Category: High-end NIHON
KOHDEN CardioLife
TEC-8300 series biphasic defibrillators, Acti-Biphasic waveform. In this article we examine all aspects of the five types of CardioLife
TEC-8300 series defibrillators.
There are five basic rigid models of the CardioLife TEC-8300K series defibrillators and they are
1. CardioLife TEC-8321K defibrillator
2. CardioLife TEC-8322K defibrillator
3. CardioLife TEC-8332K defibrillator
4. CardioLife TEC-8342K defibrillator
5. CardioLife TEC-8352K defibrillator
It is incomprehensible why many items could not
be offered as optional, that they must instead be assembled in the factory before
delivery when other manufacturers can do it in the field.
It means high inventory cost for distributors and dealers trying to sell the defibrillators! |
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The rigid models implies the lack of designing skills and a burden to users; it is impossible to upgrade a model in the field and a customer must buy a new model if such a need arises.
Which of the five models should you keep stock when your competitors only need to keep one? |
The CardioLife TEC-8300K series defibrillators cannot meet networking expectations |
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The NIHON KOHDEN CardioLife TEC-8300K series Defibrillators was intended as an advanced model incorporating a high-acuity patient monitor into the bi-phasic defibrillators. The more common defibrillator design like the CardioLife TEC-5600 series defibrillators are only equipped with a low-acuity patient monitor.
Launched in August 2011, the high-acuity Monitor in the defibrillator must have a network capability comparable to any high-acuity patient monitor in the hospital, with the ability to connect to a Central Nurse Station, the ability to upload to a ECG Data management server for 12-lead ECG reports of the monitored patient etc. This is typically realized through Ethernet LAN networking capability on the patient monitor.
Launched in August 2011, the high-acuity Monitor in the defibrillator must have a network capability comparable to any high-acuity patient monitor in the hospital, with the ability to connect to a Central Nurse Station, the ability to upload to a ECG Data management server for 12-lead ECG reports of the monitored patient etc. This is typically realized through Ethernet LAN networking capability on the patient monitor.
We were puzzled to find the TEC-8300 series defibrillators does not even have an Ethernet LAN output.
This clearly meant it does not connect to a monitoring Central Nurse Station
or send 12-lead ECG Reports to a ECG Data Management Server while still in the hospital, so how are they going to do it from outside of the hospital? This is important missing specification and we wondered how this product could meet the needs of the export markets?
It is clear again this can only be accepted in the domestic market in Japan, which is protectively-insulated from international high-tech competition, and where the bargaining power of buyers is poor.
Do you notice the defibrillators are sending back 12-lead ECG reports in a technically crude way? |
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The 12-lead ECG files of TEC-8300 are similar to that from the CardioLife TEC-7600 series and CardioLife TEC-7700 series; these files can be viewed on a PC using a proprietary viewer software from the manufacturer.
It is surprising to note the CardioLife TEC-8300 series defibrillators does not have the
technology to send the 12-lead ECG report files directly from the
defibrillator to the Internet!
To send 12-lead ECG Reports back to the hospital, the TEC-8300 series must
first transfer them via Bluetooth to a third-party device (such as a
mobile phone). The transferred electronic file is then manually sent out as email attachment using the third party device. This is too amateurish for any salesman to confidently present the product to a knowledgeable audience.
A highly simplistic way of sending electronic 12-lead ECG report files back to the hospital |
Over at
the hospital receiving end, an exclusive mail server for the sole purpose of receiving the attachments must be set up; a PC/ laptop installed with the proprietary viewer software and QP-832VK TECLink software can access the mail server to retrieve and view the attachments. In appearance it looks
like something similar to other manufacturers but in essence the structure is actually primitive and simplistic.
In the absence of technology to send 12-lead ECG reports directly from the defibrillators, one purchasing evaluation committee in Singapore (who had rejected the product) suggested in jest product improvement of just equipping the defibrillators with simple built-in fax capability allowing a hospital to receive the reports using a fax machine.
In the absence of technology to send 12-lead ECG reports directly from the defibrillators, one purchasing evaluation committee in Singapore (who had rejected the product) suggested in jest product improvement of just equipping the defibrillators with simple built-in fax capability allowing a hospital to receive the reports using a fax machine.
We know advanced defibrillators should behave like other high-acuity bedside monitors in the hospital |
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The below image shows a competing Philips HeartStart MRx with a Central Nurse Station; the HeartStart MRx was launched almost eight years before the CardioLife TEC-8300 series defibrillators.
The HeartStart MRx can be monitored as a bedside monitor on the ICU Central Nurse Station while inside the hospital, as well as when outside of the hospital. Similarly, the 12-lead ECG reports can also be uploaded to the ECG Data Management Server from the defibrillator when it is inside or outside of the hospital.
The HeartStart MRx can be monitored as a bedside monitor on the ICU Central Nurse Station while inside the hospital, as well as when outside of the hospital. Similarly, the 12-lead ECG reports can also be uploaded to the ECG Data Management Server from the defibrillator when it is inside or outside of the hospital.
A competing Philips HeartStart MRx could be linked to IntelliVue Information Center (Central Station) like any bedside monitor inside the hospital |
Advanced defibrillators should have continued monitoring connectivity even when outside of the hospital |
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When an advanced defibrillator is outside in the field, it is expected to continue the network link (using the internet)
with the hospital, similar to the way real-time stock/ Forex prices are communicated. Such network link allows remote real-time monitoring by hospital physicians to make preliminary diagnosis and care decisions while patient is en route to hospital; this important capability will save valuable time if the patient needs immediate surgery or transfer to another hospital with more appropriate Specialists and facilities.
Remote real-time monitoring en route to hospitals is expected as standard for the TEC-8300 series defibrillators |
Is there a good reason the CardioLife TEC-8300 series defibrillators choose to share connector
sockets for monitoring mainstream CO2, IBP and Temperature? |
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Why share connector sockets? |
It is claimed that a monitor sharing connector sockets has high flexibility amounting to modular capability; is this true? So far, it remains an assertion and the manufacturer does not provide supporting evidence to back it up.
The yellow adapting MULTI sockets are part of a legacy circuit known as a Multi-parameter Unit; there are concessions in exchange for using it, but this is not explained to the market and easily lead customers into having an unrealistic expectation of what the yellow MULTI sockets can actually deliver.
The Multi-parameter Unit was originally devised only to solve a product issue |
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In the 1990s, when developing the first digital modular monitor, the
development team encountered a problem of insufficient front panel space for connector sockets on the first digital multi-parameter module being made. A few sockets were specially adjusted for time-sharing use by a group of five types internal analog hardware to overcome the space limitation; to differentiate them, they were colored yellow and known as MULTI sockets.
At the time NIHON KOHDEN was responding
to an important emerging trend of using a high-density digital
multi-parameter module as basic building block for modular monitors |
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In
analog modular monitors, only single parameter modules were produced by
NIHON KOHDEN. When designing the first digital modular monitor, the
company discovered the critical care market had already moved to using a
digital multi-parameter module with higher density of electronic
components as a
basic building block for modular monitors.
Apart from the higher electronic density, the difference between a
single parameter module and a multi-parameter module is the presence of a
CPU processor in the latter; the output of a multi-parameter
module is thus processed digital data. This new development of
distributed processing made it possible for patient data to be stored and moved with the module.
Digital modules can also be connected directly to a (proprietary)
digital data-exchange network as a node.
Responding to new
trend in the 1990s using multi-parameter module as a basic building block for modular monitors |
Even occupying a 3-slot width of the module rack, the Saturn multi-parameter module (August 1998) was not big enough to hold all necessary connector sockets |
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Nihon Kohden intended a module rack integrated physically with the
main unit to form a limited footprint just big enough to stack the display monitor on top of it (see below illustration). The
physical size of the Saturn module was therefore constrained; in addition, the multi-parameter module must work in
combination with
other parameter modules like recorder, sidestream CO2, BIS, EEG, Flow/
PAW, SvO2 in the module rack.
The Saturn module was intended to be physically small in size |
The elegant but expensive solution from NIHON KOHDEN for the physical size limitation of the Saturn module was to adjust two of the connector sockets for sharing use |
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Two yellow MULTI sockets had to be adjusted for time-sharing use because there was not enough free space on the Saturn module for more sockets |
There are two blocks of patient monitoring hardware in the Saturn module.
(PART A) The hardware using dedicated connector sockets:
- ECG
- SpO2
- NIBP
(PART B) The hardware sharing the two yellow adapting MULTI sockets in a separate Multi-parameter Unit:
- 2-ch IBP (2 MULTI sockets = 2-ch IBP)
- 4-ch Temperature (2 MULTI sockets = 4-ch TEMP)
- Cardiac Output
- FiO2
- Thermistor Respiration
The adapting MULTI sockets were additionally allowed to be diverted to act as a costly digital serial ports