The 2010 EMS World Expo took us to the Lone Star State of Texas, with Dallas being our host city. Attendees had the opportunity to sit in on some great continuing education classes, as well as make their way through a virtual sea of vendors and manufacturers who were showcasing the latest and greatest tools of our trade. Read on to find my top 20 product picks and innovations from this year's Expo.
Cardiac STATus from AllMed
In the world of emergency cardiac care and management of myocardial infarction, the battle cry "time is muscle" remains true. Reducing the time from onset of symptoms until the patient gets definitive care, be that administration of thrombolytics, a trip to the cath lab or even surgery for a CABG, remains the primary goal.
While most EMS systems have stepped up to the plate with the use of STEMI (ST segment elevation myocardial infarction) protocols, there remain the challenges of identification and proper routing for the more elusive non-STEMI patients. For these patients who are actually having an MI, but who present with a non-diagnostic EKG, the diagnostic decision is based on blood tests to identify the three rapid cardiac markers: troponin I, CK-MB and myoglobin.
You can now quickly and inexpensively test for these three cardiac markers in the field setting with the Cardiac STATus from AllMed. It's a simple, three-step procedure that provides you with actionable results at the point of care in just 15 minutes. There is no separate instrument or capital expenditure required, as the Cardiac STATus is a single-use, disposable device. No daily quality control or calibration are required either, as controls are on-board already. The Cardiac STATus can be stored at room temperature until ready to use. Simply dispense blood into the unit, wait 15 minutes and read the results.
From a clinical perspective, the Cardiac STATus allows you to confidently transfer the patient to an appropriate care pathway. Financially, you can effectively work through reimbursement and improved resource utilization issues; operationally, you get enhanced ED throughput and bed utilization. It's a true trifecta of MI management in a small, single-use, disposable device.
Give your NSTEMI patients the best technology has to offer with the Cardiac STATus from AllMed.
Without question, airway management is one of the most essential elements of quality prehospital care. What makes airway management particularly challenging is that it is a combination of assessment interwoven with management. As you are continually evaluating airway patency, breathing mechanics and gas exchange, you must periodically intervene to assure your patient is breathing adequately. Examples of interventions include administering a breathing treatment, assisting ventilations or intubating patients.
When your patient is no longer breathing and you must pass an ET tube and then breathe for the patient, there is little room for error. That raises the question of how a provider develops these critical skills, especially with the difficulty of obtaining meaningful clinical experience.
Because of those difficulties in the clinical setting, the next logical choice is to utilize manikins and simulators to provide the training experience. If you are considering using a manikin for this type of training, your first choice should be the Ambu Airway SmartMan from Ambu.
What really puts the Ambu Airway SmartMan in a league of its own is a short list of three. First is ease of operation. Like any computer-driven device, there is a learning curve associated with both hardware and software, but the Ambu Airway SmartMan has user-friendly software and intuitive controls.
The second item on the short list is immediate visual color feedback. Students can see on a linear screen exactly where errors occurred, e.g., missed or inadequate ventilations, took too long to intubate, etc. With intubation training, you get real-time feedback on whether the device is correctly placed, how long placement took, and if there is an effective seal.
Rounding out the short list are the data capture and management capabilities. On the top end, you can do live archiving of testing and training results to a secured server and access the archived data either directly or remotely for evaluation and management whenever you wish. Do comparative analysis of data by skill, date and time, test type, scores or other skill parameters.
The Airway SmartMan is an outstanding training tool for teaching and honing both airway management and CPR skills. Use it as intended and your airway management and CPR skills will improve.
Every time another type of hepatitis is identified, I cringe. It sure seems to me that the world of nasty and infectious things keeps growing, and, in some cases, is becoming much more resilient and harder to manage. With those unpleasantries fresh in your thoughts, I believe it is both wise and prudent to make absolutely certain you protect yourself as well as you can out there in EMSland. One simple and wise way to do that would be with ViralClyns from Clyns.
The ViralClyns is a NIOSH-certified N95 respirator that stands alone as a flat-fold respirator with the comfortable fit and breathability of a face mask. It is also infused with the EPA-registered antimicrobial Safe Life that is added to the ViralClyns to give you an additional layer of protection.
You get two sizes to choose from, and the adjustable nose piece helps ensure an effective seal. The soft inner layer does double duty, providing excellent comfort and wearability, along with contributing to the quality of the seal.
When you slap on a ViralClyns, you get effective protection against all types of microorganisms, including bacteria, viruses, fungi, bacterial spores and protozoa. That translates in the real world to the following applications where you may find yourself tossing on a ViralClyns: protection during the cold/flu season, the ongoing war on MRSA, at crime and accident scenes, during pandemics/epidemics, during body pick-ups, when responding to biological threats, or during a disaster response.
The ViralClyns folds flat for easy storage and comes individually packaged at a very affordable price. Breathe easier and safer with protection from the ViralClyns.
One could pretty much say that an ambulance is an ambulance is an ambulance, until you see the Mirage EX Sprinter from Demers. It's a type II rig with a unique aerodynamic front cab riser and rear spoiler engineered to match the Mercedes Sprinter design. Coupled with all-incorporated LED warning lights, you get increased safety and fuel cost savings up to 12%!
There's a stack of innovative design features that are truly what I would call provider-friendly. The Demers exclusive Heads-Up Console (HUC) provides easy access to ambulance features while allowing the vehicle operator to keep his eyes on the road for greater safety. Add to that a whopping 75" high roof, which gives most providers the ability to walk upright rather than in a semi-hunched-over Quasimodo shuffle. Last but not least on the provider-friendly list, glove storage is overhead above the bench seat for quick, easy access.
The cabinetry is well thought out design-wise, and is exceptionally well-crafted from lightweight materials that combine Demers' exclusive "Interlock" rounded aluminum extrusion with modular fiberglass cabinet inserts. The molded inserts are seamless, making them super-easy to clean. Shatter-proof Lexan doors and aluminum panels work to make a safer work environment while still delivering a tough, long-lasting product.
There are also some things not visible to the naked eye that are real value adds. The Demers Management Electronic System Multiplex (DEMS) comes standard and allows incredible flexibility to easily customize the vehicle's electronic functions to agency-specific needs. Diagnostics and maintenance can be done remotely. Rather than making a costly run to the dealership, your shop can plug in directly to the Demers plant by computer for diagnostics.
Bringing it home is the best-in-class payload capacity at 2,000 lbs., with plenty of space for storage. If your agency is in the market for a new rig, it would be a crime to not take a look at the Demers Mirage EX Sprinter unit. It's a dandy!
As the EMS industry continues to move into using tablet PCs for patient care documentation and other needs, the quest for a device that will stand up to the rigors of EMS field work goes on.
Well, folks, that quest may be over as DRS Technologies brings its 10th generation tablet PC, the ARMOR X10gx, to the market. Simply put, this machine is a workhorse that combines two of the most desirable qualities required to survive and flourish in EMS: durability and reliability.
When the sales rep told me the ARMOR X10gx could survive a 4-foot drop, I said, "Then drop it." Without a moment's hesitation, he did just that. After a 4-foot drop to the floor, he picked it up, and the 32-gig solid state drive was still running just fine. To speak further to the tough functionality of this device, how about this: It is a totally sealed unit that will withstand up to 30 minutes under water, since it is both MIL-STD-810G- and IP67-certified.
Inside this bad boy, along with the solid state hard drive and the Intel Core2 Duo processing, is incredible connectivity like Gobi 2000 mobile broadband, wifi 802.11n, RF switching, Bluetooth wireless and integrated GPS. In addition, the ARMOR X10gx features customer-accessible FlexSpace, an open-source bay that supports a wide range of third-party functions, allowing customization and upgradeability through expanded I/O ports. Another great feature is the dual lithium-ion battery pack design that allows a hot battery swap without requiring a machine shutdown.
Along with the drop-shock and moisture test, the ARMOR X10gx is tested for vibration resistance, temperature and dust, giving you the confidence you need to do your job in the often extreme conditions encountered in the field. This is 4.7 lbs. of pure performance, with a10.4-inch high-visibility LCD display. What's not to like?
Every conscientious EMS provider knows the importance of gloving up and frequent hand-washing for every call. Compliance with mask use for breathing protection continues to rise, yet one area that is seriously lacking is eye protection. One inopportune splash of blood or drop of spit into an EMS provider's eyes and all other BSI/universal precautions are for naught.
You can now close that last point of entry with the Crossbow 2X eyeshield from ESS, which features a number of groundbreaking technological advances. It is the first eyeshield to be developed with two unique lens coatings. Thanks to ESS ToughZone lens treatment, the outer lens surface resists scratching, while the inner lens surface is independently treated with a hydrophilic coating. This allows the inner lens to become virtually impervious to fogging caused by ambient environmental conditions or perspiration.
Additional features making the Crossbow 2X a Top Innovation for 2010 include the interchangeable lens system that allows for simple lens replacement if a lens gets damaged versus replacing the entire frame, and the ESS Tri-Tech Fit, a remarkable universal fit that is comfortable for all-day use, as proven by the widespread use of this product by the U.S. military. The Crossbow 2X is also compatible with ESS's new U-Rx corrective lens inserts for folks who already wear glasses.
To flesh out the impressive performance characteristics of the Crossbow 2X, ESS uses the highest grade polycarbonates manufactured to ESSOPTICS standards, which in turn guarantees outstanding optic qualities. It also provides military-grade ballistic protection, compliant with OSHA, ANSI Z-87.1+ and US MIL-PRF-31013 specifications. The basic Crossbow 2X EMS package features two complete eyeshields: one with clear lenses and one with smoke gray lens, both providing 100% UVA/UVB protection. All that is left to say is wow!
It is increasingly apparent that we, like the rest of the world, will be dealing with the issue of terrorism well into the foreseeable future. However, with that bad news comes the good news that we have increasing opportunities to work with our counterparts in the military, who, without question, drive most advances in trauma care. We can clearly benefit from their knowledge and technology advances, as will our patients if a combined military/civilian response is required for a large-scale casualty event.
An excellent example of a device with both military and civilian application is the Chameleon patient care movement system from EMSled. The Chameleon is a lightweight, collapsible mission adaptable rescue system (MARS) that allows multiple options for remote or rugged terrain use, as well as use on a paved street or sidewalk. This is due to its modular, configurable design features, providing a multi-role platform that allows a single rescuer to move a patient with limited fatigue.
The base unit weighs only 16 lbs. due to its construction from TIG welded, high-quality aluminum. It folds to a neat 26" x 18" x 5" for easy storage and transportability. All configurations utilize and attach to this basic unit. Add wheels, a foot stop, a front fold-away stand and a rapid extrication handle, and you have rapid extraction capabilities in a device that is easily maneuvered over snow, ice, sand... pretty much whatever. With a quick part change, you can connect it to a bicycle, greatly expanding the capabilities of bike medic teams when deployed to large public events. Another conversion allows you to add two wheels and use the Chameleon for transporting medical or rescue gear, or any cargo you might need to pack in or out from a scene.
If that's not enough, the Chameleon allows for spinal immobilization and is hoistable in either vertical or horizontal configurations. Bottom line, the Chameleon is an incredible combination of brilliant engineering and top-of-the-line craftsmanship. In my opinion, it is the most versatile piece of rescue equipment of its type I've ever seen.
EVS is clearly on a mission to do its part in making work in the back of an ambulance safer. Since 1993, EVS Ltd. has created more safety seating products than anyone else in the EMS industry. Their unswerving commitment to invest in research and development and dynamic testing of their seating products has led them to introduce a remarkable product: the Mobility 1 Tracking System.
The Mobility 1 Tracking System starts with a state-of-the-art EVS seat, which is mounted on either a 48" or 36" track made of stainless steel or with a nickel finish. Both are easily cleaned of mud, blood and beer. Depending on need, the seat can be locked in 4" increments at any point on the track. The seat also features a new 8-position swivel base. Coupled together, you have 4 feet of right-to-left motion and the option of any of 8 points of pivot, giving you excellent access to equipment and your patient while remaining secured in a seated position. Even with the incredible versatility that the seat provides, there are some limitations for movement, most of which can be addressed by adding the optional EVS High-Mobility Restraint (HMR) System.
With the addition of the HMR System, you can stand and move around while wearing the safety harness, as it allows the straps to feed out. When the task has been completed, you can sit down and resecure in a matter of seconds.
As the EMS industry makes strides to create a safer work environment in the back of an ambulance, EVS is leading the way with its pioneering work as manifested in the Mobility 1 Tracking System. It is impressive, to say the least.
You only need to spend about 20 minutes strapped to a rigid spineboard before your lower back starts to ache. Shortly thereafter, you start hurting on the points of suspension: the occiput, scapular ridges, buttocks and heels. It is no real secret that you can wipe out that entire list of negative patient moments by simply dumping the rigid spineboard in favor of a vacuum mattress. Vacuum mattress technology has been available for over 20 years, but one of the real barriers to its widespread use in our country has been cost. You can usually buy three or four spineboards for the cost of a typical vacuum mattress, and stocking several rigs while keeping enough stash to cover for the mattresses left behind at the hospital made the costs prohibitive enough to drive some folks away. Sure, the provider agency saved some money, but the trade-off in comfort for those unfortunate patients who found themselves strapped to a rigid spineboard was no bargain. That does raise the question, what is the price of misery?
Thanks to those innovative minds at Hartwell Medical who brought the FASPLINT to the market, now, for the first time, you can add the word "affordable" to the vacuum mattress!
The FASPLINT is a lightweight (<5 lbs.), narrow-profile vacuum mattress with a semi-rigid stiffener that allows the splint to be configured for space-saving storage. You can easily form the FASPLINT under the patient's knees as it is being vacuumed out, which is arguably the single most important thing you can do to prevent lower back pain in patients requiring spinal motion restriction.
The FASPLINT combines great design and function with an incredibly budget-friendly price, while still delivering the same Hartwell Medical quality you've come to expect.
Most EMS providers view paperwork and documentation requirements as the EMS workplace equivalent of having a root canal. Like it or not, accurate documentation remains the foundation for getting accurate and timely cost recovery, providing an accurate medical record of care rendered in the prehospital setting, and for defense efforts in the case of litigation.
Let me tell you, documentation will never be the same, especially relative to the pursuit of almost paperless documentation, thanks to the SyncPen from emsCharts.
The SyncPen is a revolutionary new device that uses a handwritten form as a medium for electronic data collection. As you fill in the various sections of the patient care report, the SyncPen takes digital photographs, identifies the section where you are writing and then interprets each item as a data point that gets imported into emsCharts. Every snapshot, an amazing 75 frames per second, contains sufficient data to determine the exact location of the pen tip and what it is writing or drawing, including the time each pen stroke was made, where, and on which form it was written. You can store up to 50 full A4/letter-size pages of handwritten data before it is seamlessly imported into a secured emsCharts server.
The SyncPen is clearly an example of low-tech meets high-tech, resulting in an outstanding product. Because all of the data points are captured as you fill out the paper PCR, you can leave the original form at the hospital and download the data back at quarters for further analysis or reporting needs. No redundant data entry is required.
Despite its remarkable capabilities, there is virtually no real training required; a couple of minutes at best. Pick it up, write and sync! Sweeeeet!
Every time I think about the concept of a compact disc recording, it still makes my head hurt. What in the world made someone think "What if I took music, converted it into math, then used a tiny, intense red light to burn that math onto a spinning plastic disc? And then I could use that same red light, but it doesn't burn it this time--it just reads the math and converts it back into music." Unbelievable technology, I tell you, un-be-lievable.
While we are on the topic of technology, let's talk about the Invisible Bracelet (iB): a great use of technology resulting in a new standard in emergency response adopted by the American Ambulance Association. Here's the way the Invisible Bracelet concept works: Members in the Invisible Bracelet (iB) group carry iB identifiers with unique eight-digit PIN codes that allow any EMS responder to access important health information and notify In Case of Emergency (ICE) contacts during any emergency event. The enhanced medic network includes communities where local EMS providers are licensed and trained to use the Invisible Bracelet. Medics use their user name and password to log in to the iB search engine for read-only access to the patient's information. If medical transport is required, medics can notify up to 10 ICE contacts with the push of a button.
The iB is by no means just three or four lines of information. Patients can have comprehensive medical histories linked to emergency contact info that is easily updated via the iB website. Invisible Bracelet service is available in all 50 states; it's just a matter of checking with invisiblebracelet.org to confirm whether this service provides coverage in your area.
You only need to work one decent-size mass casualty event (mine was a 60-mph head-on train wreck involving 250 patients) to immediately understand the challenges of triaging, tagging and tracking multiple patients and all of their belongings.
Thanks to the folks at LaserBand and their work bringing StatBand EMS tag to our world, the task of tracking people and belongings is now easier and more reliable than ever.
StatBand offers four tag options including: evacuation wristbands to keep track of families in case of separation during an emergency evacuation; rapid ID wristband tags for everyday response use in situations where preprinted and uniquely bar-coded labels help caregivers identify and track family, pets, luggage, etc.; triage wristband tags, which feature a standard four-part triage tag, 12 individual barcode tags and a yellow "NOT DECON'D" identification tag for large casualty events; and EMS wristband tags to be used as a triage tag, with six additional barcode tags.
Each of the four stock StatBand tags is made of patented one-piece construction for quick assembly. Using advanced water- and abrasive-resistant three-ply construction assures the StatBand will perform under the most harsh emergency scene conditions.
All tags come bundled in groups of 25 with an easy clip-on belt fastener. Each tag and the self-adhesive labels are sequentially numbered with alphanumeric digits and Code 128 barcodes for quick and accurate identification and tracking.
StatBand emergency response wristbands have an intuitive design, making them easy to use. One more thing: All StatBands products were tested in real-world scenarios to ensure the tags stay stuck to help you do your job and serve your patients better.
Livingston Patient Transporter from Livingston Innovations
Being sent to a "man down" call is one of the biggest crapshoots in the world of EMS dispatch. Is it a man down on the sidewalk? In his bathroom curled around the toilet? On a barroom floor among the peanut shells? The possibilities are almost endless. One of the more common variations of the man-down scenario, and arguably one of the most challenging, is the man at the bottom of a flight of stairs. In the past, getting the patient immobilized on a long board and then back up the stairs was a combination of hard work and sheer muscle power, coupled with some good luck. Sadly, that approach used no technology whatsoever to spare your back.
Thanks to the Livingston Patient Transporter, you can kiss that brute-force approach good-bye. In just seconds, you can configure the device into a long spineboard carrier with a 600 lb. capacity. Once the patient is secured in position, just use the two lift levers and watch as the Livingston Patient Transporter's "track-and-cleat" system traverses virtually any flight of stairs or even difficult elevated terrain. While the track-and-cleat system provides the grip that holds the device, the ratchet drive mechanism works almost effortlessly, helping to prevent back and knee injuries as it incrementally moves the device and the patient upward.
For going down stairs, the Livingston Patient Transporter still utilizes the track-and-cleat system for traction, but you control down-stair braking with just 20 lbs. of force, which ensures your patient will have a comfortable and safe lowering experience.
Extra-large casters and easy-grip handles are people-friendly design elements, and the anti-tipping plates keep the Livingston Patient Transporter from lurching forward if the front wheels accidentally advance over the step or stair. Easy operation and an incredibly functional design of this truly exceptional product surely make the Livingston Patient Transporter a keeper!
As an added plus, the Livingston Patient Transporter folds into a compact design that will fit in a standard ambulance compartment. Your lower back will thank you for your choice of the Livingston Patient Transporter.
I thought about the time several years ago when I attended a training workshop hosted by METI and first heard the term "suspension of disbelief." That was a "wow" moment for me as I realized that suspension of disbelief, and the level to which that disbelief can be taken, is the truly magical element that makes any simulation work. The more the person doing the simulation believes and gets immersed in the simulation, the greater the benefit of the simulation.
With that in mind, METI has worked long and hard in its pursuit of suspension of disbelief, and these efforts have resulted in the release of iStan v.2
iStan v.2 is without question in the category of what could only be termed a "high-performance" patient simulator. It is a fully wireless, fully articulated simulator featuring 100% built-in systems. Recent improvements include a more ruggedized skin, with increasingly life-like qualities. Reactive eyes provide automatic response to light and trauma, adding even more realism to the iStan v.2 performance. The airway system has been improved and upgraded, in part because of the overall quieter operation of the simulator. Improvements in the patient heart sounds, lung sounds and voice are all part of the v.2 package as well.
The standard package for iStan v.2 includes six basic patients and 14 simulated clinical experiences. iStan v.2 comes complete with all major pulses: carotid, brachial, radial, femoral, popliteal, posterior tibialis and dorsalis pedis.
Heart, lung and bowel sounds all come as part of the standard package as well, as does the ability to produce flail chest, pneumothorax and either bilateral or independent chest movement/excursion. You can obtain EKGs, cardiovert, defibrillate or pace to practice all elements of the ACLS skills set with no modifications or special attachments to the simulator.
Truth be told, I just scratched the surface of what the iStan v.2 patient simulator can do. If you are in the market for a high-performance patient simulator, it would be an injustice to not check out the iStan v.2. In my opinion, in a simulator world populated with average, good and better-than-average simulators, the iStan v.2 is the Lexus.
To be honest, when I walked up to the NuMask booth to do the product evaluation, I looked at the product and thought to myself, "What's that?" I just didn't get it, mostly, I think, because the bottom of the device is similar to a scuba or snorkeling mouthpiece. As it turns out, a scuba mouthpiece is in fact what the design of the NuMask is based upon.
After getting over my initial product shock, I found reason after reason to like this device. Unlike a traditional mask-ventilation format, which is difficult to use because of the inherent difficulty in obtaining and maintaining an adequate seal, the NuMask IntraOral Mask fits behind the lips and in front of the gumline/teeth. It's easy to place, and the seal achieved with the device placed against the posterior element of the lips is outstanding. A bearded face...no longer a problem, since there is no face mask to seal. No dentures in place, again no problem, as it's the lips and gumline that make the seal happen.
The oropharyngeal airway portion of this device is also worth noting, since it is a custom, cut-to-fit OPA. Measure from the tragus of the ear to the corner of the mouth, take your shears and trim it on the money. The OPA presses in place on the back of the NuMask, and you are good to go.
Use the NuMask with CPAP and BiPAP and you'll be amazed at its fuctionality. The bottom line is pretty clear to me. This is an outstanding execution of a simple, yet great idea. Put your old ideas about mask ventilation behind and take a really close look at the NuMask IntraOral Mask and OPA. I'll be surprised if they don't become a mainstay in your airway bag.
Halo Seal from Progressive Medical International (PMI)
The road to creating the Halo seal was challenging as the folks at PMI looked to develop a high-performance occlusive dressing to treat penetrating chest trauma by effectively sealing wounds on casualties who were experiencing heavy perspiration and/or bleeding excessively. The seal needed to work even when operating in wet or other extreme environments.
You get two Halo seals per pack, since PMI assumes the injuries will be through-and-throughs. I opened a pack of Halos and stuck one on after thoroughly soaking my arm under a faucet. Other than a couple of small air bubbles that I easily forced to the side, it was total adhesion/occlusion. I waited a minute and, using the large pull-tab, I removed most of the dressing to mimic "burping" a developing tension pneumothorax. I placed and pulled three more times, and the dressing immediately achieved total adhesion/occlusion every time.
Folks, the Halo seal is the real deal. If you work in a knife-and-gun-club district and don't have this seal in your trauma bag, I'd tell you you're making a serious tactical blunder.
Simulations bring value to the training/education experience in many ways. Frequently, it is in difficult-to-obtain skills, such as pediatric intubation. For pilots, flight simulators allow them to experience events that cause planes to crash and develop work-through solutions on their own, at no risk.
I kept wondering how long before an ambulance simulator would hit the market, and voila! Simulator Solutions brought an ambulance simulator to EMS World Expo 2010.
Your first decision is whether you want Simulator Solutions to reconfigure one of your old decommissioned rigs or to provide one for you. Whatever your choice, pneumatic controls (safer, cleaner than oil) are fitted to the rig that allow it to provide a very realistic experience relative to working in a moving ambulance. Two joysticks allow the operator to control the right-to-left and forward/backward, up/down movement of the simulator. At the same time, four strategically placed cameras and microphones provide an opportunity for an instructor to watch and listen as students perform in the simulator. If desired, you can burn the entire experience direct to a DVD for review and critique after the fact.
By utilizing the Ambulance Simulator you avoid the direct costs of running a real rig on the streets, e.g., fuel, tire replacement, repairs and maintenance. There's no vehicle registration, and, compared to a vehicle on the roadways, no insurance or real liability issues to deal with.
With the creative efforts that combine a low-voltage electric power source with pneumatically created motion, you get the benefits of a believable simulation that is safe and efficient, with minimal maintenance. Glue that to a great sound system and you get the bumps, sounds and other distractions that add believability and ambience to the simulation experience. Check out the Ambulance Simulator today.
In our world, oxygen is extraordinarily unique in that life is impossible without it. While some might say the same thing about coffee or chocolate, they would be wrong...close, yes, but still wrong.
Out in EMSland, oxygen is one of our simplest, yet most beneficial interventions, and with multiple applications to boot. I've gotten rid of far more PVCs with oxygen than with lidocaine or any other antidysrhythmics combined. I've watched confused patients start thinking clearly, chest pain go away, and patients who complained they couldn't breathe suddenly breathe just fine, all from the wonders of oxygen.
Given the outstanding track record of oxygen therapy, you want to deliver it to your patients in the most effective and efficient way possible. If that's on your patient care wish list, you need to read on.
The OxyMulti Mask from Southmedic is a truly unique multi-purpose device that bundles three products into one: a cannula, a nebulizer and a non-rebreather mask. First and foremost the OxyMulti Mask is an O2 delivery system. Thanks to the pin and diffuser system developed by Southmedic, the OxyMulti Mask (which has no reservoir) delivers oxygen saturations that are as good or better than a non-breather mask with a reservoir. This allows you to use lower flow rates, which saves money as it extends your O2 supply.
Another huge perk is the cut-away areas on the OxyMulti Mask that allow patients to talk so you can actually understand what they are saying. As any veteran knows, that is not the case with a non-rebreather mask.
The delivery range of the OxyMulti Mask is 1 to 15 lpm, with a delivered FiO2 of 24%–80%. To raise the saturation, just turn up the flow. When you have other needs, like aerosol therapy or just high humidity, the OxiMulti Mask delivers. It's a solid, well-designed product with the thumbprint of Southmedic quality all over it. Check it out today.
When providers first hit the streets in the early days of EMS, almost every tool they had at their disposal (of which there were few) came from either the military, the hospital world, the funeral industry or the space program. Early suction units performed marginally and were barely capable of suctioning chicken broth or water, much less half-digested pizza or chunky beef stew. When large chunks or clots became visible in the posterior pharynx, after the liquid around them was suctioned, the recommended technique was to do a finger sweep to quickly clear the area. Thanks to the S3 Oropharyngeal Evacuation Tool from SSCOR, you can keep your digits at a distance by letting the S3 do the work.
When you pick up the S3, you have a combination suction/scoop/shovel. The angle on the scoop is close to a "hockey stick" angle, giving you excellent access and maneuverability as you work around the posterior pharynx to clear out whatever awaits. If you see liquid, just close the port and suction away. When I gave the S3 a test drive, about two dozen dried almonds had been unceremoniously jammed into the mouth of an intubation trainer. It took no more than 10 seconds to clear all but two almonds that were wedged side-by-side in the trachea. I retrieved those with Magill forceps, and it was off to the races of airway management.
A third option for using the S3 is the congestive heart failure/acute pulmonary edema scenario. When someone with CHF/APE arrests and you lie them down to intubate, their posterior pharynx continuously foams out blood-tinged matter, much like soap suds coming out of a washing machine. Position the slider over the thumb port on the S3, place it in the deep oropharynx, and you have a sump providing continuous suction to clear things up to the point where you can visualize the necessary structures to place an endotracheal tube.
The S3 Oropharyngeal Evacuation Tool from SSCOR is a must have for your airway tool-kit. Its design and use are elegant simplicity. Its capabilities are outstanding.
The move from gurney to bed or bed to gurney is arguably the single most commonly executed patient move out in EMSland. It is usually accomplished with four providers, each on a corner of the draw sheet. Each provider grabs a corner of the sheet with one hand and finds a second hand-hold somewhere else on the edge of the sheet. Because of the trench-like design of most ambulance mattresses, you actually have to lift the patient up slightly before initiating the horizontal move that gets them off your gurney and onto a bed.
Sadly, I can't tell you how many times I have seen this play out over the years. The trigger-pull event usually occurs when the patient is still slightly lifted up off the cot mattress and the provider cantilevers his lower back as he leans forward to lift the patient across. Suddenly, he gets a wide-eyed expression and says, "I think I just threw my back out." Thanks to the new Speed-Sheet from Stryker, there is no need to put your back at risk with the lift-and-transfer method ever again.
Until you activate it, the Speed-Sheet serves as an effective barrier for fluids. Once you are ready to transfer the patient from your cot to the hospital bed, you just tear the red activating tab located by any of the corners to break the vacuum between the two layers and activate the Grip-to-Slip technology, thus providing you with a low-friction transfer aid.
I was so fascinated with the vendor's claims about this product that I had to try it for myself, so we got a fellow to volunteer to be the patient. He looked pretty sturdy, but I asked him anyway, "What do you weigh in at these days?" His reply was, "260," and I felt my lower back muscles tighten up.
After activating the Speed-Sheet, I grabbed the gentleman by one shoulder and down by his belt and almost without effort slid him over onto the cot in front of me. I was stunned, to say the least. According to Stryker, the Grip-to-Slip technology reduces the force required to move the patient almost 50%. To be honest, I would have guessed it was closer to 75%.
Let me ask one simple question: If you aren't using the Speed-Sheet from Stryker, why not?