CYANOKIT from Bound Tree Medical
When you think of cyanide, it may conjure up bad images-possibly a movie scene where a soon-to-be-interrogated spy slips a hidden capsule into his mouth, bites down and is dead in the blink of an eye. The reality is that cyanide has legitimate uses in both industry and technology, and we use close to two billion pounds in the U.S. annually. But irrespective of the source, when cyanide enters the human body, it can have devastating or fatal effects.
While an industrial accident involving cyanide is a possibility, the most likely reason EMS would see a cyanide exposure would be a house fire. Many items found in your average home, from foam insulation to flooring products to nylon or rayon materials, are petroleum-based. When burned, these products generate cyanide as a product of incomplete combustion. For years, we have focused mainly on carbon monoxide (CO) as a major fire issue, and indeed it is. However, studies have shown that a significant number of CO fatalities have toxic cyanide levels as well.
In the past, treatment for an actual or suspected cyanide poisoning was complicated and time-consuming. Three separate medications had to be given in a specific order to victims. Unfortunately, the meds' mechanism of action also produced methemoglobin. When this is combined with carboxyhemoglobin, you get a patient with significantly decreased oxygen-carrying capability who can quickly become hypoxic, ischemic, anoxic and dead.
The CYANOKIT from Bound Tree Medical takes a revolutionary approach to managing cyanide poisoning. It uses an IV infusion of five grams of hydroxocobalamin, which is actually vitamin B12a. Though safely used in Europe for more than 10 years, it was only recently approved for use in the U.S. Because this drug does not produce the methemoglobin side effect, it is a far safer intervention. In fact, hydroxocobalamin is safe enough to be used on a suspected cyanide poisoning, as its mechanism of action won't make the patient sicker.
The CYANOKIT is a quantum leap in care for suspected and known cases of cyanide poisoning.
For more: www.boundtree.com; 800/533-0523.
SwiftGrip Rapid Intubation System from Dreamwest Innovations
A previous top pick in 2006, the SwiftGrip Rapid Intubation System (RIS) returns to the Top 20 for 2007, thanks to continued refinement of this already innovative product.
The new and improved SwiftGrip system has been modified to include angled and slightly larger posts for securing the head strap, making it more ergonomically friendly. While I felt the original design performed well and secured quickly, by angling the posts and increasing their size, it now seems much easier to use and even more secure. Another nice addition is the inclusion of a C-clamp that will fit sizes 14–18-Fr orogastric tubes.
Should you misplace the SwiftGrip securing device on the ET tube, the RIS now features tabs to allow for quicker unlocking and repositioning, saving valuable seconds in those critical airway moments when the last thing you need is to be fiddling around with a misplaced securing device. In addition, this version of the SwiftGrip features larger safety flanges for better security. Last but not least, the RIS comes with everything preattached in the following sizes: 6.5, 7.0, 7.5 and 8.0. The stylet is already in place, and the syringe is attached, as is the SwiftGrip securing device. With all the components preassembled in one package, it's just a matter of opening the bag, dropping the tube and getting on with patient care.
For more: www.swiftgrip.com; 800/370-8727.
LBS Jr. from Ferno
Hardly a week goes by that you don't read an article or hear a report about Americans getting larger. Whether it's our poor dietary choices, sedentary lifestyle or aversion to hitting the gym, our collective girth is increasing. EMS providers should take particular note of this, since we are the ones who carry these folks up and down stairs.