILLER has subsidiaries providing exclusive service centres in 15 countries and representatives in more than 100 countries worldwide. All shares are owned by the company CEO Alfred E. Schiller. SCHILLER is, and has been fully self- financed for more than 34 years. Also visit www.schiller.ch

SCHILLER acquires Medilog

On 1st May, Medilog became part of the SCHILLER group. Medilog will be SCHILLER’s high-end Holter system. Medilog’s additional products are an ideal complement to SCHILLER’s present product range. The SCHILLER group very much looks forward to the coming co-operation.

SCHILLER is a leading international manufacturer and supplier of electrocardiographs, Holter ECG and blood pressure recorders, spirometers, medical IT-solutions, patient monitors and external defibrillators. More than 700 employees work for the SCHILLER group in 28 subsidiaries around the world. The company was founded by Alfred E. Schiller in 1974. The CEO is convinced that the addition of Medilog’s high-end Holter will enhance SCHILLER’s product range. Alfred E. Schiller’s comment on the acquisition: “We, at SCHILLER look forward to the coming co-operation. We are proud to have gained a brand as good as Medilog.”

What does the acquisition mean?

The SCHILLER group, with its leading position on the world market, will make every effort to further boost Medilog’s success. It is already certain, that the Medilog brand name will remain. Medilog will become SCHILLER’s high-end Holter system. Other details of the integration process are not yet fixed.

Medilog

Medilog is the trademark of Huntleigh Healthcare cardiology products, the former Medical Division of Oxford Instruments. Oxford Instruments is a leading international manufacturer of scientific research systems. The Huntleigh group was founded in 1975.

SCHILLER AG

SCHILLER is a leading international manufacturer and supplier of electrocardiographs, long-term ECG and blood pressure recorders, spirometers, medical IT-solutions, patient monitors and external defibrillators. The company was founded by Alfred E. Schiller in 1974. More than 700 employees work for the SCHILLER group in 28 subsidiaries around the world. SCHILLER has subsidiaries providing exclusive service centres in 15 countries and representatives in more than 100 countries worldwide. All shares are owned by the company CEO Alfred E. Schiller. SCHILLER is, and has been fully self-financed for more than 34 years.