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Ask Appropriate Questions When Shopping For Monitor

Putting in the necessary work is a must-do when it comes to selecting the correct patient monitor.

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Choosing the right patient monitor for your veterinary practice can be a daunting task, but the keys are determining what’s right for your needs, doing your homework, and asking a lot of questions before signing on the dotted line, say industry experts.

Here are some things to keep in mind while shopping.

Determine Parameters

Are you looking for something to monitor just blood pressure or something that measures multi-parameters?

The American Animal Hospital Association and the American College of Veterinary Anesthesiologists recommend monitoring blood pressure, ECG/HR, CO2 and SpO2 (blood oxygen saturation). It’s also a good idea to check out your state’s Veterinary Medical Association guidelines.

 The more parameters, the higher the cost, and one of the most expensive parameters to monitor is the end-title CO2 (ETCO2), which measures the amount of carbon dioxide exhaled by the animal, said Dan Kozisek, customer service director of Bionet of Tustin, Calif.

“In the past, they’d have to buy a unit with [ETCO2] included, and that would’ve added $3,000 to $4,000 to the price,” he said.

 A relatively recent advancement is a monitor that is “ETCO2 ready,” making it easy for practitioners to start with a few of the basic parameters and simply purchase a plug-and-play probe when they decide to add on ETCO2.
Just as critical is having a system set up to alert you when there’s trouble, or the situation has potential for trouble, Kozisek stressed.

“Any monitor worth its salt allows you to customize your normal ranges as well as triggering an alarm when the parameters fall outside of the range. It if falls below ‘X,’ you want it to scream bloody murder,” he said.

Or say a probe falls off during surgery. “You want to be able to determine whether or not you need to jump on [the problem] now or just turn to your assistant and say, ‘Fix that probe.’ ”

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Get Customer Support

This is a big purchase. Multi-parameter monitors can range from $3,500 up to $9,000 or more, depending on the number of parameters, so it’s important to find out upfront what type of customer and technical support comes with the purchase. Who will service the monitor if a problem happens? Will it be sent overseas? Can you “test-drive” a demo unit before buying? How long is the warranty?

“After-sales support and the quality of the customer service is pretty darn important,” said CEO Paul Ulbrich of VMED Technology of Mill Creek, Wash.
In the event of a problem, you should be able to communicate your questions. Most companies offer a free trial period or an unconditional return guarantee to make sure you can get your money back if you’re not satisfied, Ulbrich said.

“These things are expensive pieces of equipment and I would approach it the same way I would approach buying an expensive piece of consumer electronics,” Kozisek said. “Does it have a decent warranty?” A warranty shorter than four years is inadequate, in Kozisek’s view.

Do Your Homework

Check out the company and its reputation. If a company and its products have a good (or bad) reputation, others will know about it. Make sure the monitor is designed specifically for the veterinary market, not the human market. Most U.S. companies produce validated vet products, but a good place to check is the Veterinary Information Network—VIN.com—where member veterinarians can exchange information and opinions.

When shopping, ask for tangible proof about the monitor’s parameters. Where was it studied? Ask for a hard copy of any documentation, white papers or referrals from other veterinarians to verify the monitor’s accuracy.

“One of the challenges that vets face is that there are no regulatory requirements,” said Andrew W. Schultz Jr., director of Monitoring and Critical Care for Midmark Animal Health of Tampa, Fla. “That can be a blessing and curse.”

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“It’s really the Wild West,” added Greg Piehl, president of DVM Solutions of San Antonio. “Anybody can bring a $1,000 monitor to market, rip off the tag and tell you it’s designed for an application that it’s not designed for. You really want to make sure and get it in writing.”

Wired or Wireless?

A wireless monitor does away with the morass of tubes and wires often known as the “spaghetti syndrome” by offering omni-directional radiotransmission of up to 100 yards.

It sends real-time information to a computer screen during surgery, and the signal can travel through metal cages, walls and around corners.

And because the monitor is digital, all the files are stored in the computer—for practitioners who are trying to go paperless.

But skeptics argue that the results can be fatal if the transmission is lost.

“If the intent is to merely send the data that’s stored in the monitor’s memory for permanent recordkeeping, that’s a good use,” Schultz says. “But if you are in the middle of surgery and you have ‘dropout’ and all of your waveform and data flat-lines because of dropout, then you’re flying blind during surgery. To me, it’s risky.”

But that scenario, says Piehl, of DVM Solutions, “has never been an issue."

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