More Thoughts From EMS Today

I lurked in the audience for a number of Podcasts from the temporary studio on the exhibit hall floor. I don’t know if podcasting is social media or new media, although I’d guess that it’s new media. At that, I think I have a better idea than the people who run JEMS and EMS Today. Anyway, the idea of just about anyone being able to produce and release their own TV or radio show is pretty cool. I think that the Founders of this nation would love the idea, although the British would probably have hated it.

As I said in my previous post on the subject there is a lot of stuff in the exhibit hall. Some of it new, some of it not so new, some of it will be seen only once and then disappear as surely as the Choke Saver did.  Which was a device developed in the late 1960s to remove objects (mostly food) from people’s airways. Along with tonsils, vocal chords, and the occasional epiglottis. Still, in many states all restaurants had to have them. Now a museum piece, they were once considered state of the art.  Such was the fate of many innovations in EMS, but I’m repeating myself.

Given that therapeutic hypothermia is now a Class I recommendation from the AHA there were a number of new devices to help cool post arrest patients. A couple of them seemed practical, while some of them were less so. I expect to see more field usable devices introduced over the next year or so. In 3-4 years, using chilled saline might become passe and be replaced with easy to maintain external devices. Or maybe not, time will tell.

There were also a number of devices and programs to help systems improve their personnel’s CPR performance. I’m dubious, but maybe they are needed. The AHA is really emphasizing good chest compressions and early defibrillation as the keys to cardiac arrest survival. Probably the key thing is that we put aside our egos, admit when we are tired, and swap out more often. Again, peopleware is harder to change than technology.

I like ambulances. Well, I better since I spend a lot of time in them. Ambulance Driver is planning a post on his perspective on ambulance design development, but he and I work in different types of vehicles and different types of systems, so I’m not stealing his idea when I post my own comments.

To me, ambulance design hasn’t evolved all that much over the years. Ambulance construction, on the other hand, has improved quite a bit. As has ambulance safety, although not as much as many people would like to see. Certainly the rolling stock is much better than it was when I started with better HVAC systems, especially in the back. Better electrical systems too, although a lot of services seem to see lighting systems that use less power as an indication to add more lights. By and large, the layout of the patient compartment hasn’t changed all that much in most cases. There are a couple of exceptions, but over all the size and shape limitations of existing vehicles dictate that not all that much is going to change.

Conceivably, I could take my current equipment, put it in a 30 year old ambulance, and run calls pretty much as I do now. I definitely could not take most of my equipment from 30 years ago, put it in a new ambulance and do the same. EMS equipment has evolved much more quickly than EMS vehicles. As long as one of the primary functions of EMS is to transport patients and as long as those patients don’t radically change their anatomy, vehicle design is going to be limited in the ability to be radically changed. What will hopefully continue to evolve is the safety, utility, and durability of the chassis. The primary design need is for a smooth ride so patients and crews don’t tossed around. Of course getting people to stop driving like maniacs would help too, but again peopleware rears it’s ugly head.

There still seems to be a lot of federal grant driven items out there. Also, there seems to be an increasing amount of gear that has been developed for military use in Iraq and Afghanistan that is being civilianized and offered for sale. I guess if there is an upside to war, advances in medical technology would be it. No doubt some of the gear will adapt better than others.

That’s all for now.