Patient Initiated Emergency Response System (PIERS)
More than one million Americans will suffer an acute myocardial infarction (AMI) this year. Within the first 60 minutes of chest pain, 250,000 will die. Before reaching any medical attention, a total of 375,000, (one-third) will die. Current studies strongly suggest that time-to-treatment is an important predictor of mortality in AMI and efforts aimed at reducing the delay between AMI onset and therapy can reduce mortality significantly. Thus, strategies having even a small relative benefit in the pre-hospital phase of AMI result in a large reduction in mortality, because of the staggering number of individuals at risk.
The overall objective of the PIERS system is the use of technology to lower the barrier between the acute coronary syndromes (ACS) patient and his entry into the medical system, by reducing delays in the three stages where delay can occur. These stages are as follows: Stage I: Patient and bystander recognition of the symptoms and signs of ACS Stage II: Pre-hospital action by emergency medical services providers Stage III: Actions by health care providers at the hospital to identify and treat patients with ACS The underlying, basic concept of PIERS is to bring critical parts of the Emergency Department to the patient in a simple, rapid, reliable, inexpensive, non-threatening way that lowers the barrier to entry into the medical treatment system. This effort must be integrated seamlessly with the current EMS and 911 system, and not become an additional cause of delay between symptom onset and treatment. The JHU/APL PIERS technology is a remote patient monitoring system for at-risk coronary artery disease patients. The PIERS system uses a 12 lead harness to provide better data and a market advantage versus existing systems. PIERS provides a comprehensive system that includes a patient’s information such as medical history, current medication, and baseline ECG. The PIERS system automatically links with pre-established physician consultants, ambulance dispatchers, and emergency rooms if a serious condition is detected and then forwards to them the patient’s relevant information. Current technologies lack the ability to use assessment of Events (Heart Attack) with dispatch and link to emergency services to provide a value-added component over a simple monitoring mode. The system could be applicable to many patient environments including – home care, assisted living, nursing situations – allowing independent living for at-risk patients. Also, the PIERS system might be applicable to other medical situations involving monitoring patients (ECG and BP) during medication trials and dosage adjustments.
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