Focusing on patient safety

Martin Flugrettung, a pioneer in Austrian air rescue, has set a new standard in pre-hospital care with the introduction of cosinuss°’s innovative patient monitoring solution in December 2023. One year after integrating the c-med° alpha in-ear sensor and the cosinuss° Health app into its medical equipment, it is clear to see how this technology significantly improves the safety and well-being of patients and supports air rescuers in their demanding work.

Martin Flugrettung has been a reliable partner in air rescue for over 20 years. With eight locations in Austria – in Salzburg, Tyrol, Lower Austria and Upper Austria – the teams complete over 4,000 missions every year to provide rapid and professional assistance to people in need. From first aid at the scene of an accident to rapid transportation to hospital, they help to shorten the healing process and save lives. The cosinuss° technology is used at all bases.

The cosinuss° monitoring technology, consisting of the in-ear sensor c-med° alpha and the mobile app cosinuss° Health, offers an innovative and compact solution for patient monitoring in preclinical settings. The sensor records pulse rate, oxygen saturation and body temperature in the patient’s ear canal, supplemented by the additional data perfusion and quality index. Thanks to the additional display of the PPG signal, further information can be provided and precise monitoring can be carried out. With a weight of only 6.5 g, a size of 4.5 cm and wireless Bluetooth transmission, the c-med° alpha can be taken anywhere.

The new patient monitoring technology has been put through its paces in numerous studies and pilot projects and compared with the state of the art. With success. A recent study published in the Scientific Reports of the Nature Journal Group, for example, showed how well the in-ear temperature during deep hypothermia, as used in cardiac surgery, matches the gold standard. This underlines the precision and versatility of the sensor, even under extreme medical conditions.

In addition to Martin Flugrettung, the technology is now also used by several mountain rescue organizations and special rescue teams in Europe (see references).

In addition, the system has also been successfully and reliably used in the highly frequented Oktoberfest Clinic with up to 7,000 patients a year to monitor the patients being transported and treated there.

“The use of the mini sensor is particularly helpful in emergency environments where we have difficulty getting to the patient or don’t want to undress them,” says Dr. Boris Buck, Medical Director of Martin Flugrettung. “It helps us enormously in terms of tactics and management, especially in mountain rescue operations, and we can no longer imagine our monitoring concept without it. Especially when large monitoring devices cannot be used, the c-med° alpha still allows us to monitor patients safely and effectively during the rescue,” continues Dr. Boris Buck.

Daily use has also shown that, particularly in the case of shock and hypothermia, vital parameters can still be derived as signals that other devices no longer display.

In certain situations, it is not possible to reliably measure vital signs with a conventional finger clip, for example when fingers are cold or trembling. “This also applies when patients are in shock,” explains PD Dr. med. Roman Schniepp, neurologist at the LMU Munich Hospital and emergency physician at Martin Flugrettung. The in-ear sensor from cosinuss° offers a reliable alternative here. Especially for patients with lung diseases or lung trauma, such as a pneumothorax (partial collapse of the lung), this new technology enables precise recording of vital signs. As a result, pneumothoraces can be detected more frequently and more quickly. This knowledge allows important decisions to be made, such as adjusting the flight route and the lowest possible altitude, in order to prevent further damage to the lungs and increase patient safety.

Avalanche rescue is a race against time. Once the buried victim’s head has been uncovered, the body temperature must be continuously recorded as quickly as possible. This is because, in addition to the time spent in the snow and the ECG values, body temperature is the decisive parameter in avalanche rescue. This is where the emergency doctors see an important contribution of the new technology, as compared to the state of the art, the esophageal probe, the ear sensor can also be inserted into the ear of the casualty by a layperson, so that continuous body temperature monitoring can begin before a person with emergency expertise arrives or can take place more quickly.

Thanks to the c-med° alpha, the all-important determination of the destination hospital for the best possible further medical treatment (normal clinic or specialist hospital specializing in hypothermic patients (ECMO option)) can be made with greater certainty for the benefit of the patient.

These may be the crucial minutes that save a buried patient’s life. In addition, the ear sensors in the ear canal also ensure that oxygen saturation, pulse rate and pulse curve are monitored – parameters that could not otherwise be recorded.

When rescuing in difficult terrain, early recognition of a patient’s cooling is very important for their safety. Hypothermia not only leads to a significantly increased, life-threatening stress level in the patient, but can also lead to more severe bleeding and a poorer outcome in polytraumatized patients. For this reason, hypothermia must be recognized and counteracted at an early stage. In daily practice, however, it is not possible to continuously record body temperature because the necessary esophageal probe cannot be inserted in awake patients. The doctors at Martin Flugrettung have also discovered the importance of the ear sensor in these scenarios and are very pleased to be able to further improve patient safety with its help.

The cosinuss° monitoring system also offers decisive advantages in technical rescue operations. It enables continuous monitoring of vital signs throughout the entire rescue process. Thanks to its compact and lightweight design, first responders do not need to transport bulky equipment and can monitor wirelessly. This means that valuable medical data is available even before other equipment or medical personnel arrive, enabling faster and more targeted patient care.

The use of cosinuss° technology at Martin Air Rescue to date has provided valuable insights that have contributed to the further development of the system. While the cosinuss° solution is not always necessary in scenarios with conventional patient monitors, it proves its strengths particularly in challenging terrain, during avalanche rescues or when treating hypothermic patients. cosinuss° would like to further expand these advantages in order to provide rescuers with the best possible support.
Feedback from the teams has also shown that additional vital parameters, such as blood pressure or ECG, could be a useful addition in order to obtain even more comprehensive information about the patient’s condition. For this reason, further development at cosinuss° will also move in this direction.

The cosinuss° technology has proven itself over the course of a year at Martin Air Rescue as an innovative addition to patient monitoring and care. It offers reliable monitoring even under extreme conditions and closes crucial gaps in pre-hospital care. It therefore increases patient safety and makes the work of rescuers significantly easier.

Photo credits: Gerrit Schweiger, cosinuss°