Best of Show: Part II
In all the years that I have attended EMS EXPO, I've never seen the exhibit hall so crowded. Then again, with more than 5,000 attendees and 325 booths, it only makes sense. It just added a little more challenge as I roamed the floor looking for the most innovative products to come our way. Here, for your perusal, is Part 2 of my Top 20 picks from EMS EXPO 2003-the best of show. Part 1 appeared in the December issue.
NecLoc Kids Pediatric Extrication Collars from Jerome Medical
In the early days of EMS, we had little to no equipment actually designed for field use. As a result, we acquired products and product ideas from the military, hospitals and the space program. In time, more and more EMS- specific products made their way to market, but the vast majority were targeted at adult patients. There was a definite logic to this, given the relative infrequency of pediatric patient encounters. Sadly, that left EMSers with little choice but to try to modify adult products or simply improvise when caring for kids. If that wasn't enough, what pediatric products did make their way to market often appeared to be little more than scaled-down versions of existing adult products.
Jerome Medical designed the NecLoc Kids line of extrication products with a focused objective: immobilizing the cervical spine in proper anatomical position and helping maintain an open airway while at the same time properly fitting a child's anatomy. NecLoc Kids collars are two-piece collars that come in three sizes: P1 (newborn to age 2), P2 (age 2-6) and P3 (age 6-12). These sizing models allowed Jerome to address the progression of neck height as the child grew, as well as the relationship between the head and back. Each collar has a large angled occipital support, ample clearance for the ears and a large opening for visualization of the trachea. In addition, Jerome chose to use the Broselow-Luten color coding system with its collars, a feature unique to their product line that simplifies size selection.
These easy-to-use, innovative collars will undoubtedly contribute to our efforts to provide the most efficacious cervical spine immobilization to our pediatric patients. Kids are always challenging patients who stress most field providers if for no other reason than we aren't just saving lives, we're saving lifetimes.
For more information, call 800/257-8440, or visit www.jeromemedical.com.
Magnum Elite Kevlar Uniform Boot from Magnum
Some old-dog EMSer once told me, "The two things that will make you truly miserable are when your teeth hurt and when your feet hurt." While good dental hygiene may solve half that problem, taking care of your feet takes a bit more doing.
Over the last 15 years, Magnum has earned a reputation for providing occupational footwear that is comfortable and provides excellent performance. Last year, the company introduced its Elite series, a line that was extremely well-received in the industry.
Now Magnum has upped the bar by introducing the first Kevlar uniform boot: the Elite Kevlar 8" side-zip boot.
Traditionally used as a component of protective gear, Kevlar has been trusted by field providers for more than 25 years.
This man-made, silky-soft fiber from DuPont offers a blend of unsurpassed strength, light weight, comfort and breathability.
The Elite Kevlar 8" side-zip boot utilizes a hybrid version of the fabric that provides excellent performance without excess weight. The use of a composite shank, rather than the traditional steel shank, also helps keep the boot's overall weight to a minimum.
The boot's Dri-Lex boot lining, coupled with an Aerospacer mesh collar, ensures breathability. In addition, the Aegis microbe shield technology resists odor, mold, mildew, fungus and bacteria, killing microorganisms as they contact the boot's surface.
With its many features, I was amazed at the light weight of the Elite Kevlar boot. Even in my size-a less-than-dainty 14-the boot is extremely lightweight. State-of-the-art technology, first-rate comfort and value all add up to one tough boot. Trust me, your feet will thank you.
For more information, call 800/521-1698, or visit www.magnumboots.com.
HeartStart MRx ALS Monitor from Philips
Continuing a legacy of innovation that included the almost-legendary ForeRunner AED, Philips offers its new HeartStart MRx ALS cardiac monitor/defibrillator featuring the SMART biphasic waveform.
The first thing that caught my eye about this monitor was the large, easy-to-read, full-color screen that allows it to display combinations of four wave displays. Given that the unit comes with oximetry, capnography, NIBP and pacing, ease of viewing is a must. In the typical monitoring view, the provider can monitor some basic patient information as well as the date, time and status of the two rechargeable ion batteries that provide up to 10 hours of monitoring.
The MRx has a status indicator light that tells you the unit is ready for use. It does regular self-diagnostic tests on an hourly, daily and weekly basis. Test results from up to 53 weeks are stored in an internal memory and can be viewed. Speaking of data collection, the MRx has an internal memory and optional CompactFlash data card that can capture approximately eight hours of continuous ECG waveforms and events, including drug and other therapy markers, plus up to 50 12-lead ECG reports.
The MRx offers a wide range of versatility based on the parameters of a given situation. Patient monitoring can be done with either quick-look paddles or monitoring pads. The unit features multiple adaptors that allow a "hot swap" with an AED.
Despite its wide range of monitoring capabilities, therapies and additional features, the MRx, even when fully loaded, weighs in at a mere 13 pounds, making it easy to carry or hook securely to most standard stretchers.
For more information, call 978/687-1501, or visit www.medical.philips.com.
CFP-15 Oxygen Generating System from OGSI, Inc.
One of the ongoing costs of doing business in EMS is that of maintaining a constant and readily available supply of medical-grade oxygen. When I got wind of OGSI's idea of "make your own oxygen," I just had to check it out.
The CFP-15 is a self-contained oxygen cylinder filling plant, new to the EMS market, that produces medical-grade oxygen and compresses it, allowing provider agencies to fill their own tanks at up to 2,200 psi. Put a CFP-15 system into place, and suddenly problems with traceability, cylinder transportation, safety, convenience and supply availability disappear.
The unit is much smaller than I envisioned, taking up a mere 30" by 16" by 36" when set up for wall mounting. Once it's set up, all you provide is a clean, dry environment that has air and a 110-volt power source. The CFP-15 is designed to run automatically and requires little to no attention once up and running. A clearly visible indicator panel lets you see at a glance what the unit is doing as it continually assesses and measures oxygen purity, as well as the pressure being delivered to the cylinder. The unit performs a continuous series of self-diagnostic tests as it monitors the process from front to back. Should a problem such as a drop in oxygen purity occur, the CFP-15 will automatically shut down and display alarms.
Another real plus is the unit's quiet operation. I sat right next to a CFP-15 while carrying on a normal conversation, and I could barely hear it running.
At some point, the question of cost must surface. For agencies using more than one large cylinder of oxygen a week, the CFP-15 can pay for itself in about two years. After that, the annual maintenance is estimated at approximately $100. Most amazing to me is the actual cost to fill a K, L or M tank. Based on the average cost of electricity around the country, you are looking at about $1. Unbelievable.
For more information, call 716/564-5165, or visit www.ogsi.com.
Tyron Wheel Safety Bands from Runflat America Corp.
Blow out a tire on a car at any speed, and you've got serious problems. Blow out a tire on an ambulance at high speed, and your problems are multiplied. As the tire deflates, air pressure no longer holds it in its correct place on the wheel. The tire's beads move into the well, allowing it to fail and immediately producing a loss of steering, braking and traction. Want a safety net should such a potentially catastrophic event occur? Take a look at the Tyron wheel safety band.
British manufacturer Tyron initially developed and patented the "well filler" wheel band following a request from England's Ministry of Defense. Once it was developed and installed, the Tyron wheel band gave British troops a "getaway" capability, even if their tires had been deflated by gunfire.
Amazingly, this device has been successfully used in Great Britain for close to 20 years on roughly 97% of police cars and 100% of fire apparatus. The band does its magic because it is installed in the well inside the wheel well, preventing the tire from coming off the rim when deflated. As a result, the tire has run-flat capabilities and can be driven on for up to 50 miles at medium speeds.
Believe it or not, Tyron bands are guaranteed for life and can actually be transferred from vehicle to like vehicle. Tyron further guarantees that the wheels on vehicles that suffer a flat under normal driving conditions will not be damaged, or they will be replaced at no cost to the customer.
In spite of such impressive qualities and guarantees, the installation of Tyron wheel safety bands is not rocket science. They can be installed by any mechanic with the assistance of instructional materials provided by Tyron's North American arm, Runflat. What I want to know is why it took 20 years to get this product across the Atlantic.
For more information, call 888/RUN-FLAT, or visit www.runflat.com.
Safety Vision Color Flat Screen Rear Vision System from Safety Vision, LP
At some point in almost every provider's career will come a time when he backs his rig into some fixed object. Whether it's big, like a building, or small, like a post, it never makes your service director happy to hear you've done a rear bumper modification. With the addition of the Rear Vision System from Safety Vision, maybe we as an industry can reduce the frequency of backing crashes.
The Safety Vision unit itself functions primarily as a rearview mirror with a wide field of view, but with added perks a mirror doesn't provide. While the unit's primary use is for backing, it also helps with turning right and changing lanes. The external components look to be well-built and feature a heavy-duty, water-resistant housing for those days when sunshine isn't part of your shift.
Operating temperatures are listed at -4ºF up to 158ºF, which should allow it to function well in most parts of the U.S. The all-color LCD turns on when the monitor is turned on or when you shift your rig into reverse-one less thing to remember. The LCD image is non-obtrusive, but highly viewable at 6.8 inches.
I found the monitor resolution to be excellent. It features both day and night sensors, and has backlight compensation to prevent whitewashing. Infrared illuminators allow it to function in almost complete darkness as well.
One real plus is the addition of a built-in speaker, which allows the driver to communicate with his spotter during backing, as well as to simply hear what is going on around the vehicle. Coupled with just a little common sense and decent driving skills, the Rear Vision System is a great idea. Your rear bumper will thank you, as will your service director.
For more information, call 800/880-8855, or visit www.safetyvision.com.
SkidCar from SkidCar System, Inc.
I'll never forget the first time I did doughnuts in a full-size pumper on an ice-covered EVOC course. What I was feeling was a blend of exhilaration and pure, unadulterated fear-could I regain control of the pumper before I finally slid it off the course and into a field? Those difficult, costly-to-set-up-and-run learning experiences could be a thing of the past courtesy of the SkidCar driver training system, which is based on the premise that most drivers, at one time or another, will put their vehicles into situations that subject them to extreme physical forces. Once a vehicle is out of control, the outcome for providers and patients alike is a real roll of the dice.
This is a total package, covering everything from the hardware that must be installed to make the vehicle skid on command to instructor lesson plans and corresponding PowerPoint presentations. The company and its representatives have a positive, upbeat attitude about their product, and they go out of their way to provide state-of-the-art accident, crash and skid avoidance training.
To date, most of their market penetration has been in the law enforcement area, but they have finally moved into the field of EMS, which I view as a real plus. One of their representatives estimated that at present, EMS is lagging a good 12-15 years behind law enforcement in this area of safety training.
The actual SkidCar hardware is almost like a second chassis that fits under the vehicle. Once installed, it allows the instructor to modify the skid characteristics of the vehicle. If the driver does something errant, the vehicle skids; if he or she drives well, it doesn't-a positive-reinforcement model. When the car skids, it does so at a slow speed that keeps the event under control and safe.
For larger agencies, SkidCar offers five-day instructor training courses that allow the training of four instructors at a time (and save the cost of having SkidCar return to do recurring training). I was not only impressed with their hardware, but also with their positive attitude and willingness to provide turnkey vehicle training, with no hidden agendas or costs. With excellent driving skills being a major expectation of most employers, SkidCar looks to be a real asset to our profession. As Dane Pitarresi, the company's president, says, "A superior driver is one who uses superior knowledge to avoid situations that require superior skills." Welcome to EMS.
For more information, call 866/SKID-CAR, or visit www.skidcar.com.
Septex Workmate from Septex
Another tool in the ongoing war against nosocomial (spread by touch) infection is the Septex body-worn personal hand sanitizer, the Septex Workmate. During routine patient care, a torn glove is an all-too-common event. While you can put on another pair of gloves, the bottom line is, if your hand got contaminated, it remains so, even inside the new glove. Ideally, you should decontaminate prior to donning the replacement glove. Then again, do you have the time to run back out to your rig's wall-mounted dispenser for a hand-cleaning moment? Probably not.
A simple, convenient solution is to reach to your side and use the Septex body-worn personal hand sanitizer. The Cordura nylon holster holds a 2.3-ounce bottle of Septex's Workmate, containing ethyl alcohol, an agent effective against most germs in about 15 seconds.
The Septex Workmate is a sensible, convenient product that allows you to quickly spray your hands and continue doing your job while reducing the likelihood you will contaminate yourself or your coworkers. And to think, it's right there on your belt.
For more information, call 888/3-SEPTEX, or visit www.septex.com.
Hammerhead-XRT from WalkAbout Computers
Removing a computer from the cozy inside environment and making it tough enough for use in the streets takes some doing. From what I can tell, WalkAbout Computers has it figured out.
The 4½-pound Hammerhead-XRT (for extremely rugged tablet) represents no less than the sixth generation of tablet PCs designed and manufactured by WalkAbout. Its hardware resides in a milled two-piece aluminum housing, providing its light weight and excellent durability.
In addition, its ruggedized hard drive sits in a special gel mount, further increasing reliability. I watched a sales rep drop the unit on the floor at least a dozen times while I was visiting with him. Not tough enough for you? The unit is also submersible in three inches of water for up to 15 minutes, should you decide to drop it in a puddle or two.
This sixth-generation Hammerhead has faster speeds, lower power requirements, longer battery life and some of the most advanced display technology in the industry. Even in the bright lights of the exhibit hall, the transreflective color screen and 800 by 600 resolution made it a piece of cake to read.
The unit is powered by a pair of lithium ion batteries, allowing hot-swapping while providing uninterrupted service. If that isn't enough, the Hammerhead has three communication slots and utilizes state-of-the-art CDMA and GPRS wireless communications technology, allowing you to transmit patient data to the hospital.
While extremely tough, the Hammerhead-XRT is not indestructible. In the unlikely event a hard drive fails, the unit is field-repairable, and the hard drive can be totally swapped out in about 10 minutes. What more can I say?
For more information, call 888/925-5226, or visit www.walkabout-comp.com.
MADett Endotracheal Mucosal Atomization Device from Wolfe Tory Medical
Establishing IV access on cardiac arrest victims is no easy trick, and when an IV line can't be established in a timely fashion, the only real option used to be to administer drugs directly down the ET tube. Unfortunately, that required stopping ventilations, disconnecting the BVM from the ET tube and squirting the drugs down the tube. While the patient was not being ventilated, CO2 levels would rise, pushing the patient's pH down and making them even more acidotic, and the resuscitation more difficult. Simply squirting drugs down the ET tube was in itself problematic, not just by interrupting the ventilations, but also because significant amounts of the drug stuck to the sides of the tube. This resulted in drug waste and left the clinician to speculate just how much, if any, of the drug was actually making its way into the system. Over the years, a combination of jury-rigged ideas and other products just could not seem to solve this problem. With the entry of the MADett into the field of prehospital medicine, it appears a truly functional solution has arrived.
The MADett has 20 inches of tubing, an elbow connector for ventilations and a female Luer that fits any standard syringe. You simply slide the MADett down a 7.0 or larger ET tube and align it with the 26cm mark on the side of the tube. This provides a visual indicator of proper placement. The Touhy-Borst valve is then tightened down, securing the device. Once it's in place, the MADett's elbow connector connects to the BVM, allowing the provider to continue to ventilate the patient while the drugs are being administered. The MADett atomizes drugs directly into the lungs at the distal end of the endotracheal tube, spraying a fine mist of approximately 30 microns. By delivering the medication beyond the tip of the tube, the MADett results in more rapid delivery and higher peak blood levels than nebulized or endotracheally injected medications.
In the cardiac world, where incremental improvements in survival have been hard to come by, I am optimistic the MADett will contribute to improved resuscitation efforts and reduced mortality and morbidity.
For more information, call 888/380-9808, or visit www.wolfetory.com.
