A new Beginning..., page-237

I have practiced in ER's for many years.

You cannot predict or stop the machine that is ER.

ER is not a lab or board committee room.

ER stands for EMERGENCY room.
It is where emergencies are treated to save lives.

Unless you have worked in the ER, it cannot be described. ER staff are angels. No one can no unless you have experienced the pressure that clinical staff are under 24 hours a day, the accidents the trauma, the loss of life, grieving parents, the screams of pain, the screaming of distressed children, seeing children die, seeing adults die, decisions staff make every minute could mean some one dies, shift work, unpredictable events, disaster planning, more patients arriving than can be processed, patients lining up to be seen, pressure from management to get patients through as quickly and cost effective as possible, nurses and Drs and all staff working week ends because they are rostered on to duty not by choice, every day it is difficult to even imaging what it is like.

The pressure in ER does not stop even when a patient thinks they have experienced ER on a trolley for a day and say gee the Drs and nurses do a great job but my meal was cold and they forgot I have tea not coffee. Don't they read the menu I filled out?

Delaying treatment in emergency cases can mean a child dies.

ER is named ER for a reason.

You can work within the ER and there are things that can be done to achieve the Resapp recording environment required.

Resapp cough sound collection needs to be done asap upon presentation and before treatment. This is the biggest challenge.

When a child has been though senior nurse triage or has arrived by ambulance with respiratory distress accompanied by panicking parents nat the ER it is urgent to treat the child asap.

Challenge , the RAP team need to go through the questions and signing of research permission and have treating team on side so as to do cough recording before admisitering treatment. This alone would be distressing for parents wanting immediate treatment of their child. It is challenging.

The challenge the RAP team had last time was getting the cough sound before the treating Drs give any treatment and all the common sense noise issues in a busy ER that were not addressed by the RAP team.

The other challenge is assuming Drs and treating Staff have common sense in relation to making the surrounding environment as quiet as possible to do a clinical recording of a cough sound. That common sense issue is said to be addressed with new instructions on the app. Common sense hopes the nurse reads the instructions on the app.

Having first access before treatment, clear directions how to collect sample, pre back ground noise checks, and minimal sounds from all in the collection area is what is needed.

Common sense can go out the window with panic and urgency to save a childs life.

It will be cooperation between the hospital treating team and the RAP collecting team that is the most important goal to calming parents and then the following Resapp recording protocols.

Brian says Resapp has a more robust algorithm to rule out common noise in the environment from interfering with cough sound identification, there are stronger protocols in place for staff to follow, symptoms of fever, physical observations are made, instructions on the app of what and how to do it, there are pre sound checks before recording cough, and every cough sound recording will be checked within a few days throughout the trial.

To me all of the above are common sense issues when making any kind of recording.

I believe that when the new protocols are followed Resapp and cooperation from treating team happens, and common sense per-veils, then Resapp has a good chance at producing great results.

GLTA
MB