EMS World Expo 2011 was the best EMS industry trade-show this year. It introduced a number of exciting new products never seen before anywhere else. Many were very serious new advanced technologies to deliver better patient care. A few were gimmicks or copies of things we already have. Some of the hottest fell into my favorite categories: airway, breathing, and circulatory support.
Airway
All the modern video-laryngoscopes were there. LMA North America showed the McGrath Series 5 video-laryngoscope, Verathon showed the industry-leading Glidescope video-laryngoscopes, Ambu had the Pentax AWS, King Systems had the new King Vision video-laryngoscope, and Truphatek (who I work for) had the Truview PCD video-laryngoscope.
One thing became clear at EXPO: video-laryngoscopy is here to stay and ready for prime time. One product that really caught my eye was the bright red version of the new Aircraft Medical McGrath Mac video-laryngoscope.
1) The McGrath Mac is a second-generation instrument, building on the legacy of the McGrath Series 5. The main internal component that houses the light source and internally reinforced CameraStick is virtually a single curved piece of steel that runs all the way up into and becomes the solid frame of the hollow grip. It looks to me like they built this thing for the street. It’s priced right for the street too, and has a very inexpensive clear disposable “blade” in two sizes. The thing I like best about the McGrath Mac is the broad field of view.
The McGrath Mac helps to solve a big problem with most other video-laryngoscopes. Often with video devices, it can be easier to see the glottis but harder to get the ET tube in. With video, the trachea is often no longer in your direct line of sight. You have to control the tube around the corner while looking at the posterior pharynx on the screen. If they don’t see the tip right away, many new users get frustrated and sometimes a little wild trying to bring the ET tube tip into view. With the McGrath Mac’s wide field of view, you pick up the tube on the screen almost immediately. This pretty amazing feature of the device should make learning video-laryngoscopy far easier for many novices.
Breathing
There were several break-through EMS, Transport, and Critical Care ventilators. While some were not physically available and are pending 510K approvals, I was able to learn many of the important details of some game-changing devices.
 Image Impact Instrumentation |
2) The new 731 series EMV+ from Impact Instrumentation is a true Critical Care Transport ventilator, capable of quite simply anything and everything you might ever need from a transport ventilator. The list of features and functions is really extensive, despite the diminutive size and ultra-light 9.5-pound weight. The EMV+ features include a robust built-in compressor and blender, 10-hour battery life, volume and pressure ventilation modes, and integrated SPO2, to name only a few.
Another feature of the EMV+ is Bi-Level airway pressure support, a better form of CPAP therapy. It’s the best CPAP I have ever seen on a device you can take in the field. The EMV+ even automatically compensates for altitude and mask leaks, and it does so almost instantaneously. This allows the EMV+ to fully compensate for positional or cyclical mask leaks in real time. I tried to trick it by pulling it slightly away from the face with every inspiration, and it still kept up by instantly increasing flow when I needed it. If you do aero medical or lots of CCT work and need an amazing new ventilator, this one needs to be on your short list.
3) Smiths Medical had a new completely re-designed version of their legendary ParaPac, the ParaPac Plus 310. The ParaPac is the original UK-engineered Paramedic ventilator. It offers independent control of rate, volume, and pressure on a rugged and proven pneumatic platform. Now it weighs less and will come with CPAP. This value-priced emergency ventilator does almost everything a Medic would ever need, except for neonates and critical care transports.
It wasn’t the only cool new ventilator.
4) Airon will soon offer the new pNeuton Mini, a reduced size and weight version of their already proven ventilation technology with CPAP. The pNeuton Mini has a sleek new elegantly compact form, with proven pneumatic ventilation and one of the best EMS CPAP functions in the business. True CPAP is actually pretty hard to do, and Airon does it very well. There are many devices that deliver high FIO2’s with PEEP, but far fewer that support positive inspiratory pressures.
 Image Laerdal |
5) Laerdal Medical demonstrated the MamaNatalie Birthing Simulator. This clever contraption straps on to the front of a real women, providing a strikingly realistic OB emergency/delivery experience. It is particularly realistic for training control of post-partum hemorrhage, the number one cause of maternal death in childbirth. I could see several EMT’s and Medics who tried it out actually starting to sweat as they approached the scenario.
Let’s face it: this is one area where we don’t get enough training. The MamaNatalie from Laerdal solves that problem by providing students an almost lifelike OB training experience. Now that’s simulation.
Circulation
6) An exciting new product to improve circulation is the BariBoard from Rapid Deployment Products. The BariBoard enables rescuers to deliver more effective compressions on patients over 275 pounds. It raises the thoracic spine of the obese patient to reduce surface area and help improve cardiac output. As the number of obese cardiac arrest patients increases, the stubborn challenge of moving blood around in these big patients grows. Frankly, it looks like the biggest (no pun intended) improvement on the old CPR Board in 20 years.
7) Timesco from the UK showed a number of really original traditional laryngoscopes. They showed the new Skin line of disposable handles, and a new product that looked great for disaster caches and other special applications. The Shakerscope is a laryngoscope handle you just shake to charge up. This could be a solution to the problem of what to do about batteries when there aren’t any stores left open.
8) SAM Medical introduced the SAM Chest Seal. The SAM Chest Seal is a self-adherent occlusive dressing, an open chest wound seal with a built in one-way valve. Once decompression is achieved (or if inhospitable environments present), you can seal it up with an included snap-on sealing cap. Boy, this thing is a huge improvement on Saran Wrap.
9) Speaking of SAM Medical, I watched while Stuart Edmonds of Bound Tree Medical Europe showed the Lewis Pelvic Applicator. The Lewis Pelvic Applicator is a clever disposable feeder mechanism for the SAM Pelvic Sling or other pelvic splint. This little wonder makes it easy to slide the pelvic splint behind a victim, to quickly stabilize a pelvic fracture before you move them. You sandwich the splint inside it, and then feed it gently but rapidly behind the pelvis of a patient in virtually any position.
 Image EKG Concepts |
10) Gary Krause, RN of EKG Concepts, demonstrated his line of ECG tools. The Pocket R-CAT for arrhythmias is an excellent reference and training tool for any Medic who wants to really master ECG interpretation. It is a 12-panel, double-sided, laminated toll that folds out to reveal 41 six-second strips with identifying criteria. It is a great pocket guide for students and field providers.
That rounds out the EMS1.com Top Ten New Products at EMSWORLD EXPO. It does strike me as a little strange that right as we are getting pushed towards simpler airway care devices and putting less emphasis on emergency ventilation, the technology suddenly evolves to help us do a far better job of both.
Does anybody else find this a bit curious? What if we really could put an ET tube in the trachea reliably every time it was needed? What if we really could deliver precise ventilation volumes at safe pressures? Is it really best for our patients to ignore improvements in technology that have recently appeared in answer to our most stubborn problems?
I sure hope not. It has become pretty clear that the rest of medicine is moving away from the antique tools of the past. In ten years very few patients in modern US hospitals will still be intubated with old-fashioned laryngoscopes. The video-laryngoscope of today helps make every intubation easier and the toughest ones manageable.
The same thing is true of emergency ventilation. The most easily saved patients are those in respiratory failure. They are also some of the most easily lost, particularly with the BVM and an unprotected airway.
Let’s get with the times and not be so hung up on tradition that we cannot improve the quality of our care by adapting to modern devices and therapies. So far the only two things holding some of these technologies back have been high prices and lack of field durability. From what I saw at EMSWORLD EXPO, it looks like even those problems are finally being solved.
