Headliners! Hot Products from EMS EXPO 2004: Part 1

Surrounded by Southern hospitality in Atlanta, GA, the 2004 EMS EXPO was not only a great success, it was in a great venue. As with any EMS EXPO, a large part of that success came from the incredible support of the vendors and manufacturers who filled the Exhibit Hall. The attendees got a great opportunity to see firsthand the newest goodies and gadgets for our profession. In many cases, attendees could actually meet the people who created, designed or built the products, adding an even more personal touch to the experience. This year, I received more than 110 submissions for new and innovative products, making the decision to ferret out these products even more difficult. Thanks to every vendor and manufacturer who took the time to submit a product for consideration this year. Listed below please find Part 1 of this year’s Hot Products from EMS EXPO 2004.

ActCel Hemostatic Gauze from ActSys Medical, Inc.

Paying close attention to the basics has always been the platform for quality EMS care. Conversely, inattention to airway, breathing and circulatory problems will almost guarantee problems with any call, and can certainly compromise survivability for those serious or critical patients who are hanging in the balance. Within the realm of basic care comes the task of bleeding control. I believe the ActCel hemostatic gauze from ActSys is going to be a must-have in our trauma kits.

With more than four years of proven performance in the dental market, ActSys only entered the EMS market in the last few months with its patented hemostatic gauze made from regenerated cellulose. Immediately upon contact with blood, the ActCel gauze converts to a glucose gel and begins to expand to 3–4 times its initial size, exerting direct pressure on the vessels that are bleeding underneath the gauze. The ActCel gauze unites with platelets, reacts with factor 12, and stabilizes blood clots by accelerating fibrin cross-linkages. In most cases, bleeding is completely controlled in less than 120 seconds, including lacerations, abrasions, punctures, capillary bleeds and even arterial bleeds.

ActCel is sterile, hypoallergenic and contains no chemical additives that might delay healing—though it does have bacteriostatic properties—nor does it contain thrombin or collagen. Once ActCel has performed its bleeding control magic, it can be left in place to dissolve on its own in about two weeks. If there is a need to remove the ActCel, it can be irrigated away with water, normal saline or hydrogen peroxide in just a matter of minutes.

The ActCel gauze is a next-generation bleeding-control product that is available now. Don’t go on your next trauma call without it.

For more information, call 800/808-9094, or visit www.actcel.com.

CoFlex-NL Printed Bandages from Andover Coated Products

I have always been one of those EMSers who considers seriously ill or injured pediatric patients a personal Achilles heel. No matter how many peds courses I’ve been through, those nearly overwhelming feelings just would not go away. Whenever confronted with those tense pediatric moments, I try to assess and treat at the highest level possible, in hopes that I can, at least in part, compensate for my mental shortcomings. Because of this predisposition, I have always had an interest in any peds-specific products that might improve overall care. As such, I was immediately drawn to these new to the EMS market CoFlex printed bandages. I’m pretty sure that the dinosaurs, hearts, happy faces, cars, butterflies and flowers will elicit a smile from most kids, but these bandages have some great performance qualities as well. The CoFlex bandages are cohesive, latex-free and can be hand-torn, making them quick and easy to apply. In addition, they have excellent tensile strength and provide controlled compression. If you put them on loose, they stay loose. If you need more compression and put them on a bit tighter, they stay that way and do not tighten further. Available in 2", 3" and 4" widths, they come in “Kid’s Packs” that feature all six designs, allowing your peds patients to pick their favorite print.

As an added plus, the printed bandages cost the same as Andover’s solid color, latex-free bandages. What a deal!

For more information, call 800/432-6682, or visit www.andovercoated.com.

Cardiac Critical Care Course: C4 from the Emergency Medicine Learning and Resource Center

Changes in the dynamic area of acute cardiac care challenge even the most practiced paramedics. Whether it’s a review or an update, the Cardiac Critical Care Course (C4) from the Emergency Medicine Learning and Resource Center is an incredibly well-designed, user-friendly tool to meet those needs.

The two-CD set provides the equivalent, content-wise, of the typical Advanced Cardiac Life Support recertification course and is approved for eight hours by CECBEMS. The C4 course can be taken by an individual or projected to a large group. For individual paramedics, the self-study, self-paced format allows learners to control the flow of the process.

There are 11 different presentations, with objectives on the front end that clearly identify key elements of the content that is to follow. Once the presentation is completed, the paramedic’s knowledge base is tested with a multiple-choice test. Unlike some CME tests that focus on minutiae or obscure medical tidbits, I felt the test questions were very focused on practical, regularly applicable content areas. This program is well-designed and well-delivered, and is an incredible value compared to the cost of a sit-down-and-take-it course. Of course, one would need to offer the skills portion separately from this knowledge and decision-based course to round out the recertification process. One of the Emergency Medicine and Learning Resource Center’s goals was to make recertification more user-friendly and to let you or your EMS system experience cutting-edge, acute cardiac-care education using a self-paced educational process. In my mind, they have clearly met that goal.

For more information, call 800/766-6335, or visit www.EMLRC.org.

ALOX Ambulance Liquid Oxygen Systems from Essex Cryogenics

In the early years of EMS, we acquired technology from a variety of sources, most notably the military, hospitals, the space program and the funeral industry. With the growth and continued maturation of our profession, we now enjoy the luxury of having many EMS-specific products from which to choose. However, every now and then we need to go back to one of our old standards and tap their resources. Essex Cryogenics has taken the same proven technology that has been landing on aircraft carriers and keeping fighter pilots alive for close to 50 years and made the jump to EMS with their new liquid oxygen systems for land-based medical ambulances.

The new Ambulance Liquid Oxygen Systems (ALOX) are available in either a 25-liter or 8.5-liter configuration. Either model can be installed in a number of locations on any ambulance without modification to the oxygen delivery panel, since the only real change to the vehicle is that of the storage vessel. The average time to retrofit a rig to hold the ALOX vessel is no more than 3–4 hours. Regarding storage capacity, the 25-liter ALOX vessel is only 28" tall, 14" wide and 18" deep. In spite of its small size, the 25-liter ALOX is equivalent to 3½ “H” cylinders! Better yet, ALOX eliminates the hernia-producing moments of muscling giant oxygen tanks in and out of your vehicle. You can refill the 25-liter ALOX in your rig in just six minutes.

For those who worry about safety, remember that this technology has been used in F-14 and F-18 fighter planes that have made countless hard landings on aircraft carrier decks for over four decades. The ALOX system has been shock-load, acceleration-load and crashworthiness-load tested, as well as explosion-tested. In the almost unthinkable event of an ALOX vessel being breached in some kind of devastating ambulance crash, the ALOX will not explode, as it is stored in a low-pressure environment, i.e., at <300 PSI, unlike the high-pressure storage of gaseous oxygen.

ALOX technology weighs less than gaseous technology, provides greater safety, lower operational costs and eliminates the possibility of workmen’s compensation claims for back injuries suffered from swapping out oxygen tanks, because there are no tanks to swap out!

Liquid oxygen may be old technology to the military, but the ALOX from Essex Cryogenics for land-based EMS vehicles is a hot new product to our world that is well worth checking out.

For more information, call 314/832-8077, ext. 323, or visit www.essexind.com.

Solaris LED Technology from Federal Signal Corporation

Ask any old-dog EMSer about the classic front bumper-mounted Federal siren. It took about 30 seconds to get wound up to full volume and about the same amount of time to wind down, but anyone within about a 250-yard radius knew that an emergency vehicle of some kind was coming.

Well, if you’ve ever pulled your rig up next to some kid listening to rap with a high-output stereo (the ones that make the door panels bulge out with each thump of the bass), you know that it takes more than a loud siren to get their attention. You need superior lighting, and that’s exactly what the Solaris LED technology offers.

The patent-pending Solaris design incorporates offset, complex reflector surfaces for beam shaping and improved light collection efficiency. Solaris reflectors take advantage of LED’s directionality to orient and direct the light from the LEDs to exactly where it is desired. This is accomplished in part by the use of prescription optics via a reflector, rather than just passing light through a lens. This new Gen3 LED technology is efficient, with little loss of optical energy. As such, just six of the Gen3 LEDs create more light than 20 of the previous generations of LEDs.

As with previous LED lighting designs, users can expect excellent performance in life expectancy, which is roughly 100,000 operational hours, and low current draw. The six-LED Solaris comes in red, amber and blue, while the nine-LED Solaris also includes white.

Federal Signal Corporation has been providing lights and sirens for fire and emergency services for over 100 years, and the Solaris technology is another innovation in that long and impressive history.

For more information, call 800/264-3578, or visit www.fedsig.com.

PowerFlexx from Ferno

When you talk about on-the-job injuries in EMS, statistics almost always point first to back injuries. A large part of the problem is that we are often required to make patient moves in awkward situations in less than optimal positions. Another key aspect of the problem is simply the sheer number of lifts that we make on an everyday basis. Of course, the most weight we typically have to lift occurs lifting patients on cots. That lift may become a thing of the past with the PowerFlexx cot from Ferno. New to the EMS market this year, the PowerFlexx cot comes with a number of modifications. The most notable innovation is that a single provider can raise or lower the cot with only the touch of a button. The actual mechanics of the lift use two separate cylinders, which produces a smooth and even lift.

Powered by a lead acid battery, the PowerFlexx can make more than 100 full cycles (one up and down per cycle) on a full charge. The battery can be charged in the rig or back at quarters. In the rare case where the battery runs down in the field setting, the entire battery box can be swapped out at the scene. This new lifting system also has an infinite number of height adjustments, thus allowing the cot to be at optimum level when transferring a patient to or from the cot. In addition, the PowerFlexx now has the highest load position of any cot on the market, allowing the cot to load easily into vehicles with increased floor height.

Other significant modifications include increasing the actual patient surface to 86" and making the surface of the patient mattress totally flat, thus eliminating hard-to-clean nooks and crannies. Over the years, Ferno has brought many innovative products to the EMS market. The PowerFlexx may be the most significant in regard to helping prevent back injuries.

For more information, call 800/733-3766, or visit www.ferno.com.

The Fasplint from Hartwell Medical

When you find yourself confronted with a really nasty trauma scenario or a situation where equipment retrieval may be difficult, Hartwell Medical’s Fasplint semi-disposable vacuum splint—similar in design and function to the company’s classic Evac-u-splint—may well be the answer. I say semi-disposable because the unit can be easily cleaned and reused if needed, but it is so affordable that it need not be retrieved under more challenging circumstances.

Unlike air or rigid-style splints, the Fasplint, once applied, easily molds to fit the contours of patients and their injuries, so even difficult fractures/dislocations can be splinted and stabilized quickly and comfortably. In addition, the Fasplint provides secure immobilization using circumferential pressure, which greatly reduces the potential for tissue, vessel or nerve damage in situations where the patient may have extended splinting time. The Fasplint has multiple applications and also works well for head/neck stabilization.

I had two of the Hartwell Medical reps splint me multiple times on a long spineboard and I felt both comfortable and secure each time. Once placed on the Fasplint, I noticed that the device partially sinks into the handles on the spineboard, further limiting movement. Once vacuumed out and with criss-cross strapping over my shoulders, I was pushed and pulled and did not feel any appreciable movement up or down the spineboard.

The Fasplint is impervious to fluids and can be cleaned with anything from commercial products to household cleanser for re-use, or just simply tossed. It is made of pliable material for cold-weather use, and is x-ray- and MRI-compatible. The Fasplint comes in three easy-to-store sizes and is definitely worth considering as one of your trauma care tools.

For more information, call 760/438-5500, or visit www.hartwellmedical.com.

Punctur-Guard Internal Blunting Needles from ICU Medical, Inc.

Along with the evolution of EMS hardware, there seems to be a parallel evolution of bugs, bacteria and nasties out in EMS land, just waiting for the unwary, inattentive or ill-prepared provider. As such, careful attention to body substance isolation and universal precautions have never been more necessary than they are today.

One of the ongoing risks in our line of work is that certain functions still need to be accomplished with needles. Needles easily puncture the skin and may be contaminated with bloodborne pathogens. A 1997 study by the CDC found that 61% of accidental needlesticks occurred literally within seconds after a device was removed from the patient’s vein and before activation of the safety feature could be accomplished. In that same study, 83% of the injuries were attributed to devices that required activation following removal from the patient’s vein.

Helping us reduce that risk, in part, is ICU Medical’s new product line, the Punctur-Guard blood collection and infusion safety needles. Their patented products are the only ones that can be blunted while in the patient’s veins.

Available in a winged butterfly set or as a blood collection needle, each can be blunted internally once venous access has been achieved, allowing for a sharp entry and a blunt exit. During a blood draw, once you finish your last tube, simply push the tube an additional ¼ inch to activate the blunting feature. An audible click indicates that blunting has occurred. With the butterfly, there is a middle wing in addition to the two traditional wings. Simply turn the middle wing clockwise (to the right) to activate the blunting feature. Easy as pie.

For more information, call 800/824-7890, or visit www.icumed.com.

Emergency Care Simulator from METI

When the very first manikin became available for EMS training purposes, the benefits were plainly obvious. A student could practice a technique in a no-bad-outcome, lawsuit-free setting until the time they were safe to work on real patients.

Over the years, literally dozens of manikins with many different training purposes have hit the market. A few years ago, there was a quantum leap in manikin development as computer technology allowed manikins to “respond” to interventions with a number of physiologic and pathophysiologic capabilities. As one might expect, these were quite expensive—in some cases, costing in the lower six figures—and far outside most training programs’ budgets. In addition, the support technologies that allowed them to function were cumbersome, essentially requiring that the simulator be in a fixed location. The Emergency Care Simulator from Medical Education Technologies, Inc. (METI) has changed that scenario, providing a lifelike and medically authentic simulation system that offers many of the features found in the high-end models in a much more affordable and portable format.

This simulator runs off compressed air, using an airport card that allows the operator to work at a remote location. It comes with a dozen pre-programmed scenarios, including two types of AMI, a young asthmatic, CHF, a stab wound to the chest and more. In addition, you can author your own scenarios in pretty short order. I sat with one of the folks from METI and authored a custom scenario in about 30 minutes. I identified the events I wanted, put them in order, saved the whole deal and hit “play.” With proper interventions, the scenario ran. Amazingly, with either a lack of interventions or inappropriate interventions, the simulator responds accordingly, and the patient can crash or die.

In truth, a simulation is always a simulation, and whether the tool is a live patient with props and moulage or a manikin, there are limitations. But the simple fact of the matter is, you can’t get a real patient to produce any pathophysiology, and the Emergency Care Simulator clearly can. This simulator provides a more than reasonable suspension of disbelief, allowing providers to become more immersed in their assessment and provision of care, thus increasing the value of the simulation. In a word, this product is impressive.

For more information, call 941/342-5609, or visit www.meti.com.