Why Nancy Giaimo, CNP prefers Cardiac Science
Our stress load can run up to 20 patients that have to be done in four hours. So you cannot have equipment that is not going to be reliable and this equipment here, we purchased three years ago, and it has not been down one day in three years. And we use it five days a week. It's used everyday from eight to noon and there is very few times there is not someone on the treadmill. And the reliability of the equipment? I have not had any problems with it. Very little maintenance has been done to this equipment. So, as far as reliability for Quinton, I am impressed. Prior to coming here, I had not dealt with the Quinton, so it was a nice decision that we made to go with the Quinton.
When we were offered the new machine here, the Quinton Q-Stress, I liked that it had the Windows capability, because we were going to the electronic medical records and this will hook in and we can download these stresses to our Pyramis system and to our desktop.
And I like it because it is true colors as far as EKGs, I can see ST changes as they are occurring. When I want a print in EKG, it is true to what is on the screen. On the side of the screen when I am doing the stress test, it shows the ST changes as they are occurring. So if I see ST depression or ST elevation, it is right there and I can count the boxes and know how much it's decreasing.
We do have cut-offs that we have to use and this machine makes it very simple. And if I see the ST depression or ST elevation, I can stop the test for patient safety. So it is very user-friendly. If the patient is having difficulties with the elevation I can put it into pause or I can put it into a manual mode. I can control the elevation -- and it's very mouse-friendly. It's all done by a mouse. So it makes it very easy for the person.
The physicians also review the EKGs after I reviewed them and a lot of times they will review the composite at the end that looks at the worst ST scenario and they will go back to see when in the test this occurred because sometimes that tells us if it was at max exercise or if it was a prior to exercise starting. Some patients start with EKG changes. So we want to see whether that was prior to or whether it was during max exercise.
This machine is better from the old equipment that I had at the other facility because it is Windows-based and a lot of our equipment, a lot of our computers are all Windows-based.
In the other system we could not do an electronic medical record (EMR). As far as entering blood pressures, changing the protocol in the middle of the protocol, you could not do that where here you can. And that makes it much easier for the provider, because there are times during its stress tests that the patient becomes overworked but doesn't feel like they want to stop immediately. You can slow it down so that they can finish the test and get the information that we need. On the other equipment, that wasn't available. So it was very non-user friendly.
It also was very difficult to -- if something happened during the test, say, you had a power failure or anything, you could not retrieve the data where on this machine we can retrieve the data, because it does go onto the hard drive.
I could even print it out and make it available for the physician if the physician wanted to review it. If I did a previous test, I could print that one out, and the one that we've done today and be able to compare, if there was any EKG changes, if there was any ST depression, ST elevation and it's very simple to pull it up.
It would generate a lot of work if I did not have the Full Disclosure option because a lot of times, I go back to the Full Disclosure once I am done with the test and I go to the reading room to finish my paperwork. I go to the Full Disclosure to look and see if the computer picked up some ST changes that I didn't see. And sometimes it does. And it is nice to have that full disclosure because it allows me to review the test, after the patients are already done.
I can immediately hit the screen right button and it will print exactly what is on the screen at that time. And if a patient goes into an arrhythmia and they want that arrhythmia, always you want it printed up. This machine will allow you to hit the print button that will continuously print until we hit that button again, so it allows a long continuous strip.
My five-year history with Quinton
When I started here at Barnes St. Peter's about five years ago we had the Quinton 3000, which was an older machine. The viewing on that machine was the black with the green and it was very difficult to see EKG changes. So when we got to choose our new equipment, I did want to stay with Quinton, because I was comfortable with that equipment.When we were offered the new machine here, the Quinton Q-Stress, I liked that it had the Windows capability, because we were going to the electronic medical records and this will hook in and we can download these stresses to our Pyramis system and to our desktop.
And I like it because it is true colors as far as EKGs, I can see ST changes as they are occurring. When I want a print in EKG, it is true to what is on the screen. On the side of the screen when I am doing the stress test, it shows the ST changes as they are occurring. So if I see ST depression or ST elevation, it is right there and I can count the boxes and know how much it's decreasing.
We do have cut-offs that we have to use and this machine makes it very simple. And if I see the ST depression or ST elevation, I can stop the test for patient safety. So it is very user-friendly. If the patient is having difficulties with the elevation I can put it into pause or I can put it into a manual mode. I can control the elevation -- and it's very mouse-friendly. It's all done by a mouse. So it makes it very easy for the person.
Easy for physician use
On a rare basis, the physicians have to step in and do the test for me if I am off. And they find it very user-friendly, because they don't use it very often, because I do 90% of the testing here and when they have to step in they have found it very user-friendly. It's very self-explanatory.The physicians also review the EKGs after I reviewed them and a lot of times they will review the composite at the end that looks at the worst ST scenario and they will go back to see when in the test this occurred because sometimes that tells us if it was at max exercise or if it was a prior to exercise starting. Some patients start with EKG changes. So we want to see whether that was prior to or whether it was during max exercise.
Other systems
I used a different system at another facility that I worked at. We were not lucky enough to have Quinton. So when I came here and got to use the Quinton, I felt it was a better product for us and as far as user, the techs, I could teach the techs to do things with the machine that we weren't able to do with the other facilities.This machine is better from the old equipment that I had at the other facility because it is Windows-based and a lot of our equipment, a lot of our computers are all Windows-based.
In the other system we could not do an electronic medical record (EMR). As far as entering blood pressures, changing the protocol in the middle of the protocol, you could not do that where here you can. And that makes it much easier for the provider, because there are times during its stress tests that the patient becomes overworked but doesn't feel like they want to stop immediately. You can slow it down so that they can finish the test and get the information that we need. On the other equipment, that wasn't available. So it was very non-user friendly.
It also was very difficult to -- if something happened during the test, say, you had a power failure or anything, you could not retrieve the data where on this machine we can retrieve the data, because it does go onto the hard drive.
I could even print it out and make it available for the physician if the physician wanted to review it. If I did a previous test, I could print that one out, and the one that we've done today and be able to compare, if there was any EKG changes, if there was any ST depression, ST elevation and it's very simple to pull it up.
Connectivity, Full Disclosure, and other workflow benefits
With Pyramis, I'm downloading these as well. So the physician would have access also to that same test data via the Pyramis system – at their office, at the reading room here in the hospital, which makes it very nice.It would generate a lot of work if I did not have the Full Disclosure option because a lot of times, I go back to the Full Disclosure once I am done with the test and I go to the reading room to finish my paperwork. I go to the Full Disclosure to look and see if the computer picked up some ST changes that I didn't see. And sometimes it does. And it is nice to have that full disclosure because it allows me to review the test, after the patients are already done.
I can immediately hit the screen right button and it will print exactly what is on the screen at that time. And if a patient goes into an arrhythmia and they want that arrhythmia, always you want it printed up. This machine will allow you to hit the print button that will continuously print until we hit that button again, so it allows a long continuous strip.
Nancy Giaimo, CNP
Barnes-Jewish St. Peter’s Hospital
Related Products
Quinton Q-StressPyramis
