EMS Technology for the
WildernessWill Smith, MD, EMT-Pwww.wildernessdoc.com
Objectives
Discuss some current and new EMS technologies.
Discuss how to evaluate if an EMS technology is appropriate for patient care in the Wilderness
Disclaimer
I have no financial relationships with any companies or items presented.
Board of Advisors for Chinook Medical Gear - volunteer position; sample products.
I’m Just sharing my experiences of what works for me!!
Research and make your own judgments!
THE BIG QUESTION?
What medical care in Wilderness Medicine makes a difference without delaying transport?
What to Bring?
What to bring?What is the mission/trip?
Urban vs. Wilderness vs. Technical
What to Bring?Known or Unknown Location?
What to bring?What is the known number of patients and their conditions? How many people on trip?
What to bring?Evacuation options?
Helicopter vs. Ground vs. other
Hours, Days, Weeks
What to Bring?
Level of Rescuers
WFA, WFR, W-EMT-B/I/P, RN, NP/PA, MD
BLS
ALS
What to Bring?
Will ‘it’ work in the Wilderness?
Batteries
Temperature
etc.
What to Bring?
Now you did ‘x’ can you do ‘y’?
What to Bring?
Can you afford it?
Do you need it?
Who is trying to sell it to you?
Is there science?
What to Bring?
Medico-legal Considerations
Standard of Care
THE BIG QUESTION?
What medical care in Wilderness Medicine makes a difference without delaying transport?
Airway
Pain Management
It Depends...
Airway
ABC’s
Oral/Nasal Airway
King Tube (supraglottic airway) - EMT-Basic
Gold Standard = Intubation (ET tube)
Airway
NuMask (OPA)
www.numask.com
Nasal Pharyngeal Airway (NPA)
Airway
Supraglottic airway
King Airway
Combitube
LMA
i gel
AirwayEndotracheal Intubation
increased tracheal stimulation
CirculationStop Bleeding - Tourniquet (CAT)
Oxygenation/Ventilation
Other Vital Signs...
Pain Management
Intranasal Fentanyl
Intranasal Ketamine
Oral Pills/Pops
Summary
Carefully evaluate each medical device you take into the Wilderness:
Make sure it is going to do the job you want it to.
Make sure you need to be doing that job.
Questions?www.wildernessdoc.com