Paramedic Blog

The new AllMed SpeedStrap SC is my latest version of the 12-point SpeedStrap for backboards with pins. The center strap is 3” longer than our regular model, and the three middle straps are free-floating on the center strap. You can slide them up and down for proper alignment with the pins. The SpeedStrap SC can either be left on the backboard like our regular SpeedStrap, or it can be stored in the carry case provided. It can be applied quickly and easily.

To use the SpeedStrap SC first place the top red colored strap at the very top of the chest, high up under the arms. Then secure the remaining straps for rapid and effective patient immobilization. The top two shoulder straps are designed to help secure the CID, for integrated alignment of the cervical spine. You can apply it quickly using the speed clip pins, or leave it pinned on the board and use the center buckles to open the straps for patient positioning. This versatility is of enormous value in heavy snow conditions when using the clips becomes very difficult.

SAM Medical has designed a new applicator delivery system for CELOX™ called CELOX -A™. The new applicator device with plunger, now makes it possible to place the CELOX ™ hemostatic agent deep into the site of a traumatic wound. It will help deliver the clotting agent close to the source of bleeding.

This product reminds me of an old military medic trick. I’ve heard stories about corpsman carrying tampons and pushing them deep into penetrating wounds. The new SAM CELOX -A™ Applicator looks a lot like a tampon injector or syringe, loaded with granules of their CELOX ™ hemostatic. It comes in a slim and rugged package that will conveniently store anywhere you need it.

CELOX™ is a new high-performance granular hemostatic material. It is a proprietary marine biopolymer designed to stop high-volume arterial bleeding. CELOX™ is suitable for many applications, including deep arterial bleeds. CELOX™ clots blood fast, does not generate heat, works in extreme cold and on heparinized patients.

Once upon a time there were a group of brave Fire Policeman. One evening they directed traffic around a bad car wreck. After the helicopter took the patient, they retired to a nearby lounge.

At the lounge they did shots while watching the exotic dancers. After several rounds one of them had a moment of inspiration. He was watching the final minutes of his favorite dancers routine. When she tore off her pants in one deft move, he loudly exclaimed, “That’s what we need, tear-away safety vests!” And thus a new design was born, the 5-point breakaway safety vest.

Or so the story goes,

The new AllMed Nighthawk Intubation Kit is a compact and versatile deployment system for the innovative TruLite Disposable Laryngoscope. It holds 2 TruLite Laryngoscopes, and two SwiftGrip ETT Kits. It’s the most versatile, compact, high-performance intubation kit on the market. It also uses the lightest weight and brightest disposable steel-bladed laryngoscope in the world. 

The Nighthawk Intubation Kit can be used as a separate hand-held kit, has a hidden loop for belt-carry, or can even be mounted to a load-bearing Molle tactical vest with four Lift-The-Dot snap-loops. It's perfect for Tactical EMS, Wilderness EMS, USAR Teams, and Disaster Caches.

The TruLite Laryngoscope is a completely disposable, integrated handle and blade combination. The blade and handle are permanently attached together. Every blade has it’s own power supply from 2 AA batteries in it’s own compact and lightweight handle. The Trulite has a finely crafted stainless blade with a real forged tip. The focused white-blue light is not only incredibly bright, it's also the ideal color spectrum for laryngoscopy.  They are offered in color-coded Mac 2, 3, and 4 sizes, and soon in Miller 1, 2, 3, and 4 sizes.    

Compact 11" x 6" x 1.5" Size, Weighs Only 1.2 Pounds, Forged Stainless Steel Blades, Super-Bright blue-white LED illumination, No Cleaning Cost

The Swiftgrip ETT kits include the ET Tube, rapid Swiftgrip ETT Holder, a polished aluminum stylet, and even a syringe. Everything is packaged completely assembled and ready for instant use. The innovative Swiftgrip ETT Holder is the only commercially available device that can almost be applied blindfolded. It is also the only one already loaded on the ETT when you open it, and leaves the oral pharynx available for inspection and/or suctioning.

Each Nighthawk Intubation Kit will automatically come with a size 7 and 8 Swiftgrip, a #3 and #4 Macintosh TruLite Laryngoscope, and 4 AA batteries. The Nighthawk Intubation kit is manufactured from rugged waterproof; 500-denier black nylon polyurethane coated fabric and features a durable double-pull YKK zipper.

It offers both patient range and complete equipment redundancy, yet weighs only 1.2 pounds stocked.

I received a copy of an interesting survey by Leflein Associates, of about 150 Paramedics and 150 EMT's (sponsored by Zoll). It reveals a lot about EMS provider's attitudes regarding the current consent degree under which Physio Control is producing defibrillators. Under the terms of the current consent decree, if you want to buy a Physio-Control defibrillator you must sign a letter which:

1. Describes “…the nature and immediacy…” of your need, and
2. Certifying that you “…have previously standardized on Physio Control defibrillators…” and
3. “…Need the Physio Control defibrillators to provide adequate emergency care to patients…”

Some of the key findings in the Leflein Associates report include:

• 60% of those surveyed agree that the consent decree will affect the ability of EMS agencies that use Physio-Control products to deliver proper pre-hospital care. This includes 56% of those who currently use a Physio product.
• 56% of those surveyed think EMS Agencies that use Physio-Control should switch to another brand as a result of the consent decree. Among current Physio owners, 45% agree.
• Only 36% of EMTs and Paramedics were aware of the consent decree before this survey. There was a higher awareness (50%)  among those planning to purchase Physio-Control next. 
• Respondents ranked reliability (92%), durability (85%) and functionality (80%) as the most important factors in an AED or Manual ALS External Defibrillator.
• Things like price (36%), previous experience with the brand (36%) and brand reputation (38%) rank lowest.
• But curiously, when those who were planning to purchase their next defibrillator from Physio-Control were asked why - their responses largely reflected the brands cost, reputation, and their previous experience.

For a pdf of this report, just send me your request and I'll reply with a copy attached. Most of the big companies do these kinds of consumers’ surveys all the time. This one, while no more objective than most of its type - is still very interesting.

To me it says there is a big disconnect between what we say we do, and why we really do it. Even the most carefully considered equipment-purchasing decisions are still largely driven by emotion. In other words, the feelings still count a lot more than the facts. This is not necessarily bad thing, but it certainly is a human thing.

The drug-crazed patient does not care you wear light blue while the police in your community wear dark blue. He reacts to the visual styling cues and will often mistake you for a cop in the first few seconds. In many parts of the world this is no big deal, but in any modern American big city it can get you killed.  The second problem is that we work in a very physically demanding profession. We often compound heat stress by wearing older style polyester fabrics. We really need comfortable garments that give us complete freedom of movement to efficiently do our very physical type of work. We are also in dirty outside work environments, and are frequently exposed to different sources of fabric stains. We really need uniforms that both repel fluids and wick perspiration away.

We still frequently wear dark colors that cannot be easily seen at night. We have the new Federally Mandated ANSI compliance deadline driving the purchase of safety vests and coats. But the big unanswered question is will EMS staff wear the new safety vests? Perhaps if we had great looking hi-viz shirts and coats, no matter the season or circumstance we would be safer. The challenge will be to create professional, functional, and great looking hi-viz uniforms for EMS providers.  There have been many new developments in fabric manufacturing and fabric coating technology, which can provide our industry valuable new benefits. Most of these features were first seen on golfing apparel and other high performance outdoor sports apparel.

Polyester uniforms were always hot and sweaty, iron-wearing permanent press sauna suits. Not these new polyester fabrics. The new generation synthetics often have wicking properties and are now much more breathable. Spiewak recently introduced their leading edge SPDU, Spiewak Performance Duty Uniforms. These advanced technology uniforms have over 30 advanced features. They are manufactured from new performance polyester material, which has amazing mechanical stretch properties. It also features a nanotechnology fiber coating, which makes these uniforms incredibly fluid resistant.

Atlanco recently introduced a new 24-7 line of performance uniforms with the Tru-Spec brand label. They’re new 24-7 Series brand 60% cotton, 40% performance polyester polo shirt is breathable and wicks moisture away. It also has an anti-microbial treatment for odor control. These new performance polyester fabrics have amazing comfort compared to fabrics of the past. The material has an incredibly rich, natural feel. Washed on the hot cycle it still fits exactly the same as new.

Another good example is the Perfection Uniforms Eclipse Series performance polyester polo shirt. This shirt also introduces a whole new uniform look. The styling details do not share one design line with police apparel. It features epaulets more like a racecar drivers suits than a police shirt. The pockets, penholder, microphone clip and all the styling details subtly create an official professional uniform appearance that is markedly different than a police officer. The performance synthetic fabric of the Eclipse Polo is remarkably breathable. Russell Mills specially developed this innovation pique weave performance-poly material for sports apparel. Like other modern fabrics of this type, the shirt is much more comfortable and wicks perspiration away from your skin so it can more easily evaporate to keep you cool.

These new high performance fabrics promise to keep us cleaner, drier, and much more comfortable while doing a difficult and physically demanding job. Some like the style of the new Perfection Eclipse even hold the promise of helping to make us safer. These are some of the features and garment technologies that are likely to drive EMS market demand in the very near future.

Medtronic said it would reduce its workforce by 1,100 positions on March 3^rd, 2008. A company spokeswoman said, "Yesterday's announcement does not impact Physio-Control employees." Medtronic took the reigns when it merged with Physio-Control in 1998. The Physio-Control brand name is one of the best-recognized names in the EMS product Industry. Founded in 1955, it is also one of Redmond Washington’s largest employers. Most of the very first portable defibrillators widely used in EMS were developed and manufactured by Physio-Control. But today times must be tough at Physio-Control.

Physio-Control’s parent company Medtronic, Inc. and their two top executives signed a consent decree of permanent injunction related to Automatic External Defibrillators (AEDs) manufactured by Physio-Control, Inc. on April 30^th, 2008. The consent decree prohibits the manufacture, distribution, and export of specified AEDs at or from Physio-Control's facility in Redmond, Wash., until the devices and facilities have been shown to be in compliance with the Food and Drug Administration's (FDA) current Good Manufacturing Practice (cGMP) requirements, as set forth in the Quality System regulation for devices.

My first defibrillator as a new Paramedic was the reliable but heavy Lifepak 4. Once it flew out of the unlatched door of my moving ambulance. When we pulled over to pick it up and checked it out, it still worked fine. Physio-Control durability became the standard by which other EMS products were judged. They also produced the first truly portable EMS defibrillator/cardiac monitor, the Lifepak 5. Tens of thousands of these rugged little devices were sold. In some cases, they gave decades of reliable life-saving performance. Physio-Control then set another new standard with the first integrated 12-lead capable portable cardiac monitor/defibrillator, the Lifepak 12. With each new accomplishment, Physio-Control successfully partnered with EMS clinicians to meet our rapidly evolving product needs.

When Physio-Control Inc. suspended shipments of its LIFEPAK defibrillators in January 2007; the company cited vague issues with its quality-control systems (read that story here). A few weeks later, it eliminated 300 jobs, or about 30 percent of its work force. The FDA's recent injunction against Medtronic and Physio-Control cites 11 violations, reported by FDA inspectors during a 2006 visit. Previous FDA inspections in 2000, 2003 and 2005 showed similar violations. FDA issued warning letters after the 2000 and 2005 inspections, citing the cGMP violations (Read the injunction here).

Medtronic said a year ago that it would spin off Physio-Control into an independent public company by October 2007. However, those plans were put on hold when manufacturing process problems were reported in January. In recent filings with the Securities and Exchange Commission, Medtronic reported that it still plans to pursue the spin-off. Over the six-month period that ended Oct. 26, Physio-Control operated at a $30 million loss before interest and income taxes. They will report financial results for the fourth quarter and fiscal year, which ended April 25, 2008, on Tuesday, May 20, 2008. It is unclear exactly how long it will take Physio-Control to comply with the injunction agreement, at which point it will again be able to sell its defibrillators. However, if Physio-Control does not comply with the agreement it will have to pay a fine of $15,000 per day, in addition to $15,000 per day for each violation.

The company continues to support EMS customers without interruption. Physio-Control has been paying the sales, service, customer care, and all mission-critical staff salaries required to maintain a strong supporting presence in the EMS market. The brand was built on service, and this commitment has been maintained despite recent challenges. Many in our industry are closely watching this evolving situation with growing concern. Only this last weekend, I saw a law firm advertising on television for clients in a class action suit against Medtronic for alleged faulty internal defibrillators. Medtronic Physio-Control has been a vital partner to EMS for over 30 years, and recent news highlights the growing risk to this longstanding relationship. 

We were also very favorably impressed with the Safety Site. We were able to break it with our throw test, but only the replaceable lens. It continued to operate and we found that it performed remarkably well.  It did not appear likely to survive being run over. We were impressed with the light intensity and long-range visibility.  It features a high performance light reflector that permits visibility at over 2 miles.

The Safety Site has the brightest bulb, a Super Bright Luxeon made by Whelen, a leader in emergency lighting. Over the last 2 years they have had only 10 returned, most after having been run over by drunk drivers. A case can be made that if the flare is brighter, it should get hit less often. It also offers the best battery life of one hundred hours.

Turboflare was perhaps the first electronic flare and is physically the largest. But it was not as bright or visible as either the Safety Site or Powerflare.  They offer a wide variety of accessories like flags, triangles, and cones to help make it more conspicuous. When we threw it against the wall, it switched off but came right back on. When we ran over it, we broke the legs off. The Turboflare comes in two versions, Yellow for pedestrian use and Orange for commercial or industrial use.  The difference is the battery life and durability. The orange one can take more abuse and has a battery life of 30-hours. It offers a fair balance of performance and durability.

We believe the Safety Site and Powerflare offer the best combination of price, performance, and durability. AllMed will offer both options for our customers’ consideration when choosing a safer alternative to burning road flares. We will offer both the brightest flare, and the most durable flare.