Blood Pressure Monitoring in Air Ambulance Emergency Medical Services

Clinicians in emergency medical services (EMS), often times called emergency medical technicians (EMTs), have quite a difficult and complex job. Simply caring for patients in life and death circumstances is stressful. Add the burdens of retrieving patients in the field and transporting them to a hospital, and there are enough challenges to make it two jobs. These multi-layered difficulties are also posed of the medical equipment used in EMS. In air ambulance or aeromedical evacuation (Medevac) situations, these challenges are at their most extreme limits with high ambient noise making the gold standard of manual blood pressure (BP) measurement near impossible. It is certainly more problematic than having it measured during an annual checkup. Its performance, in terms of

1. accuracy, or agreement with the standard,
2. precision, or agreement with the sample mean,
   and
3. trending, or agreement with the direction of change,

is often more critical given the higher level of acuity needed. Because clinicians need to focus on their patient, they rely on their equipment no matter how far from ideal the circumstances of measurement are. However, these circumstances are important and separate functional equipment that improves the care EMTs provide from that which makes it more burdensome. The following simulation study of BP monitors in an air ambulance 1) presents the current state of performance in patient monitoring and 2) details the difficulties that monitors encounter in a Medevac environment.