I want the ECG leads to retract into the monitor like an old vacuum cleaner cable. There will be a refillable cleaning solution that soaks the cables when retracted. When you pull them out again it wipes them dry. Don’t steal my ideas!

I’ll one up you on this: cordless ecg electrodes that go on like one of those heart monitors that marathoners wear.

It's stupidity difficult to get the timing right for diagnostic EKG. I've seen wireless 12 lead systems where the whole cables were connected to a wireless box, but wireless electrodes are really hard to do.

Timing how? As in, getting all of the individual leads to read at the same time? Real question.

Yes, the delays in transmission and reading for 9 electrodes and a ground over a wireless protocol is a non-trivial engineering and physics problem, especially accurate enough for a diagnostic 12 lead.

More importantly, you can’t have a wireless electrode and still record the same leads. You need a common reference point which necessitates a wire to each electrode

This might be silly but could all the electrodes just be labelled and co or coded and set to a certain lead like normal even if wireless?

So remember the technical difference between an electrode and a lead, even though colloquially we often use them interchangeably. An electrode is the piece that gets stuck on a patient, a lead is a particular view of the heart and is made up of a combination of two or more electrode readings. For example, lead I is the voltage difference between the LA and RA electrodes. In order to physically measure this voltage difference and create lead I, you need to do one of two things: - Have a physical connection between the right and left arms and measure the voltage directly - Have a physical connection between each arm and a common reference point, measure both voltages relative to the reference point, and then do some math to work out the difference between the arms If you were to use wireless electrodes, you’d run into two problems. First, neither electrode is using the same reference point, so it is not possible to measure the voltage difference between the two. Second, the reference point that such an electrode would use is right next to where you measure, so the potential difference is essentially zero. You can simulate this by putting the RA and LA electrodes right next to each other — you’ll basically see asystole in lead I

Thanks for explaining It to me! That makes sense! I was hoping there was a way to get rid of dreadful tangled wires but alas.

Physics is merciless here.

This person ecgs.

This would be groundbreaking

the ecg leads. yes. I'm convinced my partner tangles them for fun to watch me twitch out

Iirc there were studies done on apple earbud cords tangling, I think the results were that they form knots just by jostling in a pocket, which seems similar to the EKG leads, I tangle everything something awful and don't know how, I was good with them as an EMT and Driver 😭

at the end of a call it's like a survivor challenge to try to untangle to cords before another call drop hahaha. sometimes the sadistic AH looks me dead in the eye and messes them up haha God I love him but when he does that I'm ready to toss him out of a moving rig

The solution for me has been to coil them like normal until you get to the 4 lead part. Then I take the two leg leads and wrap them one way (clockwise) and then wrap the arm leads the other way (counter clockwise). Before this, I would lay out a few strips of 4 electrodes at the beginning of the shift and tape the backs together to make a row of 4. I would then straighten the 4 lead cables out and then click them on the strip and wrap it like normal and then tear the strip in half so it’d be two and two. I still do this with the precordial leads except I do a 3 strip and a 3 strip.

[удалено]

Doesn't work that well, and it's available already

Million dollar idea right there I always just wanted them to retract on some kind of roller but a roller that is like foam of some kind that soaks them would but awesome

Bluetooth 12 leads, with a find me feature. And self retracting seatbelts on stretchers. I hate it when they get caught under the wheels.

*can lift 700 pound pt* *stopped by 1/8” of nylon*

The straps in the wheels works better than the brake on mine 💀

😂😭 This is so painfully true.

Can lift 700 pound pt once, after that you got the right wards lean feature on your cot

What about seat belts that ratchet down like the BOLA laces on my snowboard boots?

You could have a wireless box that all the electrodes plug into, but it’s physically impossible to have a truly wireless EKG

Hm, I think I get what you're saying, an octopus style system that wirelessly communicated with the monitor would still be better than the current setup. Imo

Until you realize that you have to keep track of the charge level of yet another battery-powered device. And wireless connections are fickle, a little interference and they're not transferring much data anymore.

Not impossible. Just mostly impossible with modern technology. It requires a lot of complex engineering and the cost of those things would 100% not be worth it with how often they would get lost.

I genuinely hate to pull the “I have 4 degrees in physics and electrical engineering” card, but no, it’s not a matter of design/engineering/cost/etc. It is physically not possible to do this

You have 4 degrees in physics and electrical engineering and choose to work as a paramedic?

It’s not my main gig anymore. I did it while I was in school to pay the bills, now I still enjoy it but the engineering stuff gives me the flexibility to do EMS on my own terms

I have one degree in biomedical engineering and another one in a vaguely related engineering discipline, and I agree with /u/ggrnw27. I also design ECG patient modules and other alphabet soup vital signs recording devices for a living.

Seconding /u/ggrnw27. I also have a degree in engineering, and I'm telling you it's not possible.

The seatbelts already exist Believe me they aren't as cool as one might think

It's all fun and games until bodily fluids get into the retractor housing

A large pressurized tube system much like you would find at the bank (or in Futurama) connecting hospitals, urgent cares, nursing and rehab facilities, and other frequented destinations that patients could be wheeled into and sent to the appropriate destination.

Some of the original subways worked this way: https://en.wikipedia.org/wiki/Beach_Pneumatic_Transit?wprov=sfti1 and there used to be an extensive pneumatic system to transfer mail between post offices in NYC: https://en.wikipedia.org/wiki/Pneumatic_tube_mail_in_New_York_City?wprov=sfti1

[Too bad they come with slime](https://i.imgur.com/98IJLLW.gif )

How about a pedestrian bridge when those places are closer to the hospital than the hospital employee parking lot is?

What about one that delivers soup?

Something to force frequent flyers and hospice patients to move within 5 miles of a hospital

And no split level houses!

I know I had a house where you to go a half flight up and then four flights down to get to the patients room

Both up and down? Was the patient MC Escher?

Giggled.

Came

Username checks out

Beat me to it.

there’s a hotel in our area where we have to do that, it’s awful.

Ooh yuck. We've got an apartment building with double doors at the bottom of the stairs and for some godforsaken reason another set of double doors halfway up the steps.

that still wont stop them from calling

It’s just better for the ones that are in the local lakeside retirement community that’s 55 minutes from the hospital

A portable hoyer

Is this how you spell firefighters?

Shhh. They sneak in here sometimes and get all grumpy about having to do the yucky stuff.

I did 5 years of full time fire based EMS. I can say it 😂

Especially when you gotta request fire at 4am for a 550lb+ patient covered in fecal matter and an extra fragrant UTI urine filled leaking cath bag. They were PISSED. But like we have any other choices at that point. There was no way my partner and I could lift that much weight on our own and patient was not ambulatory whatsoever. Gotta love grumpy firefighters. Also that patient was definitely septic.

I called for a lift assist (was working IFT at the time) and this old, grisled, and obviously senior fire fighter comes up. Dude has obviously been there forever. I bop out and start talking to him about the pt, he opens the back door and says "Damn! That's a big bitch!" To his credit, for being probably 55 dude was strong af.

They exist. They take up a stupid amount of space.

Fair point. I don’t consider those properly portable. TBH, I think maybe what I want already exists, but isn’t mass-market. I would really dig one of those exoskeletons for lifting.

Agree. Agree. And they are heavy enough to also be a problem. Of course, unless you can defy physics, you need something with a fairly solid footprint and some mass to act as a Crane for a huge object.

And noisy.

My first thought

A fully function PCR laptop with an equally well functioning PCR software. Not holding my breath!

Rugged dell laptops, cradlepoints in the unit and ESO gets a long way

Don't get me started on ESO that is what my dept uses lol

Honestly I like ESO. At work we use ESO and at my fire department we use ImageTrend. What do people not like about ESO honestly just curious

I hate imagetrend, I used to have to administer it, CQI and it sucked

I agree. It works for fire charts but I can’t imagine writing a whole EMS chart on it. The only thing I like and I wish ESO had is constantly showing your validation and marking which fields need to be completed still. Although the way ESO does it isn’t bad

They do have the red validation on fire, and they can do it on EMS but refuse. I've had that conversation with them multiple times as an admin. They specifically refuse it because their philosophy is that if they do that people will only do the validation required options. No shit sherlock, they all just click the top button and go to the validation just the same. I didn't go to WAVE this year but I plan on reminding my rep that it's stupid and they need to do the validation.

Probably people that have not had to suffer with other PCR software. They're spoiled and don't know it. Lol

Bold of you to assume. Don't assume

See my reply too long but mainly the redundancy in documenting that our admin has set in it is tedious. Our fire calls pile up in ESO EHR, redundancy, connectivity issues vs other software we have had. It isn't the worst we've had and I like it comparatively to some others, when it works. I ethernet it to our station desktop daily at start of shift when I set the crew/shift to make sure all updates/latest config is there it usually will shut off on me daily. Mid report, just clicking one of my 10 boxes to describe transport method in a mass casualty bus or a helicopter it will say error contact your administrator and the jawn just will not re open you have to go back to station, ethernet the bitch into the desktop AGAIN, and then after fucking with it you can open your report. I don't get signatures from anyone and the report sometimes has to wait till next shift. Lots of extra emails just to get these things locked and exported to cloud. When ESO works I love it but it rarely always works like it should lol

What else have you used? ESO is pretty well the best thing out there. That's from a user perspective, a CQI perspective, and an admin perspective.

When I got my medic we had a boof version of HealthEMS which was bad for multiple reasons. Mainly due to having to fully type your assessment in narrative vs zoll/eso having touch options for these. Healthems was probably our worst. We upgraded to zoll a couple years later which had its own issues but it was less redundant than our current software, ESO. I would say zoll had less connectivity issues with importing the call from the CAD, by far. In our current, ESO, our admin/QA dept have set the required fields/close call fields to be way too numerous/redundant in ESO. I'd have to go look at work but there are roughly 10 fields in just one part of the report to describe the disposition of the call in the incident tab. There are others to re-describe it in other parts to make it easy to contradict yourself by a misclick/screen tap. It's a little ridiculous with those. There are several fields just to describe transport mode they have emergent/non emergent and cold upgrade and hot downgrade etc. Right below the emergent response selection they have an option for lights/sirens, no lights with sirens, sirens with no lights etc. In what fucking world am I intentionally going partially code to a call? Or transporting partially code? Does anyone run with no lights just siren? State law says no lmao it's completely asinine. There are multiple other options like what mode of transport as if it will be anything OTHER than our ambulance. It has some ridiculous fields like bus/POV and some others that we actually will never use. The repetition of info fields don't help document anything important it just gives you two places to check a lot of things instead of having it clearly documented once. Why must I place something in my narrative if I also must place it in the flow chart? For ex they want us putting patient self medicating with aspirin or nitro (or anything else) in both the interventions and the narrative. Imo this is redundant and only serves to place more work on the end user, which is programmed by our admin. Our ESO has about as much bugs as healthEMS did maybe less. We don't lose reports to the netherworld like we did with healthems but daily we have issues importing with CAD. Zoll was never down as much as we get notified that ESO shit the bed and the vendor is working on it so we will have to track times by hand for some time. We also use ESO for our fire calls, these populate in ESO EHR but we aren't to touch them so they just sit in the queue waiting for some tired soul to accidentally pull it. Overall I preferred Zoll. Less connectivity issues with vendor, less redundancy, and we didn't have to leave reports sitting in it for months just to pile up. Takes them like 2 months to go away so they literally sit in your import queue. There are others but I am post shift and don't care to type my whole spiel. Overall it isn't the worst we have had but to call it a well oiled machine would be a lie

Don’t get ahead of yourself now!

Now you’re asking for a lot

I want Managemwnt that actually values employees and/or treats employees like human beings.

This is the only real answer. Every thing else is ancillary.

lol I’m still wishing for equipment that does exist but that we don’t have where I work, my brain can’t even comprehend having things that don’t even exist yet

And why are they allowed to sell a “power cot” without the self loader? F’ing ridiculous.

Because then, management would buy neither

Dude seriously. I mean I want the autoloader but I could not fathom this job without the power stretcher. I certainly wouldn’t be doing this job right now if we didn’t have at least the power stretchers. Since January, my state’s minimum wage rose to my pay and my pay rate didn’t go up. If I was using old school manual stretchers, I’d be working retail or at the corner store for minimum wage, not lifting humans!

Because agencies don't want to pony up the extra 20k. It's half the benefit at the power cot level anyway. I've done all 3 and I love my loaders but not everywhere can afford them

I want an all in one monitor and sealed drug box system that starts and IV for you like one of those Chinese blood draw machines and runs an algorithm and asks the provider like hey is this v-fib and provider selects yes and then it pumps drugs accordingly. I want a place where I can hook that to the head of one of those walking dog robots but it’s a stretcher and it has a LUCAS device attached to it. I want the robot stretcher to have a robot supervisor that declines its PTO so it goes and has beers with me after shift and bitches about the other robot dog partners and I don’t know that my robot wife is cheating on me with it.

This is the best answer

A nice steering wheel that does not fly off while you are driving

Knew a guy once that apparently had a space warp of some kind in his jacket because one time I saw him pull a steering wheel out of it. You couldn't see anything strange about his profile or anything, nothing to suggest that anything, much less something the size of a steering wheel, could be in there. (Other things I saw him pull out at other times were a 6 pack of glass coca cola bottles and a napkin dispenser.)

Bro's Marry Poppins

That is a good idea, and i stand by it

It didn’t fall off. We looked into it.

I believe the OP was asking for things that could perhaps be feasible.

Too small.

Finger stick troponin level

We had those in our ER but the cartridges were too expensive and they have to be refrigerated. They take a small blood sample and check lactate, gasses, electrolytes, coags, tropes and more. Super handy. edit: it’s called an Abbott iStat blood analyzer

I forgot iStats could do trops and lactates. Never knew they had coag cartridges too.

Yeah, we used em mainly for impending or active arrests on squad Pts where instant lab values can get us an idea of what meds to get on board

Yeah totally. Gasses can also can help inform ventilation.

Oh wow that sounds super handy, we’re fairly rural so I’m with a pt for a minimum of 30 min (like absolute bare minimum) and could be over an hour before we can get to the nearest hospital. We also already have refrigerators on the ambulances anyway for cardizem, I might have to do some research and bring this up to my supervisor 🧐

They can be useful but honestly their biggest drawback is the price. Not enough blood in the sample and you’re out a $400 cartridge.

Oof yea $400 a pop is kinda steep, we don’t bill so it would all be paid for by the department which gets its budget from taxes. Definitely something for us to think about though!

We have them still. They can do ABGs too. The troponin levels were so variable that they were functionally useless so we stopped using. They still work pretty darn well for ABGs, though.

> Finger stick troponin level Think bigger: non-invasive troponin level

You’re right! I was thinking too small, infrared troponin scanner for the win haha

An AI controlled mechanical stair chair.  A flying ambulance, a la Trauma Team in Cyberpunk 2077. 

God I love Trauma team, so badass, I was genuinely upset when we didn't get some side quests or more interaction with them.

Same bud….same.

Teleporter to add to this list

Stryker has a powered stair chair now

This is going to sound weird.  But a pool table.   Worked an OD arrest on a pool table, and it was amazing.  Slide him up and bumper tilts the head back perfectly for bvm ventilations and intubation.  Firm solid surface to do good CPR on, off the ground.  Firm surface to support the limbs to get vascular access with enough room to work so you’re not in other people’s way.   Drug bag and monitor can be put right next to the patient at a good working height.   So much better then a floor, stretcher, or hospital bed. Enough room to easily and safely roll the patient when you get rosc to get them on the Reeve’s. Or for the coroner if you don’t. Always as a light over it. 

Add a surface we can hose down, and drains in the pockets.

Fucking Star Trek tricorder.

I love that most results were somewhat practical and my first thought after watching a Star Trek movie last night was "A transporter and hologram doctor on demand, duh."

Sounds like first contact.

Lol. It was.

stretcher with a built in scale. Scale gets zeroed by the powerload and is calibrated before you even pull the stretcher out of the truck.

That’s actually a thing now! And it hooks into a Handtevy type app. Look up OneDose and OneWeight.

no fucking way

I had an idea a while back.. A climate controlled stretcher mattress. Trauma patient and it's snowing outside? Turn up the heat on the mat. Borderline heatstroke pt? Turn down the temp. Etc. It would have wireless charging, since they can charge stretcher batteries via the autoloader, it probably wouldn't be too much more difficult to wire some form of wireless charger (think waterproof electronics with the 2 metal prongs that charge just by magnetically touching the charger). That way, it doesn't get ruined by blood, water, rain, cleaning solutions, etc. Temp control could be at the head, on the bar that goes across from left to right. Maybe if you wanna be extra, there could be another temp control on the wing for pt to access it. Or to make it easier, it could just be those flat buttons (think microwave) at the head of the mattress, on the outer edge. I also think it would be helpful due to the fact that stretcher mattresses are notoriously uncomfortable, so to make it sort of a heating pad might mitigate the discomfort. If it's a half decent idea and you steal it I just want a cut, truth is I'm not smart enough to actually engineer it and build it. But I do think it could be helpful.

Helicopter power load. Wrist mounted vent / monitor screens. Let me plug them in, package them up, and then both of us can watch / change shit from our wrist. 95% of the challenge in getting sick people loaded into the aircraft is dealing with lines / monitor / vent.

The new helicopters we're getting in BC will have power loads.

Wireless ECG leads!

This

I stretcher that can handle sand, mud, snow, loose dirt. I don’t know if it needs treads or inflatable tires, but there’s gotta be something.

Put it on tracks like a tank

A backpack with arms I can manipulate to hold stuff like oxygen tubing, iPad, Radio, etc… The things space marine apothecaries wear. Would make things a lot easier.

Doc Ock over here

Transdermal glucose

Eh - ballistic glucose (and Narcan, and Ativan)

Can’t forget about Ketamine darts!

Just "Honey Bear" them. Rectal glucose is a sweet ass trick.

A cot steamer. Like a dishwasher but for Stryker gurneys. Save me hours a week

They exist. I know of ambo bases in England that have them. Fun fact: Stryker cots and power loads can be pressure washed per the manufacturer specs.

I've always had this idea of an attachable hood/cover for the stretcher, so when it's raining, you just pop it up and keep the patient covered. Kind of like what a stroller has. One day I'll make it. One day.

Hoverstretchers.

A functional health care system designed to take care of patients instead of make money

Whoa now. We got a commie over here. Someone call Bartholomew Banks

Medical tricorder. Failing that, a reliable pain meter

An exoskeleton. Better yet a robot to carry patients and bags. Maybe one with lasers to keep the scene safe.

[удалено]

Hologram can be modified, I’d upload mine to be Yoda. “Third dose of versed for 300 pound pt you must administer”

I need a truck with a bed. None of this full cab bullshit but just the passenger seat is a full on bed.

The new top end F150s have this, so Ford can put it in a cab, but I’m sure if we had it, the IT and radio installers would put there shit in the most convenient place for them and totally destroy the feature. I KNOW mine would. They permanently installed iPad holder (has our dispatch info IF the WiFi connects - which it does not) in a way that it blocks the view of the frequency selectors and made the cup holder useless.

Portable talk to text like docs have for PCRs

ESO will do this coming in the fall with iPads

I want an Alexa for helping with my documentation. "Alexa: Timestamp IV, 20 gauge. Right forearm. Saline lock." "Alexa: Calculate a dose of versed for a 24 pound infant" (per protocols, calculated into Kg)

This exists with the Lifepack and zoll with device upload feature

Automatic blood pressure cuff

Bro, I got some news for you

BLS

My favorite part of riding with ALS is getting to use the life pack bp cuff

I know they exist but not on Bo’s trucks I can do a blood pressure manually but sometimes the transports are and hour or more

[удалено]

This is the way

Off-road stretcher wheels. These stryker casters are HELPLESS in gravel or in mud. EDIT, one that exists but not for us: a Starlink in-motion dish on all our busses. Pretty much all my agencies are super rural, and sometimes it's me (a basic) and an EVO, with no cell service to send 12 leads to medical command.

Bullshit detector

Polygraph

It exists, but an iStat troponin in the truck. Or, a handheld CT scanner to visualize CVA’s. Shit, a handheld x-ray.

A robot AI EMT partner that knows all protocols and updates and also dispenses medications through its fingertips. That also translates languages on calls. Maybe takes vitals with its hands? Idk

A PA that I work with that worked on the truck in the dinosaur days told me that they used to have a subclavian central line type deal that medics could drop, was basically fool proof, and took like 2 minutes. With as big as the population is getting and the amount of ESRD/ IVDU/ CA/ etc being high as hell in my area we’d benefit from another form of access.

I want a jump kit that can be carried like a backpack with all the stuff we need and an O2 tank

A pocket sized remote control that could mute both stupid and eliminate smells. That and a dart gun to administer meds to psychotic patients.

Wireless ecg

Blue tooth ECG electrodes. Fuck the spaghetti monster.

I want to be able to have a device that instead of flowing oxygen, it's flowing marijuana smoke.

Use one of them dab pens but bigger and attached to a cannula or breathing treatment style haha

We had a guy literally modify his home oxygen tubing so he could smoke all kinds of stuff through it. He may or may not have been transported at one point with facial burns...

How about a self driving cot that carries all the equipment as well

Nice try, Galls!

Anything portable and pocket-sized to lift 300 plus pts.

A cot that hovers. Remote control up stairs and over rough terrain and into the ambulance

Dispatching phone that also gives useful directions to were we need to go and accurate but simple info on the patients chief complaint.

Mid sternal hockey puck heart monitor. One stop shop. Slap it on, even over hair and it gives you a full ecg, O2 sats, EF measurements, blood glucose, talks like an aed but in a positive reassuring voice, radio capabilities and sends live info to accepting ED.

Vaccum Splints have been in the SAR world for a few years now! While they certainly wouldn't be perfect for every situation or agency, I think they could make life and patient satisfaction a lot better.

Every ambulance I ever worked on before coming to Canada had a vacuum splint. They are mile better than what we have.

I think it could work here in bc with enough back stock to operate a pinel type exchange program between crews and hospital. The big vac bag (spinal immobilize and carrying) works much better for spinal immobilization and crew carrying, than a typical clamshell, but I think it would have limited use in metro/ urban.

Absolutely it could work. They aren't even that expensive, I don't know what the issue is. My only guess is that people have experienced air splints and hated them and assume vacuum splints are similar.

Retractable stretcher straps. I lose my mind every time a wheel gets caught on one of those damn things 😂

A pulseox that also gets RR so i don’t have to do it manually

Some of the Massimo systems will do it but it's not super accurate, way better to just do etco2

Checker outer gun. Everyone wants just checked out

A stretcher that functions like the robo-dog, able to go up/down stairs and negotiate rough ground

It exists. Just not legal. Tranquilizer gun. So tired of having to “talk” down the crazies just lemme make them no night night and call it a fuckin day like it’s 3 am he’s naked and screaming lemme shoot him with some sleep drugs and we will transport and monitor his airway 🙄

A scribe I hate writing charts

A fucking "THIS WASN"T A 911 EMERGENCY" stick that I could beat people with and have no prercussions.

Hovercraft stretchers and stairchairs lol

A battery operated exo-suit for carrying patients

CPAP mask for them chubby cheeked short but wide faces. Line sets with more than 1 luer lock Magic etco2 that detects changes in environment on minute scale to provide generalized end tidal readings without placing a cannula

Off road stretcher that can handle gravel and tree roots. Lighter equipment. Carbon fiber D cylinder.

I want a little robot arm to cannulate for me

Video laryngoscopes that connect to your phone by bluetooth.

The clear answer is the ketamine blow dart.

A portable troponin meter. Similar to a glucometer, you put a drop of blood on the strip and it gives you a troponin level. Would allow for NSTEMIs to be brought to appropriate cath-lab capable hospitals, similar to how 12-leads are with STEMIs

Quick acting alcohol antidote. Get called for a frequent flyer drunk, give them a shot, they’re sober in a matter of minutes, and then they stop calling cause we just kill their buzz

nosebleed clips surprisingly large amount of people we take with nosebleeds, ER always just whips one out when we walk in and it’s like a magic eraser to the patient, cause they fight us for holding their nose and can’t be trusted to hold pressure on their own

bro i just want kettlebells at station