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Home  >  EMT Products  >  Patient Monitoring  >  Exciting new EMS devices for 2013
December 18, 2012
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Firemedically
by Mike McEvoy

Exciting new EMS devices for 2013

Let's take a look at the events that shaped how we worked in 2012 and the technology that's on its way in the months ahead

By Mike McEvoy

Superstorm Sandy broke more than records on the East Coast, paralyzing the Big Apple and seriously affecting the lives and property of nearly 20 percent of the United States population. After-action critiques will likely reveal significant opportunities for improvement in planning and response.

While the iPhone 5, Facebook and the Olympics captured media and search engine attention, this was a rough year for many. As though numerous active shooting incidents were not enough for EMS, Mother Nature delivered a premature butt kicking by starting flu season a few months early.

Couple that with our introduction to the wonders of bath salts, and we can almost appreciate why Washington and Colorado decided to legalize marijuana.

Fire and EMS services took notice of a significant increase in member suicides and have slowly begun to formulate strategies that will reduce these senseless losses. Thefts of ambulances reached an all-time high during 2012; most of them unsecured or left running near a dirtbag who was apparently short on self-control.

Not since 2003-04 has the flu season started so early. That winter saw the death rate more than doubled to 50,000. Unlike 03-04, this season's strain (H3N2) is incredibly closely matched by the flu vaccine.

This will serve the 37 percent of the population who are vaccinated quite nicely. The rest stand a good chance of joining the typical 200,000 hospitalized and 24,000 who succumb to the flu each year. When asked why the flu season started so early, Mother Nature had no comment. Go figure.

You were probably not too distracted during 2012 by Twitter mentions of Whitney Houston, Lance Armstrong, David Petraeus, Jerry Sandusky, and Trayvon Martin to notice that drug shortages continue to plague EMS.

You probably have also pulled clumps of hair from your head trying to understand the rollout in your home state of the new EMS Educational Standards. Maybe you can't call anyone to talk about it because your service didn't heed the FCC narrow banding deadline of December 2012. Cheer up, though: 2013 is shaping up to be a year of innovation.

The tech ahead
Great minds have been hard at work throughout 2012. Expect the New Year to bring some exciting new EMS devices that could significantly change your practice. Released just in time for COPD Christmas giving is the first iPhone pulse oximeter, the iSpO2 by Masimo.

Available to consumers on Amazon.com, the iSpO2 is a fully functional pulse oximeter comparable to portable EMS units costing $600 or more. Expect to see an FDA approved version for medical approved during 2013 (or buy the less expensive consumer version on Amazon).

Sometime around March 2013, one of the most exciting innovations in ambulance stretchers will roll out of Ferno. Everything you have always wanted in a powered ambulance cot and some features you may never have imagined will be incorporated into the "INx " stretcher.

Pay attention to Fernoems.com for all the details and if you are thinking about buying new stretchers, hold off. Study the INx closely; your psychic abilities will tell you there's much more innovation just down the road from this worldwide leader in patient care equipment and transport.

A tad late in the CPR feedback market, Physio-Control will likely roll out their TrueCPR feedback device during early 2013. Released this year in Europe, TrueCPR provides more accurate assessment of compression depth than currently available feedback devices when used on a stretcher (with or without a backboard). Its portability and accuracy make it an ideal technology for EMS responders.

Huge strides
Starting in 2013, you will likely see huge strides in capnography and pulse oximetry technology.

To begin with, you have probably at one point in your EMS career seen a product manufactured by PHASEIN. Based in Sweden, PHASEIN makes all kinds of gas analyzers, including capnography.

Their EMMA capnometer has been on the market for years. In 2012, Masimo (see iSpO2 above) acquired PHASEIN and you can expect to see their technology elevated to new heights, starting with EMMA in 2013.

Now you're probably thinking, "a capnometer is old technology, " and you're right. However, take a miniature, instant on device, powered by a couple AAA batteries, with alarms, and no need for calibration and…add a waveform. Presto! You would have quite a nifty miniature capnography unit. Dreams may come true.

Two other innovations that might see the light of the medical market in 2013: capnography waveform analysis algorithms and pulse oximetry derived blood pressure.

Astute EMS providers and Respiratory Therapists have long recognized patterns in capnography waveforms that suggest pathology. Shark-like waveforms indicate reactive airways; effects of treatment can be gauged by their resolution.

Quantifying capnography waveform slopes and angles can help clinicians more objectively measure changes. Ultimately, this could lead to algorithms that might someday flash warnings on the screen to suggest the respiratory pathology in progress.

Pulse oximetry is now in its fourth generation and all kinds of data can be elicited from the body using this non-invasive technology. Expect to see pulse oximetry derived respiratory rate and blood pressure during 2013. Time will determine the accuracy of these measurements, but less invasive is the future of medical monitoring.

For those troubled over the NFPA 1917 Standard for Automotive Ambulances, fear not. The Committee is going right back into cycle to revise the document, starting in 2013. On the subject of standards, pay attention to The Joint Commission (TJC), the hospital accreditation body in the U.S.

Their increasingly tighter requirements for flu vaccination are clear signals that flu shots will someday be a requirement for continued employment. That should be sending a message to EMS services and there are two very simple ways to start shifting the culture in your service: offer free flu shots and get a signed declination form from any member who refuses. If you don't start somewhere, you'll never get anywhere.

Let's hope for less damage in 2013 from Mother Nature and let's be ready to respond and mitigate senseless tragedies brought upon us by others. Be well and be brave in the New Year.

About the author

Mike McEvoy, PhD, REMT-P, RN, CCRN is the EMS Coordinator for Saratoga County, New York, a paramedic for Clifton Park-Halfmoon Ambulance, and Chief Medical Officer for West Crescent Fire Department. He is a clinical specialist in cardiac surgery and teaches critical care medicine at Albany Medical College. Mike is the EMS editor for Fire Engineering magazine, a popular speaker at EMS, fire, and medical conferences, and lead editor of the Jones & Bartlett textbook, "Critical Care Transport". In his free time, he is an avid hiker and winter mountain climber. Contact Mike at mike.mcevoy@ems1.com.
Comments
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Kelly Grayson Kelly Grayson Friday, December 28, 2012 6:12:52 PM They are not "dirtbags." They are ethically deficient conveyance-deprived opportunists.
Kyle Jackolin Kyle Jackolin Friday, December 28, 2012 6:55:58 PM When do we start doing lactate in the field?! That's going to be the next big breakthrough when it's combined with an aggressive sepsis protocol.
Kelly Grayson Kelly Grayson Friday, December 28, 2012 7:03:30 PM South Denver Metro and a number of others already are. And the price of the meters is only going to come down as more people adopt the technology.
Mike McEvoy Mike McEvoy Saturday, December 29, 2012 3:15:05 AM The last FDA approved lactate meter was pulled from the market in 2012. Unless you have some big buckaroos (like for an iStat), lactates are way in the future.
Bob Sullivan Bob Sullivan Sunday, December 30, 2012 6:39:21 PM I'm not sure what brand we have, but we have them and they correlate closely with the hospital's. Look for some abstracts about it at the NAEMSP annual meeting.
Steve Steffgen Steve Steffgen Friday, December 28, 2012 6:35:02 PM So.. PC's "TrueCPR" is "exciting", even though it is essentially Phillip's Q-cpr and the puck?
Physio-Control, Inc. Physio-Control, Inc. Wednesday, January 02, 2013 1:46:33 PM Actually, there is a difference between the technology available in competitive devices and TrueCPR. TrueCPR uses a 3D magnetic field to measure the relative distance between a sensor on a patient’s chest and a reference pad behind their back as a rescuer performs compressions, regardless of patient movement. Competitive CPR feedback technology uses a single accelerometer to measure movement of the patient’s chest. With no reference point behind the patient’s back, these devices capture all movement such as compression of the surface the patient is lying on, or movement of a vehicle that is transporting them. Additional information on the technology in TrueCPR can be found in the JEMS 2012 EMS State of the Science supplement: http://www.jems.com/article/patient-care/application-development-promises-better

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