How Rugged Technology Supports Ambulance Crews in Testing Times

COVID–19 saw a shift in how some ambulance crews and rapid response teams operated across the UK, from forming collaborative response and mobile support units, to creating purpose-built temporary hospitals such as the NHS Nightingale hospitals.

Communication and technology are undeniably essential in supporting these ambulance crews and emergency service teams, and implementing the latest technologies is crucial to driving improved efficiency and keeping one step ahead.

The Durabook Z141 Military-Grade Rugged Laptop

But with so much technology available and squeezed budgets, organisations must consider efficiency over complexity, and ensure assets are able to perform to the maximum throughout their lifecycle.

For example, Durabook’s newly launched Z14I rugged laptop not only withstands the harsh conditions that emergency teams experience, but it also delivers the power, performance, and functionality to seamlessly integrate with new technologies for any given situation.

Running on Windows® 10 and using an expansion module, or via other connections, it can quickly be transformed on-the-fly into any number of different solutions — from an ultra-portable workstation, to a server or storage device, or remote command centre; ideal for temporary hospitals such as NHS Nightingale. 

Click Image To View The U11I

As technology develops, ambulance crews could be adopting different ways to deliver treatment and respond to emergencies. For example, drones present new potential for medical emergency response and aid delivery, and they can be controlled by the Z14I to complete their missions.

A central rugged device like this also has the capacity to collect and process recorded data of incidents in real time to provide instant intelligence to teams on the ground, as well as back at the hospital where teams may be preparing for incoming patients.

Today, ambulance crews rely on technology to support their daily work lives. Increasingly, they are using rugged devices that withstand the harsh environments they often operate in, while delivering the functionality needed to improve patient care.

For example, Durabook’s U11I rugged tablet helps ambulance crews make critical decisions, helps them to quickly access electronic patient records, and can also transfer patient-specific information to the hospital before arrival.

Running on Windows® 10 and including an embedded smart card reader, it is the only rugged tablet available today with the further option of adding a second smart card and RFID reader. This allows for secure user authentication and the safe collection and transfer of sensitive data.

This feature has also proven essential for quickly accessing historical patient information, recording diagnoses, and securely sending data to the hospital before the patient’s arrival so that treatment can continue without delays.

Also important for ambulance crews is Durabook’s cleaning guide, which outlines how customers can sanitise their devices to reduce the spread of contaminants while ensuring continued performance, all in line with and satisfying industry standards.

Durabook has been manufacturing mobile rugged devices for over 30 years. Its military-grade technology offers deep functionality and high performance at affordable prices. Emergency services — especially ambulance and healthcare workers — often use technology where potentially harmful germs and bacteria are present. It’s vitally important for them to understand how devices can be safely sanitised to reduce the spread of contaminants while ensuring continued performance.

With so many ways in which rugged technology can help and assist ambulance crews — especially in enhancing infection control measures, and in increasing the fluidity and immediacy of communications between services too — we can see that such devices really are a vital piece of equipment aboard any modern and up-to-date ambulance.

Dräger Oxylog® VE300: An Evaluation in Use by Critical Care Paramedics

South East Coast Ambulance Service NHS Foundation Trust (SECAmb) critical care paramedics have given feedback on the
Dräger Oxylog
® VE300 ventilator, following its use during a product evaluation which was undertaken by Kingston University and St George’s University of London. Interestingly, a special focus of the evaluation was the included CPR mode built into the ventilator in order to test its overall usability in daily practice.

Background

The aim of the evaluation was to assess, audit, and evaluate the use of the Dräger Oxylog® VE300 ventilator and the attitudes of its users towards the device during the period when it was being trialed by SECAMb’s critical care paramedics.

Five Oxylog VE300 ventilators were provided by Dräger for the project. As there are ten critical care paramedic (CCP) bases across SECAmb, each ventilator was allocated to two separate bases; operating from the first base for six weeks, and then from the second base for another six weeks in 2019.

The extended scope of skills and experience which CCPs possess when it comes to treating treating the most vulnerable and high-risk patients using advanced clinical procedures and equipment made them perfect candidates to offer reliable feedback about the overall functionality and usefulness of the Oxylog VE300 ventilator.

In total, they used the Oxylog VE300 in 55 different ventilation cases with all available ventilation modes: intra-arrest/ CPR mode, post ROSC/apnoeic patients, transport, handover, and NIV/CPAP. The CPR mode was used in more than every second ventilation case.

CPR in Advanced Life Support

During CPR, ILCOR guidelines on ventilation are rarely achieved due to a tendency to either over or under ventilate patients, both in terms of frequency and tidal volume. Most mechanical ventilators have difficulties with this as they struggle to cope with high airway pressures generated during CPR.

The Dräger Oxylog VE300 is a prehospital ventilator with a ‘CPR mode’, which is pre-set to deliver ILCOR recommended ventilations as well as modulate flow during compressions in order to effectively deliver tidal volumes without excessive airway pressure.

Summary

More than 80% Positive Feedback

The majority of clinicians had a positive experience, and various themes were evident by their comments. Participants suggested that they felt the overall care they provided was enhanced in comparison to using existing equipment.

Clinicians were impressed with the device and its capabilities, and most felt it allowed them to deliver additional and beneficial care to their patients. Whilst feedback was varied, the majority (81.8%) felt that their overall experience was positive.

The CCPs felt that the handover experience was improved by the use of the device, as they felt it helped them deliver a smooth and professional handover with minimal interruptions.

Usage and Alarms

The case mix which was identified
when analysing the usage data clearly shows a high percentage of usage in cardiac arrest, and of the CPR mode. This demonstrates a use for an advanced ventilator with this function, as the currently available ventilator in South East Coast Ambulance Service does not tolerate usage during CPR.

The majority of respondents found the alarms helpful, and comments were varied in terms of reasons why, but a common theme was that individuals were grateful for being alerted to a specific issue that could be addressed.

Mechanical Chest Compression Systems and Supraglottic Airways

The Oxylog VE300 appears on the whole to deliver what it is designed to do. It delivers mechanical ventilation in a range of modes including, uniquely, a CPR mode. This allows clinicians to deploy the device whilst CPR is ongoing: both with human-delivered CPR or, as provided in a small number of cases in this product evaluation, in combination with the LUCAS® Mechanical Chest Compression System.

There were also examples of this device working effectively with the i-gel® supraglottic airway, instead of formal endotracheal intubation. The Oxylog VE300 also provides a further convenient solution to the problem of needing to carry oxygen cylinders to drive the ventilator by allowing their integration into the body of the device.