New and Developing EMS Technologies

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1 New and Developing EMS Technologies Will Smith, MD, EMT-P Grand Teton National Park NPS EMS Advisory Group

2

3 Objectives Discuss New EMS Technologies Airway Breathing Circulation Trauma/Other Collaborate on experiences of others in the room

4 Disclaimer I have no financial relationships with any companies or items presented. I m just sharing my experiences of what works for me!! Research and make your own judgments!

5 Airway Gum Elastic Bougie (GEB) KING LT-D / LTS-D Continuous End Tidal CO 2 Monitoring

6 Gum Elastic Bougie (GEB)

7 Gum Elastic Bougie (GEB) Facilitates intubation in difficult airways ET tubes bigger than 6.0 mm $9.49 from www2.mooremedical.com

8 King LT-D

9 KING LT-D / KING LTS-D Supraglottic Airway Ventilatory seal of >30 cm H 2 O Single port for inflation

10 KING LTS-D

11 KING LT-D / KING LTS-D Alternative to Combitube and BVM Sized Size 3: 4 to 5 ft ( cm) Size 4: 5 to 6 ft ( cm) Size 5: > than 6 ft (180 cm)

12 KING LT-D / KING LTS-D Video QuickTime and a decompressor are needed to see this picture.

13 Continuous End Tidal C0 2 Monitor and Confirm ET tube placement!!! Critical in Pediatric Intubations Monitor CO 2 as factor of resuscitation.

14 Continuous End Tidal C0 2

15

16 Breathing CPAP Boussignac Carbon-fiber Oxygen Cylinders Oxymizer

17 CPAP Continuous Positive Airway Pressure Improves oxygenation in CHF/COPD Boussignac CPAP Powered by Oxygen at 15 to 25 lpm Achieves CPAP of 5-10 cm H2O

18 CPAP

19 CPAP

20 Carbon Fiber Oxygen Tanks $475 High Pressure Regulator -$115

21 Carbon Fiber Oxygen Tanks DD Lite 3.7 lbs (c/w Alum D lbs) 3,000 psi (c/w Alum D - 2,015 psi) May need special filling to get max psi 2 l/min = 5.5 hours C/w Alum D of 2 hours

22 Oxymizer

23 Oxymizer $19.49 Saves oxygen by 2:1 to 4:1 by storing oxygen until early inspiration, so oxygen isn t continuously flowing into the surrounding environment To reach 2 lpm flow rate of 0.5 lpm 6 lpm flow rate of 3.5 lpm

24

25 Circulation IntraOsseous (IO) Access CPR Vest Impedance Threshold Devices Carbon Monoxide (CO) Measuring Electrolyte Monitoring (Na +, K + )

26 Intra Osseous (IO) Access EZ-IO FAST 1 BIG

27 Major AHA Changes (2005) Intraosseous (IO) vascular access Same meds and doses as IV Need pressure bags/flushes May need Lidocaine flush Adults and Peds Deemphasized ET meds

28 EZ IO

29 EZ IO $547 1 gun, 3 adult needles 15 gauge - Adult 25 mm 15 gauge - Pediatric 15 mm

30 EZ-IO

31 EZ-IO Hand Driver $ chinookmed.com No batteries More Compact

32

33 FAST1 (PYNG) $ for one setup Save withdraw device

34 FAST1

35 BIG Bone Injection Gun $64.95 for one setup 15 guage - Adult 18 guage - Pediatric

36 CPR Vest AutoPulse

37 AutoPulse Video

38 Impedance Threshold Device (ITD) ResQPOD $

39 ResQPOD Increases forward blood flow Ventilation Timing Lights (every 6 sec) Prevents Hyperventilation!!

40 ResQPOD Video

41 Electrolyte Monitoring i-stat Exertional Hyponatremia Na + Hypothermia Arrest ph K + >12 mmol/l = DEAD

42 Carbon Monoxide (CO) Detectors RAD 57 Measures SpO 2 SpCO

43

44

45 Trauma Pelvic Binders TPOD SAM Pelvic Binder

46 Pelvic Stabilization - T POD

47 Pelvic Stabilization

48 Pelvic Stabilization - T POD

49 Pelvic Stabilization - T POD T-POD (Trauma Pelvic Orthotic Device) $98

50 Pelvic Stabilization - T POD Video

51 Pelvic Stabilization $75

52 Pelvic Binders

53 Nasal Atomizer Rapid Med Administration Versed - Sz/Agitation Narcan - Overdose Opiates - Pain Topical Anesthetics and Vasoconstrictors Epistaxsis, NG tube placement, Nasal ET

54 Nasal Atomizer www2.mooremedical.com $2.85

55 Summary What to Get? Evaluate Needs Research Product(s) Cost/Benefit

56 Questions? Lecture Notes:

57 EMS Technologies Airway Gum Elastic Bougie King LTS-D Continuous End Tidal Breathing CPAP Carbon Fiber Oxygen Tanks Oxymizer

58 EMS Technologies Circulation Intraosseous (EZ-IO) CPR Vest (AutoPulse) Impedance Threshold Device (ResQPOD) istat CO Monitor (RAD 57)

59 EMS Technologies Trauma Pelvic Binder (T-POD) Clot Enhancers Other Quick clot Nasal Atomizer (MAD)

New and Developing EMS Technologies

New and Developing EMS Technologies New and Developing EMS Technologies Will Smith, MD, EMT-P Grand Teton National Park Jackson Hole Fire/EMS www.wildernessdoc.com Objectives Discuss New EMS Technologies Airway Breathing Circulation Trauma/Other

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