ICU Tools Provide Real-Time Data

Heidi Kemmer, DO, FACOS,FACS
Dr. Kemmer earned her medical
degree from Touro University
and completed her residency at
Beaumont Hospital, Trenton.
 

With an emergency room that sees 83,000 patients a year – making it one of the most-visited ERs in the metro area – North Kansas City Hospital trauma staff must be ready for a myriad of scenarios at a moment’s notice.

Thankfully, the five trauma surgeons, two full-time trauma nurse practitioners and four part-time advance practice providers that comprise the NKCH trauma care staff are equipped with the latest technology. This allows them to serve patients more efficiently and provides real-time data for faster responses.

“The more tools we have to evaluate a patient, especially when their clinical picture isn’t clear, the better off we are,” said Neuro ICU Surgical Director Heidi Kemmer, DO, FACOS, FACS. “We want to get more information quickly because that helps us intervene quicker and allows the patient a better outcome.”

One such device is the FloTrac®, which uses the pressure in the arteries to measure how well the heart is pumping blood, including key numbers like stroke volume and cardiac output. It doesn’t need to be adjusted with other tests. This makes it useful for tracking a patient's heart function, changes in their condition and how they respond to treatments, as long as they have an arterial catheter.

“If we're having difficulty deciphering what type of shock a patient has, the FloTrac can help us,” Dr. Kemmer said. “For example, if a patient is getting sepsis policing or pressure requirements, the FloTrac can help us target therapy better for a patient to ensure they're not getting fluid overloaded.”

Another resource is the Ceribell® electroencephalography (EEG), a crucial piece of equipment for seizure patients. The device fits on a patient’s head like a crown and can evaluate seizure activity and any seizure burden. If the device detects seizure activity it sounds an alarm.

“This allows us to intervene quicker,” Dr. Kemmer said. “With a traditional EEG (electroencephalogram), the machine needs to be left on, make a recording and then read by the neurologist.”

The ultrasound at bedside machine provides a lot of information quickly. It can help evaluate for fluid or blood in the chest and abdomen and assess heart function and a patient’s volume status in real time.

“Using this information, we can assess the heart’s function and check for fluid levels by looking at a blood vessel in the belly,” Dr. Kemmer said. “This helps us make quick decisions about the patient’s care based on their condition.”

The Belmont® Rapid Infuser allows for a  large-volume blood transfusion in short amounts of time. The CLR Irrigator is used to treat hemothorax by flushing the chest with saline. It helps doctors remove blood and blood clots from the chest through a tube placed at the bedside..

“Our goal with CLR is to reduce the need for chest surgery and manage the situation at the bedside,” Dr. Kemmer said. “A benefit of these tools is that they allow us to identify any issues within a patient’s critical window and give them the best outcomes.”

This technology puts NKCH on par with every other trauma center in the area. What makes the difference, Dr. Kemmer said, is the people who use it. 

“All the technology and state-of-the-art things are nice, but nothing beats good bedside nursing care,” Dr. Kemmer said. “I think we’re really lucky that we have a good nursing team who can keep up with the latest technology and not lose sight of what’s important to the patient.”