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

Breathing

CirculationStop Bleeding - Tourniquet (CAT)

Oxygenation/Ventilation

Other Vital Signs...

Splinting

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