Philips Tempus ALS: Better for All!

By ADMIN 0 Comments

by Kevin Uhl, EMSC
Cincinnati (OH) Fire Department

While reading pages and pages of IPMBA product reviews about items that are “better for us”, I didn’t see too many articles focused on items that are “better for the public we serve”. I felt compelled to share our experience in Cincinnati as we developed our EMS Mountain Bike Unit (CFD EMBU). I love gear and gadgets as much as, if not more than, the next person, but it ultimately all comes down to taking care of those we serve.

When we started building an Advanced Life Support (ALS) team of paramedics to deploy on mountain bikes, our process started the same way as I imagine yours did. In addition to arranging for IPMBA training, we developed inventory lists (down to the exact number of angiocaths) based upon local protocols, standards of care, and our medical director. I often equated it to taking a paramedic ambulance camping. We thought we were cruising right along, mirroring existing lists from current drug boxes and other EMS cabinets. Then the realization hit us: there is no way we would be able to carry our fancy, 30+ pound (13.6+ kg) monitor with ECG, 12- Lead, waveform capnography, pacing, cardioversion, et cetera; the one piece of equipment we turn to a lot.

So, an Automated External Defibrillator (AED) is what it had to be. There was no other option at the time. Well, back to the drawing – or rather deleting – board. We had to delete this drug because of no ECG, delete advanced airways because of no waveform capnography, etc. Arguably, a host of ALS equipment and drugs remained even with just an AED, but still, when I described us as an “ALS” bike team, I never felt right saying it. We lacked the equipment necessary to provide our public – our patients – with all of the current standards of ALS care.

Well, as they say. timing is everything. We weren’t up and running for very long when Philips got FDA approval for the Tempus LS to work in conjunction with the Tempus PRO, resulting in the Tempus ALS. At about four and six pounds (1.8 and 2.7 kg), respectively, these two little devices offer even more features than our 30-pound (13.6 kg) devices do, and they are easily carried on our bikes.

The Tempus ALS is a modular system. The PRO is the diagnostic tool (ECG, 12-Lead ECG, B/P, SP02, waveform capnography, temperature, VL, and more). The LS is the therapy tool (defibrillation, synchronized cardioversion, pacing, etc.). The system is rugged to military specifications, and the batteries are incredible.

In addition to being a clinically robust system, Tempus is a connected device utilizing a web-based cloud entitled Corsium. Corsium allows encrypted, HIPAA-compliant, two-way data streaming, enabling situational awareness of all interventions, photographs, patient acuity, via cloud-based e-PCR integration.

The choice was obvious, and although this system was originally designed for flight and NASA when developed under a smaller company called RTD many years ago, the same characteristics that made it ideal for those applications (small, lightweight, rugged, long battery life, connectivity) are needed by ALS mountain bike programs.

Side note: As a new paramedic, my first monitor was rather large, weighed a ton, had a tiny green screen displaying one lead at a time, and had two paddles on which we applied the gel and which we applied directly to the chest using our hands. To think of what I can do now from the trunk bag of a mountain bike blows my mind.

Pros

In addition to the aforementioned features, check out their website for a complete list of specifications. It is an amazingly powerful little device.
We now have a truly 100% ALS Mountain Bike Team, capable of delivering the same level and standards of care as an ALS Medic Unit or ALS Fire Company.
We have found compatibility and uploading with most EMS Software e-PCR programs.

Cons

Cost: We were fortunate as a municipality to have a source for funding the purchase. The price tag is no higher than that of any similar EMS monitor; however, it costs more than an AED.
Learning Curve: There is a learning curve, albeit small, as there is with any new piece of equipment, particularly one of great importance.
More Stuff! (could also be a “pro”): Once we became fully ALS, where we going to put all the stuff? We had to redo inventories and balance the bags, but it worked!

Local protocols vary, but there is consistency regarding patient standards of care across the country. Why serve your patients differently when your paramedics happen to arrive on bikes? Why send paramedics if you are not going to equip them with all the tools they need to do their jobs? Is it “time, not muscle,” just because of mode of transportation? For the patient suffering a heart attack, is delayed 12-Lead acquisition and transmission acceptable?

We have enjoyed deploying the Tempus ALS in Cincinnati and have seen our patients benefit. If you want to run a complete ALS bike program, we would highly recommend it.

About the EMBU: With administrative support, assistance from other established fire department-based EMS bike programs, Cincinnati Police Department’s IPMBA Instructors, private donations from the Cincinnati Fire Foundation, and voluntary participation by members, CFD has been able to assemble and develop an EMS Mountain Bike Team comprised of almost 10% of their Paramedics. The EMBU represents the fire department and places emphasis on professionalism and exceeding standards for the public they serve.

In addition to providing EMS coverage at large events, the EMBU makes it a point to engage in public safety events, public relations affairs, and community service. The EMBU (as a team) makes it a priority each year to “give back” each year by volunteering. In 2020, CFD’s EMBU used their pedals, bikes, and panniers to deliver turkey dinners to underprivileged families during Thanksgiving time.

Kevin is been with the Cincinnati Fire Department for 22 years and currently serves as the Captain of Emergency Medical Operations. He began building Cincinnati Fire’s EMS mountain bike team in 2018 to meet the increasing demands for better EMS delivery and access during events. He can be reached at kevin.uhl@cincinnati-oh.gov.

IPMBA Product Review