In the medical helicopter environment, size and weight matter. The more of each that's given over to equipment, the less is left for patients.

      That was one of the factors driving Quad City Med Force's choice of the pNeuton S transport ventilator, from Airon Corp., for its EMS helicopter operations. The service, with bases in Colona, IL, and Burlington, IA, performs around 1,000 transports a year.

      "The lighter your equipment is, the better off you are in a helicopter, and the bigger the patients you can take," says the service's chief flight nurse, Carol Zimmerman, RN. "The attractive thing about the pNeuton S is that it's small and lightweight. Those are big considerations. Some of these other units are extremely big and heavy and difficult to store. We have to be able to secure this equipment in flight."

      Beyond its petite size (4" x 8" x 6") and weight (6 lbs.), the main attraction of the pNeuton S was its ability to deliver continuous positive airway pressure (CPAP). Quad City Med Force used other ventilators previously, but those lacked CPAP capability. The pNeuton S uses the same CPAP system as its MACS (Mask CPAP System) counterpart from Airon. Additionally, the pNeuton S doesn't need batteries or electricity—it runs pneumatically. "So we don't have to worry about plug-ins for electrical power, batteries failing, things like that," Zimmerman notes. Med Force acquired one for each of its helicopters, plus a backup.

      The pNeuton S comes with easy-to-use controls for tidal volume, respiratory rate and pressure limit for volume-targeted or pressure-limited ventilation. The training curve was comfortable, Zimmerman says, and when questions came up, Airon provided extensive assistance.

      "All in all, it's been a very reliable vent for us," she says. "We're very pleased with the product."

      For more information, visit www.pneuton.com.

     When Todd Carnell, quality management chief for Hillsborough County Fire Rescue in Tampa, FL, says his agency has used the Selec-3 IV system from Biomedix "for at least 10 years," you know that a: he's a satisfied customer, and b: it must be a really great product. "Before we got this system, we carried two IV set-ups—the 10 and the 60, or micro and microbore," he explains. "The Selec-3 really simplified things. It's space-saving in the ambulance, which is a big commodity, because you only have to stock one set of IV tubing as opposed to two. Or, if you use a 15-drop set, you have to have three sets."

      Unlike so many products, Biomedix seems to have gotten it right the first time, since almost no changes have been made over the 10 years Carnell has used it. "It's just a rotating drip chamber that you twist to go to the drops per milliliter that you want," he says. "This is one of those things that works and, ‘if it's not broke, you don't fix it.' In the medical field, if you get a product that's very nice and you try to replace it with something that's inferior in any way, people scream and yell and don't appreciate it. We've been very happy with this system."

      "We run around 80,000 to 82,000 calls a year and carry at least three and as many as 10 of the Selec-3 sets on every ambulance and fire truck at all times," says Carnell.

      Asked if he has any advice for prospective users, Carnell says, "If you're still using separate systems, I would highly recommend switching over. I know there are other products out there, but the only one I've used is the Selec-3, and I don't see any reason why we would change from that."

      For more information, visit www.biomedix.com.

     When the Unified Fire Authority was established in Salt Lake City, UT, last July, a vehicle comparison led them to conclude that Braun stood out above all others, says Unified's fleet manager, Jerry Jones. "We bought 11 vehicles from them then and just ordered nine more. The last one will be delivered in May and all 18 will be in service by July. We're currently using the Chief XL C4500 built on a GM chassis. We liked the fit and finish of the vehicle, how it's built, how it holds up, and the custom fit inside. It's just an outstanding piece of equipment."

      The Chief XL features 72" of headroom, a module length of 166–169 inches, and optimal interior and exterior storage space. The Prestige Package features the EZ Glide Door, which lets rescue personnel slide the ambulance door against the module rather than out into traffic. "This vehicle is safe for providers and for patients," says Jones, "and we've heard a lot of patients say it's a nice, easy ride. It's also user-friendly inside and gives providers easy access to everything they need for patient care."

      In addition to the vehicle's overall quality, Jones is particularly impressed with Braun's customer service. "The Braun family goes the extra mile to take care of their customers," he says. "They really care about how customers are treated, whether it's for service or warranty, or anything else. From the top of the food chain all the way down, everyone bends over backward to help you out."

      For more information, visit www.braunambulances.com.

     During any disaster, large or small, emergency personnel must be prepared for immediate deployment to the scene. Until recently, however, the Hamilton County Health Department in Noblesville, IN, didn't have that capability, other than throwing whatever would fit into a couple of pickup trucks and company cars, says public health coordinator Chad Jenkins. They finally decided on the Reeves ICP trailer from DHS Technologies, and Jenkins is glad they did.

      "We just received our trailer a few months ago and have already conducted two extensive set-up and tear-down drills with it," he says. "In the next 3–4 months, we'll be doing a minimum of two more drills, one of which will be a timed, functional exercise and a full-scale event. We chose the ICP because it's a very mobile concept, as well as being scalable and upgradable. We purchased a second shelter that could be attached to the existing mobile command post to create a mobile clinic where we could provide emergency prophylaxis on the spot during a public health emergency."

      In addition to providing support to the community, health department staff has done extensive NIMS ICS training so they can deploy to larger emergencies if needed. "We've already found a number of inventive ways to use the trailer and soon hope to register it as a national asset," says Jenkins.

      "One key function for us was DHS' EMS customer service, which is unparalleled," he adds. "They actually came out for our training. When one of the hospitals accidentally broke another Reeves product, they were on the spot instantly to help repair it and correct their training so it didn't happen again. I'm a military guy who has dealt with procurement and purchasing, and I'm very thorough. I wanted to make sure the taxpayer money I spent was getting the best bang for the buck, as well as the most durable product and best customer service."

      For more information, visit www.dhstechnologiesllc.com.

     When you're pulling 12-hour shifts on the mean streets of greater L.A., you need a couple of things from your ambulance: 1) toughness and durability, and 2) enough comfort to get you through. Torrance-based Gerber Ambulance Service found both in the new Apex from Crestline Coach.

      Gerber has added five of the vehicles since December, and plans to get more.

      "What we liked from Crestline was the attention to detail and the durability of the product," says Gerber Operations Manager Matthew Steeneken. "We were impressed by the powdercoating and the undercoating and a lot of ther things that weren't industry standard."

      Built on Crestline's AeroBody design, the Apex has an integrated roll cage and all-aluminum construction that contributes to better fuel efficiency and more available payload. It isn't huge (body length: 151"; body width: 90"; interior height: 67"), but it optimizes operational space and offers options and floor plans usually seen on larger ambulances.

      The Apex's overall comfort, Gerber personnel have noted, extends to the cab.

      "The configuration allows for the driver's and attendant's seats to actually recline," Steeneken says. "I've never seen that. On a 139-inch wheel base, it doesn't seem possible." An operations manager also notices the little things: Insulation. Door latches that can be released without using the handle. Heat and A/C along the roofline, running the length of the patient compartment.

      All those little things add up big. Crews have noticed too, and can't wait to get behind the wheel.

      "Everybody wants their opportunity, and we're trying to limit it right now to some of the better drivers, so they get a good breaking in," Steeneken says. "The guys pretty much live in these things for 12 hours a day, and they really like to take full advantage of the equipment."

      For more information, visit www.crestlinecoach.com.

     With around 60 full- and part-time employees, scheduling was getting to be a chore for managers at North Carolina's Johnston County EMS. "We were spending more time in the station working on it than we should have," recalls EMS Captain Matt Leicester. And Leicester was tasked with finding a solution.

      What he found—EMS Manager, from Aladtec—helped Johnston County optimize and simplify its scheduling process in a number of ways.

      "We wanted something that would be easy for employees to access and figure out," Leicester says. "Honestly, some of the other programs we'd seen were just not user-friendly. EMS Manager had a system that was comparable or better in most every way, and cost significantly less."

      EMS Manager is an online scheduling and workforce management system that can be used by both supervisors and employees 24/7 from anywhere with an Internet connection. The sophisticated scheduling system includes a broad array of time-saving features such as rotations, group e-mailing and phone text messaging, availability submission, shift sign-up requests, time off requests, and trades. But EMS Manager goes way beyond scheduling. The system also features a custom employee database for tracking things like certifications and immunizations. A multi-level file sharing library is included to allow administrators to give employees access to things like forms, procedures, policies, photo galleries, training documents and even training videos. The system also includes an event calendar and a multi-level forum. The forum is great for company wide discussions and training exercises.

      Johnston County's new employees get versed on the system during orientation. It's been easy to implement and learn, Leicester says, and even users without much computer savvy can pick it up quickly. Even better, it's paid quick and tangible dividends.

      "Once we implemented it, we were actually able to cut close to 30% off our overtime within a couple of months," Leicester says. "We cut roughly $10,000, and reduced it down to essentially two-thirds of what we'd been paying. We thought that was astounding."

      For more information, visit www.aladtec.com.

     The call wasn't a 9-1-1 emergency response—it was just a routine transport. But the unusual thing for New Jersey's Alert Ambulance Service was the size of the patient: close to 700 lbs. Even by the standards of today's heavier patients, this one was large.

      In the old days, moving a patient that size would have hugely increased providers' risk of injury. Fortunately for its crews, Alert recently outfitted its 52 ambulances with POWERFlexx powered cots from Ferno. "That really made it a lot easier for our staff to maneuver this patient," says Operations Manager Brian Stanwise.

      The POWERFlexx features a lifting capacity of 700 lbs., and can accommodate up to 1,000 in the low position. Its height is universally adjustable between 13–41 inches. Alert supplemented theirs with a half-dozen LBS removable bariatric boards for additional comfort and support with bariatric patients.

      The service moved to the POWERFlexx last year after seeing too many cases of its personnel getting hurt.

      "We were looking to decrease our number of Workers' Comp incidents," says Operations Director Dawn Polo. "With the manual lifting, we'd had quite a few back injuries. We were looking for ways to reduce those."
They chose the POWERFlexx based on the previous performance of a half-dozen units in their critical-care trucks and good experiences with other Ferno products, and deployed them companywide last fall. Six months later, there have been no further lifting and moving injuries specific to the stretchers.

      Crews have specifically appreciated the ease of loading. Automated wheel retraction lets both providers support the cot's weight at the foot end. As well, integrated charging has been a convenience.

      "At first we were bringing the stretchers into our bay area and charging them there," says Stanwise. "Getting the quick-disconnect self-charging in the ambulances was a great asset."

      "You don't have to change out batteries," Polo adds, "and that's a big plus as far as we're concerned."

      For more information, visit www.ferno.com.

     When you live in a metropolitan area with 1.5 to 2 million population density, it's critical to be able to respond to disasters that may generate large numbers of casualties. The Hampton Roads (VA) Metropolitan Medical Response System is one of those areas that qualified for federal grant money through the Department of Homeland Security and took advantage of it to purchase seven fully stocked MCI trailers from Disaster Response Solutions, Inc. Two things sold HRMMRS on this company: price and their willingness to custom-build the trailers, says training and logistics coordinator David Long. "We wanted to address five primary capabilities," says Long. "We wanted to expand our incident command system; we wanted the ability to operate in a hazardous material environment; we enhanced our PPE supply to include N95s and hooded Tyvek coveralls that can be used in a biological event, mass casualty event where there's lots of blood and biohazard threat and during a radiologic event. Then there's our medical supply cache, which, depending on the severity of injuries, would allow us to treat up to 250 patients out of the trailer. Finally, we built in a rehab capability, putting an awning on the trailer where we could rehab responders who have been exposed to environmental extremes."

      Prior to buying the trailers, Hampton Roads just relied on how many ambulances they could get and how long it took them to get there, says Long. A couple of areas had MCI trailers, but they weren't stocked the same, so you never knew what was coming, he says. "With these trailers, you know exactly what is coming, so that has definitely improved our capability to respond compared to the past.

      "Our advice to others is that you really need to evaluate how you're going to deploy your resources in an actual emergency and plan for it to be multifunctional," Long adds. "Don't build it for just one purpose. Consider all the things that are going on in today's environment and enhance your capabilities across the board."

      For more information, visit www.mcitrailer.com.

     In the fast-moving world of medical technology, longevity can be hard to come by. And when a product you first purchased a decade ago still meets your needs better than anything on the market, that's something to notice. It was just about that far back that County Rescue Services, an air and ground provider based in Green Bay, WI, obtained their first Uni-Vent Eagle Model 754 portable ventilator from Impact Instrumentation. The agency is still enthusiastic about the product today.

      "We were looking for a smaller unit that was more user-friendly than what we'd been using," says County's air medical coordinator, Lt. Shaun Stamnes, who oversees training and equipment recommendations for the aviation program. "The Eagle was easy to set up and use, and had other features we liked, like built-in PEEP and extended battery life. Weight was also a concern, since they were going aboard aircraft."

      At just over 12 pounds, the Eagle fit that criteria. It also offers graphics display, powerful monitors and alarms, an interactive demo/teaching mode, and fast startup sequence. County purchased two, then obtained a third through ne of its hospital partners. They're used for ground and air critical-care transports.

      The Eagle's ease of use is something that's still appreciated today. "They are, as we say, paramedic-proof," says Stamnes. "They're numbered right on the face, so you can go step by step to set the unit up. From turning it on to setting your rate, your I/E ratio, tidal volumes, it walks you right down the line. And if there's any error or you have something set wrong, it'll alarm and tell you exactly what the problem is. So it makes it very easy to diagnose what your issues are."

      The Eagles are also extremely sensitive to physiological changes in the patient.

      "If we set something up and the patient's physiology changes," Stamnes says, "we don't have to worry about the system continuing to ventilate and causing problems."

      For more information, visit www.impactinstrumentation.com.

     There's nothing wrong with keeping narcotics in a locked box that needs to be opened with a key, but it leaves medics operating on the honor system when it comes to missing drugs or unstocked containers. With the Knox MedVault, there's no guesswork involved, says Jim Wilkins, supervisor for Penndel-Middletown EMS in a northeast suburb of Philadelphia.

      "Prior to last November, we were using a dual-lock system and had started looking for ‘a better mousetrap,' because everyone was using the same thing," he says. "We liked the MedVault because we don't have to worry about unaccounted-for keys, and we can immediately lock users in or out and have an audit trail to see who's accessing the box and when."

      The audit trail is collected via a USB port and provides a time and date stamp, including the user ID for each activity.

      "As for keeping up with stock, our guys still have to go into the box to inventory what's in there, but we know who is going in and when. Prior to this, we never knew for a fact that individuals were actually checking the boxes like they said they were. Now it's absolutely validated. Every authorized user has an individual PIN code number, and if someone leaves the service, we simply have to hook the computer up to the device and take away their access privilege."

      Another feature that appealed to his agency, says Wilkins, was the ability to mount the drug lockers in each paramedic unit.

      "Quite frankly, they were a bit bigger than the existing key boxes because of the electronics in them, so we had to come up with a new location in the vehicle to mount them," he says. "That being said, they are mounted and satisfy what we need."

      For more information, visit www.knoxbox.com.

     It's cold. It's wet. It's dangerous. It's a water rescue. And like all emergency response services, it's a job where you have to be able to rely on your team, your training, and your tools. According to Thomas Markus, a senior water rescue specialist and 25-year veteran of the field, one of the best tools is Kershaw's fixed-blade Responder. "This is a very friendly knife to hold even when your hands are gloved-up and chilled," says Markus. "The handle's curve is specially designed to fit securely into a cold-cramped hand."

      The Kershaw Responder features a premium AUS8A partially serrated, stainless-steel blade with black Teflon coating. The blade has a built-in cutting hook that zips through cord and webbing. The Santoprene handle is ribbed for a secure grip. "And the non-absorbent materials make it easy to decon, too," adds Markus. The secure-grip handle features a carbide glass-breaker tip built into the butt end. "It breaks tempered glass with a single blow. It will even go right through Mercedes windows," notes Markus.

      The blade has a blunt, but beveled tip. This makes it safer when cutting in close quarters without sacrificing punching power. "There was a rescue in the Green River where a guy got trapped in a log jam in his kayak. There was no way to free the kayak, so they had to punch a hole in its bottom and get him out that way. The Responder's beveled tip is sharp enough and tough enough to do that," says Markus.

      The Responder's sheath has both cord eyelets and strap slots for multiple carry options. Markus concludes: "The sheath's positive-locking action makes it secure for use on your PFD for water rescue, but it's also great for street use, special operations, and the bomb squad likes it, too. Nobody is going to pry the Responder from your sheath—or from your hand."

      For more information, visit www.kershawknives.com.

     Two years ago, Steve Davison, division chief of EMS for the Town of Fishers Fire Department in Fishers, IN, felt bogged down with trying to sort through paper records to see what kind of job his department was doing. That was before they discovered Medusa's Siren ePCR Suite. "We did a customized application that allowed us to put on multiple departments but still keep our own identity," he says. "It also allowed us to spread the cost out equally among the neighboring agencies. One of the best things about the system is that it allows us to look at our data and easily see what we're doing operationally and clinically."

      There was about a three-month learning curve, says Davison, but that was mostly true in departments with older employees who were a bit more reluctant to learn something new. The one fly in the ointment, he says, is that hospital emergency departments still want paper reports to confirm patient data, which means ambulances are carrying printers to comply with their request. "We're working with the hospitals to get them to view the reports online, and we hope that within the next year they'll see the benefit to logging on and minimizing paper use within their departments," he says. "We just want to get to the point where we can give anybody who needs access a log-in to the system so they can view only the data for their facility. It's a teaching issue for us and comfort level with the EDs as well."

      Nothing is 100%, and there have been a few glitches along the way, but they've all been worked through. There have also been several updates, as should be expected with anything technological, says Davison. "Once we get the major updates done, we can make changes ourselves by sending it out across our servers and it will automatically update all the computers in the field."

      For more information, visit www.medusamedical.com.

     "Airway training is always a challenge for EMTs of all levels," says Kevin Kaminski, EMT-P, EMS and trauma coordinator at Fort Memorial Hospital in Fort Atkinson, WI.

      He says: "I think I know what I'm doing with intubations, but with a Nasco Life/form Airway Trainer, the realistic feel validates the product."

      The product in question is one of Nasco's Life/form Airway Management Trainers. Fort Memorial uses products from the company to train area EMS providers. Nasco offers a full line of Life/form airway training devices and accessories.

      The head and torso of an adult is designed to facilitate practice of airway management using both manual maneuvers and mechanical devices. Students can insert oral and nasal airways, and practice a range of intubations, ventilation and suctioning. Other models depict child and infant anatomy, and allow practice of skills like CPR and defibrillation. Nasco's Advanced Airway Management Trainers offer tongue swelling and laryngospasm, in addition to all the standard features.

      A selling point to the trainers is the realism of the manikins.

      "If somebody who didn't know it was a manikin went in with a blindfold and wanted to intubate, they'd probably think they were dealing with an unresponsive person," Kaminski says. "That's how realistic they feel."
Hospital staff at Fort Memorial have purchased various products from the company over the years.

     "A huge selling point to every Nasco customer that I have talked to is the company's three-year warranty on Life/form products," says Kaminski.

      For more information, visit www.enasco.com.

     When it comes to piloting ambulances and fire apparatus to emergency calls, you can't be too careful. They're heavy vehicles and heavy responsibilities, and those behind the wheel must be as safe as possible.

      Recognizing this, the Edmond, OK, Fire Department has long provided its drivers with EVOC training. Then, last year, at a demonstration in Oklahoma City, they were introduced to the SkidCar system.

      "SkidCar can actually show you what happens as a result of unsafe attitudes and unsafe operation behind the wheel," says Maj. Mike Fitzgerald, one of the department's lead driving instructors. "If you're driving in an unsafe, unprofessional manner, it's going to drive that home."

      The SkidCar system outfits various vehicles—including a fire truck (SkidTruck)—with a wheeled frame and hydraulic dolly that are used to illustrate the results of poor decision-making and help drivers learn to prevent the loss of traction that leads to skids. It's what the system's creators call "the science of controlled driving."

     "It emphasizes things like dealing with your balance platform, your weight transfer, eye movement and stuff like that," says Fitzgerald. "If you make mistakes, the system shows you those mistakes, but in a safe way. Then if you actually get into these situations, you've been there before and hopefully can recover. It's a great way to learn how to avoid bad situations and remain in control of your vehicle."

      Edmond received its SkidTruck system last June. Once its instructors were trained, they moved on to training department drivers. Around 40 have now been schooled since September.

      The department also acquired a trailer that will let it take the system around the area and train other departments, making it a resource for the entire region.

      "The feedback has been great—people really like it," Fitzgerald says. "Driver training has to be presented in a way guys can learn, and this is a dynamic way to teach the right principles."

      For more information, visit www.skidcar.com.