Newer hand-held ultrasound equipment has been adapted for the rough and tumble use that takes place in the back of a speeding vehicle, and is proving useful as well. The ultrasound can be used in a variety of ways by EMS personnel, checking for such traumatic injuries as a collapsed lung or to check to see if the heart is beating, Kempema says.
“There's a lot of really important data that can be collected before they get to the hospital,'' he says. But they are very sensitive devices and have had to be adapted for EMS use so they don't break as easily if dropped or jostled in the field.
Kempema notes that video laryngoscopes, which make it easier to intubate a patient, also are becoming available for EMS providers. While they are easy to use and the evidence is strong that they help, cost becomes a factor, he says. Video-equipped models proved in studies to be useful cost $8,000 to $10,000, which adds up quickly if outfitting multiple ambulances, he says. Newer versions, whose efficacy has yet to be established, cost closer to $1,000, while traditional laryngoscopes are low-budget items costing in the hundreds of dollars.
Another technological advancement for EMS has been the EZ-IO vascular drill, Matin says. Seriously injured trauma patients may have such a low blood pressure that installing an IV line the traditional way is difficult. The EZ-IO drills straight into the bone, where fluids and medications also can be delivered to the patient. “It sounds kind of barbaric, it really isn't,” Matin says. “It is very, very effective.”
An area that has gotten attention and been adopted relatively widely concerns power-assisted stretchers, which can vastly reduce the amount of weight an EMS responder has to lift in a given day, reducing the odds the responder will suffer a back injury, historically a common problem in the industry. The issue has been given a higher priority as more important as Americans become more obese, with some EMS units now carrying equipment specifically for overweight patients.
“We've seen a pretty significant reduction in injuries with the use of those stretchers,” says Ron Thackery, senior vice president of professional services for AMR. The company spent $10 million on power stretchers for roughly 1,800 front-line ambulances, Thackery says. The stretchers have an extendable frame that raise or lower as needed to get a patient in or out of an ambulance.