In a critical situation, paramedics are required to perform life-saving techniques intelligently and quickly to try and ensure that anyone in distress has a chance to not only live through the night, but to go on and live healthily for years to come.
Thanks to new and improved equipment and techniques that are now being employed by American Medical Response paramedics, successfully saving a life is becoming more frequent.
According to David Durand, spokesperson for AMR, three revolutionary devices are currently in use by paramedics that help address a wide array of conditions seriously ill patients face.
A new power drill no bigger than the size of an adult hand was brought in just last week to hook a patient up to an IV in a matter of seconds. The catch? It has to be drilled through a bone.
Another new device is a piece of plastic that attaches to the end of a syringe to help get medicine into the body faster. No needle, no pain. And the best part? The medicine absorbs into the skin inside your nose and mouth.
Though it is not new, an improved design on a breathing apparatus that AMR paramedics began using a year ago has shown to be extremely effective in helping others to breathe during times of respiratory distress.
“I am excited to see how these devices will help others,” Durand said. “It is called ‘practicing medicine’ for a reason. It is because people are always working to improve the care of patients.”
Though it looks like a small nail gun, the EZ-IO kit is a drill, or power driver, that creates direct venous access through the bone.
The power driver drills a needle into the bone, allowing for emergency delivery of fluid, medications and blood products directly into the vascular system within 5 to 10 seconds.
This new equipment comes at about $1,000 a kit, and there is currently one in every AMR ambulance in the county, Durand said.
And while it sounds painful, videos posted on the Internet of people who have utilized the kit say it feels just like a regular IV insertion.
However, Durand said an EZ-IO kit is best suited when IV access is difficult or nearly impossible — such as when a patient is in cardiac arrest or when they have suffered severe trauma in an accident.
Also, sometimes it is hard for paramedics to find a usable vein for IVs for older patients; the EZ-IO kit would eliminate that need.
“We have been able to create IV access through the bone in the past, but that was done by literally screwing a needle in with your hand,” paramedic Eric Hooper said. “There was always the fear that you could slip or go through the bone. The drill tells you exactly how far down you go and when to stop drilling.”
The EZ-IO kit includes a handheld driver, two needles, tubing for IV fluids and a wristband for patient identification.
Though paramedics have yet to use the new drill in San Joaquin County, Durand said paramedics in Stanislaus County — roughly the same size as San Joaquin County — use the EZ-IO kit 10 to 15 times a month, so he predicts similar numbers here.
The intranasal mucosal atomization device, also known as the atomizer, turns liquid medicine in a syringe into a spray, allowing it to be absorbed by mucus membranes in the nose or under the tongue.
This means that no needles are needed to get medicine absorbed into the body, Durand said.
The atomizer comes in handy particularly for people who have suffered from a drug overdose — especially from opiates like heroin.
“Opiates cause your respiratory system to be depressed, causing your veins to become smaller, making it very difficult for paramedics to try to find somewhere to put an IV,” Durand said. “This spray absorbs almost instantly, and in a matter of seconds, the patient begins to wake up and become more coherent.”
The atomizer is not necessarily helpful on those who have suffered from a methamphetamine overdose, however. Methamphetamine actually relaxes air passages and opens them up, which increases the intake of oxygen so that the body can fight harder or run faster. Thus, something like the atomizer is not needed.
Also, unlike an IV, the atomizer can be used in any position.
This gives paramedics more liberty to place it in the nose or under the tongue while others are working to get a patient oxygen or hooked up to other breathing or medical apparatuses.
“I seriously wish I had thought to invent this,” Durand added. “It is the simplest device and it is so effective for those who can benefit from it.”
Standing for “continuous positive airway pressure,” CPAP is a non-invasive breathing apparatus that helps provide respiratory support to patients with mild to severe breathing distress.
CPAP is best for patients who suffer from a wide range of respiratory issues, from asthma to shortness of breath from congestive heart failure and acute pulmonary edema.
But CPAP is not for patients who are in cardiac arrest, Durand said, because their medical needs are heart-related, not lung-related.
Used over the past year and a half by AMR, the head gear used to hold the breathing apparatus in place has improved in design, making it easier to keep on the patient’s face.
The main breathing section of the mask still rests on top of the patient’s mouth, but a flat band that sits right above a patient’s brow allows a strap to wrap around his or her head and velcro tightly, keeping the mask in the same spot rather than letting it slip around.
This allows for increased oxygen flow and potentially a quicker hospital recovery, Durand said.
“CPAP buys time for administered medications to work with regards to the lungs ... it gives the lungs the ability to better expand, helping the patient to breathe better on their own,” he said. “This can help reduce a patient’s need to be on a ventilator for extended periods of time once they are in the hospital.”
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