Jul 2, 2014

Over the past fourteen years or so I have owned a lot of different brands of boots: Magnum, Rocky, and 5.11 to name a few, and even a pair of boots I found at Walmart called Brahmas that I used as a spare set for a winter or two.  A couple of months ago though, I found what might be the worst pair of boots that I have encountered. One of the benefits of my new job is I am issued just about every piece of my uniform that I wear.  We get shirts, pants, a belt, jackets, and even boots.  It is very unusual coming from the private sector where I had previously received just shirts and was left to fend for myself for most of the rest of my uniform.  My 5.11’s that I was issued when I got hired were about a year and a half old and were starting to look a little sad.  Admittedly, I don’t take as good care of my boots as I probably should but in the past, if I had gotten a year out of a pair of boots I was pretty happy with them. As a replacement for my boots, I received a pair from a brand called HAIX, which apparently is a German company.  Full disclosure, I only wore these boots for about ten days before going back to my 5.11’s but the experience that I had was less than satisfactory.  Here is what I thought of their Airpower R1 model. Fit:  Although I had been fitted by a “specialist” who sized me once at our headquarters, these were by far the most uncomfortable boot that I had ever put on.  It was not a width issue or anything like that, the pain that I experienced was actually in my heels which ran up the back of my calves.  At the end of the day, my feet flat out hurt.  I could not wait to take these boots off. Functionality: The zipper down the center of the boot is an interesting feature.  I found, however, that you pretty much needed an engineering degree to tighten the laces on the boot.  They run laterally...

In all my years in EMS and my almost 14 as a paramedic I have seen a lot of creative solutions to the problems that we face on a daily basis.  Some have worked and stuck for years.  Others?  Not so much.  There are two all too common issues that I seem to encounter on a week by week (or even shift by shift) basis that have some very logical products on the market that I feel present an excellent solution to an otherwise challenging issue.  Also, I feel the need to mention that neither of these companies solicited me to write reviews of their product.  These reviews are based on my own personal experience. The EP+R Hand-E Hand Hold Device – One of the biggest challenges of any cardiac arrest or even an unresponsive patient that we are required to move on a backboard present is the conundrum of how to keep their arms secured so that responders can assess them and provide treatment.  Some use tape, other try to tuck their hands into their pockets or waist band, or even use a creative tie with a cravat.  The best solution that I have found though is EP+R’s Hand-E device. Back in 2006, one of the paramedics that I worked with in Massachusetts decided to solicit a few companies for demo versions of their hand restraint devices.  There were straps that needed to be wrapped a certain way, and a few solid devices that aimed at keeping a patient’s arms “in” to prevent them from snagging on door jams or ambulance cabinets.  We tried a handful of them and none was as easy to use and effective as the Hand-E.  It’s quite simple to use: after attaching the device to a waist strap of a backboard you put a patient’s wrist in each of the openings and secure it with the rubber strap.  A patient’s  arms remain reasonably flexed to allow the flow of IV fluids to continue while their elbows are kept close enough to the body that moving patients through doorways or taking them out of an ambulance becomes remarkably easier. According to EP+R’s website, the Hand-E retails for around $22....

Early in January I was contacted by Coast Portland and given the opportunity to review their HP 14 LED flashlight.  Their timing was perfect, as I was in the market for a new light since my old one had seen better days.  This was my first opportunity to use an LED flashlight as all of the ones I have owned prior to this have been halogen.  I have heard from a lot of people that these days, LED was the way to go, so I decided to give this one a try. For the last month, I have been using the light on the job.  Here is what I thought about it: At $65, the HP 14 is affordable and not overpriced.  It advertises a run time on the high setting of just shy of 5 hours, with a considerably longer life of 20 hours on the low setting which when compared to LED flashlight reviews of similarly priced lights is excellent.  In the month that I used the light, I had no issues with the quality of its performance.  The battery life seems pretty true to me and the quality of the stream stayed consistant. The first thing that stood out to me about this light was its overall appearance.  The HP 14 is a sharp looking light.  It is light weight, comfortable in your hand, and easy to use and adjust.  Not only is it powered by 4 AA Batteries, but they are included with the light. Switching from high to low is as easy as double clicking the power button on the back end of the light.  The lower 56 lumen setting offers a much softer but still bright and usable option.  The telescoping focus while quick to adjust but takes two hands to do.  At its narrow setting, you get a nice tight, bright stream, with the wider one giving you a nice area and it softens the light enough that on the low power setting you can easily check a patient’s pupils.  The light needs to be usable not only to illuminate a scene but for patient care as well when being used by a paramedic.  The HP 14...

ER Over crowding.System abuse.Lack of resources.Lack of treatment pathways.Its all there! Last night, I was in Philadelphia for the Chronicles of EMS 3 City Meetup for the premier of Firestorm, a documentary about the Los Angeles Fire Department and their struggles to provide efficient appropriate care to the citizens of Los Angeles in a setting where resources are often scarce, hospitals are closing, and abuse of the system is out of control.The atmosphere is described by one LAFD Captain as “The Perfect Storm” with no relief is sight, and from what I saw last night, that statement couldn’t be more accurate. Firestorm focuses mainly on the men and women ofLos Angeles’ Station 65, which houses two Paramedic Level Ambulances.It is one of the busiest stations in the city.They deal with everything that one would expect to deal with in an urban setting.The spectrum ranges from violent crime, like shootings and stabbings, MI’s and major cardiac events, to stubbed toes, fevers, and abdominal pain patients.Their options for patient pathways are limited, just as they are in almost every otherEMSsetting that you’ll find, and their task times are increasing due to ER closures and generalized overcrowding.On numerous occasions, ERs inLos Angeleshave wait times in excess of 24 hours. One scene that was particularly telling of the struggles that the LAFD faces featured a woman and her young son.She wanted the 2 year old evaluated because he had a fever and had appeared to have been shaking.The child, from the assessment that one could make by watching the movie, was clinging to the woman, appeared to be acting in the shy and bashful manner that you would expect from a kid under the age of 3.The LAFD Medic painted a picture of his assessment, that in short and without straight out saying the words said “He seems to be okay now, and would be more appropriately evaluated by a pediatrician.He doesn’t need an ambulance.”The woman’s reaction?”I’d still like to get him checked.We all have our opinions.”The Medics then did the right thing, and loaded the kid up and transported him. Now, this woman will probably sit in the Emergency Room for 12+ hours, with her already sick...