The best EMS products in 2010
I just love simple ideas and products that actually work and hold up on the street
This was an exciting year in new EMS products. We have seen the rapid growth of several exciting new technologies. Some of these are exemplified by new emerging trends or devices for pre-hospital diagnosis and treatment. Others are driven by the real needs of EMS providers, some even by EMS providers. This year we have seen a few really simple low-tech solutions to stubborn patient care problems. I just love simple ideas and products that actually work and hold up on the street. Here are a few of my favorite new EMS products and product trends of the last year.
One EMS product seeing explosive adoption around the country in 2010 was invented by a paramedic. It is called the S3 Oropharyngeal Evacuation Tool from SSCOR. This simple inexpensive and disposable implement is a huge step forward in basic and advanced airway management. Jeff Rehman, a firefighter and paramedic with North Metro Fire invented this brilliant upgrade to the standard disposable rigid suction implement. It does three different things; hence the name S3. The first thing it does is suction.
Unlike most suction yankauers, it has a large lumen. Its uniquely soft material is less traumatic and the internal stylet assures lumen patency, regardless of what shape you bend it into.
The second thing it does it scoop. Ever had someone vomiting more than the skinny suction catheter could handle, plus been reluctant to stick your fingers in someone's mouth? You can scoop out foreign matter and emesis much more effectively with the spoon-shaped tip of S3 than you can with your fingers anyway. Plus it could save you from getting bit.
The third thing S3 does is sump. If you are a paramedic and you arrive on scene a currently or recently aspirating cardiac arrest patient, you can suck them out while closing the thumb-hole with the closure collar. Slide the gently curved S3 way down into the posterior pharynx to help control things while you intubate over the top. Once they are intubated just leave it in for some additional insurance, particularly if CPR compressions are in progress and/or they are actively vomiting.
I love any new innovative products that can make an EMT's job easier and safer. The S3 is one such product. For what it does it is easily worth the price and maybe more. This is a very inexpensive product clearly and cleverly designed by an EMS provider for an EMS provider. It can make a nearly impossible and not uncommon problem much more easily manageable.
Another simple airway related product that finally stated seeing the attention in 2010 that it deserves is the NuMask. This product is not exactly new, just finally getting discovered. One of the overlooked critical and common ventilation problem areas is the mask seal. Nowadays, we use inexpensive masks that come on the inexpensive disposable devices. Many rely on some kind of cushioning seal or inflated collar.
Worse, we often have to use them with one person using on hand to maintain the critical mask seal. Consequently they are notorious for leaking; particularly around the bridge of the nose, or on bearded, deformed, or badly damaged faces.
The NuMask takes a whole new approach. It works sort of like a divers snorkel. The mouthpiece goes inside the mouth, but in this case over the teeth rather than inside them. You hold light tissue pressure around the outside of the face and adjunct to create an incredibly effective seal. It works quite effectively on some of those persistently stubborn mask seal challenges.
Of course it has an SO standard fitting so it will work with virtually any brand or style of Bag Valve mask. It possibly might be very cool to try out with a CPAP device. I think the big problem is we already get face masks with most resuscitators. Well, when you get something for nothing you usually get your money's worth. I have already stuck one of these little lifesavers in with every one of my BVM's and resuscitators.
A more traditional new external mask is called the ECO Mask from Intersurgical. It offers a seal-sealing flange that works on air pressure, not air cushion. It is completely free of PVC, so it is a more responsible solution from an environmental view. Plus the darn thing works great and comes in every possible size. I really like the version they offer with an oxygen reservoir bag and valve. It's probably the first oxygen delivery non-rebreather mask that makes a great seal on almost anybody.
Another great product that is not exactly new but is seeing much broader adoption this year is the latest CombiCarrier II from Hartwell Medical. This elegantly engineered piece of rugged patient handling equipment combines the best of scoop and spine board into one. The durable locking mechanism insures smooth and positive lockup of the easily separated halves. The concave surface holds your most injured patients with security and stability. I just love the way it handles. I don't think any agency that ever gives the thing a try will ever want to give it back. Sometimes when you try to make a product do more than one thing, it does both rather poorly. Not this time. The CombiCarrier II really is both a better back board and a better scoop stretcher rolled into one.
An emerging trend this year is the emergence and growth of video-laryngoscopy. The buzz at this year's ASA Conference in San Diego is that in 10 years we will all look back on the blade & handle visual laryngoscope as a primitive instrument. With a video-laryngoscope, more than one person sees the tube goes between the vocal cords. It makes the difficult anterior airway easier to see, particularly when the head and neck are motion restricted.
Verathon makes the industry leading Glidescope, including pre-hospital and military version called the Ranger. You will probably find a Glidescope in the majority of large hospital anesthesia departments. We are now seeing only the beginnings of these devices adoption by EMS providers, but they are quickly becoming commonplace in hospital anesthesia departments.
We saw the recent introduction of many new models and improvements to older ones this year. Karl Storz who makes the C-MAC Video Laryngoscope and is now appearing at many leading EMS conferences, Ambu offers the Pentax Airway Scope, LMA has the McGrath Series 5 Video Laryngoscope and King Systems the new King Vision, Aircraft Medical the new McGrath Mac, and the new Truview PCD, is from Truphatek (who, on full-disclosure, I work for).
Some of these devices use a more traditional blade and handle with screen approach. Others have a J-shaped insertion member with screen at the top, which contains a pre-loaded ETT. These are just the latest in what has become a rapidly evolving trend towards broader use of video devices.
This year we have also seen a huge upsurge of the Sprinter based ambulance. They are smallish, but light, nimble, and fuel efficient. They could also offer advantages in safety if appropriately configured. Frankly, I like them. I know real smart Medics that love working on them. Anything that improves efficiency and safety while reducing work stress has to be seen as a positive development. While certainly not ideal for every application, these little vans can be great for getting around in dense and crowded city streets. Two years ago you maybe saw one or two offered at the major shows. This year most of the major converters offer one.
Lastly, the most surprising new development is that our technologies are being better supported with real education. At almost every EMS show, the big vendors now bring in speakers to deliver live briefings on the latest technology. Many of these are really outstanding. You can nowadays learn as much in the exhibit hall as the lecture hall.
The defibrillator companies do live how-to's on the finer points of interpreting and even transmitting 12 lead ECG's. Software companies give hands on tutorials right in the booth. At the Texas EMS Conference in Austin this year, I heard Troy Smith, NREMT-P, LPN, Snohomish County Fire at the Bound Tree booth lecture on end-tidal CO2. I really learned a lot in this condensed version of his well-known series on Capnography: Learning Through Waveforms.
This has been a very interesting year in EMS products. Some these offer the front line EMS provider really innovative new ways to make their life a little easier and safer. Many of the companies that serve the industry are now offering better educational support for their technologies. Many of these new products add very little to our cost of providing care. That makes them all the more important and positive developments in my book.
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