Kern County, California to deploy AI-powered ECG devices

DrParasite

DrParasite

The fire extinguisher is not just for show
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Beginning in February, Kern County will become the first in the state to equip all EMS providers with handheld, AI-enabled 12-lead ECG machines​


KERN COUNTY, Calif. — Starting in February, Kern County will be the first county in California to deploy new AI-powered electrocardiogram machines to more quickly detect heart attacks in patients in the field.

Kern County Public Health announced Thursday it had recently purchased 100 new Kardia 12L handheld electrocardiogram machines, also known as ECG or ECG machines.

Unlike the county’s current portable ECG machines, which need 12 physical connections, or leads, to a patient before a reading can be made, Kardia’s machines need only five such connections.

Read the complete article here:
www.ems1.com

Calif. county to deploy AI-powered ECG devices

Beginning in February, Kern County will become the first in the state to equip all EMS providers with handheld, AI-enabled 12-lead ECG machines
www.ems1.com www.ems1.com
 
I thought about posting this. I talked with one of the EMS personnel who spearheaded this project when I went to recert in Sept.

I’m interested to see how this pans out, and, how it may or may not affect our volume specifically.

I know California gets quite a bad reputation often, but after reading the EMS1 article re: the OCEMSA MD, I do think there are worse off counties. I also think the state would benefit from a state-wide EMSA.
 
I mean, haven’t they been technically AI since the first 12 leads came out with a diagnosis box?
 
FiremanMike said:
I mean, haven’t they been technically AI since the first 12 leads came out with a diagnosis box?
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To be completely honest, that's what I was thinking... however I know many/most paramedics are taught to ignore the dianosis, which never made much sense to me... Since the cardiac rhythms are mostly defined objectively, I would think they are mostly accurate... outside of artifact from the patient moving, of course.

I'm curious how these new machines can make diagnoses with only 5 leads, while current Lifepaks require 12; however, if these get added to every first responder truck, it can help improve door-to-balloon times on stemis, as well as give Cath labs advance notice that a cardiac patient is on the way. Imagine having a firefighter/EMT on the engine or QRV call a stemi alert (with guidance on stemi imposters), before the paramedics even get to the patient's location... could be interesting.
 
DrParasite said:
however, if these get added to every first responder truck, it can help improve door-to-balloon times on stemis, as well as give Cath labs advance notice that a cardiac patient is on the way. Imagine having a firefighter/EMT on the engine or QRV call a stemi alert (with guidance on stemi imposters), before the paramedics even get to the patient's location... could be interesting.
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This is essentially the thought process. Add them to BLS fire engines in the outskirts of our county. And, because the county itself is spread out, oftentimes ALS comes from a distance.

I’m not sure how it will work either, but if it does improve DTB times and proves to be as accurate as depicted the justification for bypassing an ALS provider to further diagnose an actual cardiac event may prove its merit.

This may see more justifiable helicopter utilization criteria being met, but more importantly, and improvement in these patient’s outcomes encountered.

Either way, at least I have to tip my hat the the EMS Agency for creating ways aside from just “adding more paramedics” to a system, which, still has not shown any solidfied added benefits. Plus, what is the actual number of paramedics needed to make that difference?

So, again, just thinking out loud. This seems like a reasonable effort with considerable merit behind it.
 
DrParasite said:
To be completely honest, that's what I was thinking... however I know many/most paramedics are taught to ignore the dianosis, which never made much sense to me... Since the cardiac rhythms are mostly defined objectively, I would think they are mostly accurate... outside of artifact from the patient moving, of course.

I'm curious how these new machines can make diagnoses with only 5 leads, while current Lifepaks require 12; however, if these get added to every first responder truck, it can help improve door-to-balloon times on stemis, as well as give Cath labs advance notice that a cardiac patient is on the way. Imagine having a firefighter/EMT on the engine or QRV call a stemi alert (with guidance on stemi imposters), before the paramedics even get to the patient's location... could be interesting.
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It’s because they’re wrong frequently and they don’t account for mimics (BBB, LVH, etc) and don’t pick up on the rarities (scarbosa, wellens syndrome, etc)..

They’re right on the obvious ones, but the obvious ones are obvious to even the most rookiest of rookies..
 
FiremanMike said:
It’s because they’re wrong frequently and they don’t account for mimics (BBB, LVH, etc) and don’t pick up on the rarities (scarbosa, wellens syndrome, etc)..

They’re right on the obvious ones, but the obvious ones are obvious to even the most rookiest of rookies..
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right, but why not? since there are objective criteria for the mimics, why did the monitor have such a hard time identifying the mimics? Couldn't they have been programmed to identify the mimics due to their objective definitions?

and I needed to look up wellens sydrome; thanks for making me learn something on my day off... and because I had to, so should everyone else:

OMI, NOMI, and EMS: The Case for EMS Recognition of Occlusive MI - NAEMSP

When pediatric patients present to EMS with seizure, vomiting, or respiratory depression, it’s critical to consider non-accidental trauma (NAT) - especially in infants under 12 months. This post highlights how EMS can play a pivotal role in identifying and intervening in cases of suspected child...
naemsp.org naemsp.org
 
I think this is a potential game changer for rural and frontier areas and I hope this pilot program in Kern County is successful. The key is the transmission to the 3 hospitals for determination.

Long term, I would like to see studies that show the quality of the AI interpretation and, if they are proven to have a very strong rule in vs rule out capability, perhaps this can be used by BLS agencies where ALS units are further away for some of those RMAs that they were on the fence about. Or even better could convince a patient who may be having a cardiac episode that it is not just indigestion.
 
CCCSD said:
5. Five per Fire Truck. Just ask them.
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Lol, you’re definitely familiar with CA EMS.

But to be honest, and so we don’t offend the fire crowd, in general this seems like a much more logical approach than years past and the old, worn out dogmas.

Perhaps the time has come for EMS to actually rewrite the systems design, and not just add more intermittent labor.

But, TBD on what the devices themselves will prove efficacy-wise. Basic ECG interpretation is at times even lost on some paramedics, and active CP and and ACS diagnosis/ admission goes beyond ***STEMI***.
 
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