Pocket-Sized ECG: Mobile Health Solution for EMTs

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Discussion Overview

The discussion centers around a new mobile electrocardiogram (ECG) device designed for emergency medical technicians (EMTs) that can be attached to an iPhone. Participants explore its potential applications, limitations, and comparisons to existing technologies and apps.

Discussion Character

  • Exploratory
  • Technical explanation
  • Debate/contested
  • Conceptual clarification

Main Points Raised

  • Some participants highlight the convenience of a pocket-sized ECG device that integrates with smartphones, noting its potential affordability and accessibility.
  • Others mention existing smartphone apps that can measure pulse or other bodily sounds, suggesting that similar functionalities are already available without specialized hardware.
  • A participant emphasizes the importance of the electrode interface in distinguishing this device from other apps, arguing that it is a medical-grade ECG, while others question the accuracy due to the close placement of electrodes.
  • Concerns are raised about the device's suitability for EMTs, with one participant arguing that accuracy is critical in emergency situations and that traditional ECG setups are necessary for reliable readings.
  • Some participants express skepticism about the device's effectiveness compared to automated external defibrillators (AEDs), which are already widely used and provide accurate readings.
  • There are discussions about the potential risks of relying on mobile health devices without proper medical training, with references to negative outcomes from patients seeking online advice instead of professional care.

Areas of Agreement / Disagreement

Participants express mixed views on the practicality and reliability of the mobile ECG device. While some see it as a valuable tool, others remain skeptical about its accuracy and appropriateness for EMTs, indicating that multiple competing perspectives exist without a clear consensus.

Contextual Notes

Limitations regarding the accuracy of the device due to electrode placement and the potential for misinterpretation of readings by untrained users are noted. The discussion also reflects concerns about the broader implications of mobile health technology on patient care and decision-making.

Ivan Seeking
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... a device small enough to fit in the pockets can be snapped into an iPhone, turning it into a working mobile electrocardiogram perfect for emergency medical technicians.

...The doctor said he hopes to have iPhone ECG, priced at less than $100, on the market by April. The application will unveiled at the Consumer Electronics Show in Las Vegas this weekend...
http://www.koco.com/r/26359301/detail.html?source=htv

https://www.youtube.com/watch?v=dY7ZQM5eah8
 
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My HTC Desire can do that, you place your finger over the camera gently (it turns the flash on) and then displays your pulse. I compared it with my pulse measured simultaneously and it was spot on.

Very clever app and it was completely free.
 
Cool, although the price is really steep. I can already do something similar to that with my iPhone: there are several free apps that use the microphone to pick up different bodily sounds (abdomen, heart, lungs). My iPhone was able to pick up my heartbeat and display it in a way similar to the demonstration.
 
the programmable display applications are endless!
 
I think what makes this different from other apps is the electrode interface. I noticed some apps that use sound, but as I understand it, this is a medical-grade ECG. The other apps would not be appropriate for medical applications.
 
I know there are a few for my phone that use bluetooth heart monitors.
 
Great news - I know the group that were developing the official SPI/I2C interface to the iPhone.
They had a terrible time of it, it was an official backed Apple project but at every point they hit the Apple - "the first rule of iPhone is you don't talk about iphone" - attitude.
 
Ivan Seeking said:
I think what makes this different from other apps is the electrode interface. I noticed some apps that use sound, but as I understand it, this is a medical-grade ECG.

The electrodes are kind of close together for a traditional Lead-II measurement.

http://www.medicine.mcgill.ca/physio/vlab/cardio/images/einthoven_expl.jpg
einthoven_expl.jpg


I didn't watch the whole video to see if the doctor discussed what affects the closely placed leads have.

I wonder if you can move it around some to get approximations to some of the other lead combinations from a 12-lead EKG setup... Would be nice if you could see one of the views to help look for STEMI.

http://www.newcardio.com/images/graphs/ecg-graph.gif
ecg-graph.gif
 
I don't think it will work for EMT's, i am one and ecg's well they have to be accurate. The purpose of a 12 or 18 lead is the accuracy so you won't make as many mistakes. Not been able to distinguish between fine VF (ventricular fibrillation) and asystole is bad and it may waste time and at a time like this time does go one min per sec figuratively speaking of course. Also if you need to know the rhythm you are probably have a defibrillator and drugs, and at my level the drugs are the same for flat line and VF. Plus all defibrillator's ie every one has a ECG aed(automatic external defibrillator) you can't override the shock no shock decision, unlike a semi automatic external defibrillator you can you override its decision, and it have a screen to see the rhythm, and manual defibrillator has to as is fully manual. plus it will probably blow up if you shock it so there is no point at all for me or anyone at work but in saying that it is cool and i want it
 
  • #10
There is also a blood pressure monitor app for the iphone:

http://www.knowabouthealth.com/withings-to-launch-worlds-first-iphone-blood-pressure-monitor/7492/

withings_bp-monotor.jpg
 
  • #11
berkeman said:
The electrodes are kind of close together for a traditional Lead-II measurement.

http://www.medicine.mcgill.ca/physio/vlab/cardio/images/einthoven_expl.jpg
einthoven_expl.jpg


I didn't watch the whole video to see if the doctor discussed what affects the closely placed leads have.

I wonder if you can move it around some to get approximations to some of the other lead combinations from a 12-lead EKG setup... Would be nice if you could see one of the views to help look for STEMI.

http://www.newcardio.com/images/graphs/ecg-graph.gif
ecg-graph.gif

I would say that the leads being this close, lacking the leg, is going to make this less than the "medical grade" previously mentioned. It's still, from what I can see, a very impressive thing for a phone that was never designed to do this... to do. This is a very fun toy that people should use, and by the law of averages it will probably save a life or two. HOWEVER, let's be real... anyone who needs to consistently monitor their cardiac rhythm accurately needs to be in a hospital. Anyone who needs to monitor their pulse and pulse/O2 gets to spend a cool 500-1000 USD on a little finger-clip style monitor.

As for first medical responders, that's clearly a load of crap; automated defibrillators are getting cheaper and more common, and they do this AND treat symptoms if they exist. Remember however, that same defib is more accurate with its full lead setup, but it can work with electrodes alone. I just don't see the point of this being marketed as something to not paramedics... and paramedics don't need it.

If I had an iPhone instead of a blackberry... I'd get it though... it looks like a lot of fun to me.
 
  • #12
what said:
There is also a blood pressure monitor app for the iphone:

http://www.knowabouthealth.com/withings-to-launch-worlds-first-iphone-blood-pressure-monitor/7492/

withings_bp-monotor.jpg

this is expensive, you can get cheaper automatic BP's from your pharmsist, and the will be more accurate. plus without training you won't have a clue what is really wrong you maybe able to say it is high or low. but handy for show and tell but as a medical tool not so much
 
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  • #13
misnderstudge said:
this is expensive, you can get cheaper automatic BP's from your pharmsist, and the will be more accurate and without training you won't have a clue what is wrong really now hand for show and tell but as a medical tool not so much

Agreed 100%
 
  • #14
nismaratwork said:
Agreed 100%

Also agree. I have mixed emotions about this kind of thing. While these new gadgets are certainly cool, we seem to be (more and more) putting "health care" in the hands of those untutored in health care.

Its like all the internet sites like WebMD. I can't tell you, how many times in my short medical career, I've seen patients in the ER who's problem is compounded because they got bad advice on the plethora of health forums that exist on the net, by people who are no more doctors than their plumber is.

While it one day be very cool when home computers can very effectively assist in ones health decisions, we're not there yet. And these kind of "toys" have, I believe, a tendency to drive people from seeking real health care when they often need too.

There was a guy in the ER a couple weeks ago that lost a hand because of necrotizing fasciitis. Rather than go to the doctor he posted pictures uploaded from his mobile phone to a medical advice forum. He got some "go see see your doctors" and some "its just a rash put hydrocortizone on it-s". Unfortunately, because he scared he'd make an unneeded trip to the doctors office and be faced with a bill-He chose the latter instead of the former. Cost him the hand to boot.

I saw a similar story a couple of years ago when I worked in clinical micro with necrotizing fasciitis, where a mom sought web help for her son rather than hauling him off to the doctor. Her son, who was graduating high school in the spring and had a scholarship to Yale for rowing. Cost him both of his legs...Sad stories.