February 6, 2012

Informed's EMS ALS Guide Reviewed

I recently had the opportunity to review Informed’s “EMS Field Guide – ALS Version”. I took the guide with me on every shift for a month and used it at every opportunity that I could. Overall I found the book to be an asset. It’s a good size for carrying in my back pocket or in my backpack, plus it contains a bunch of useful information. Below is a breakdown of my experience with the product.

In Field Use

For the first couple shifts, I had trouble remembering that I had the field guide with me. I was used to using my nurses drug reference, a medical dictionary and my Android phone. Once I started to get the hang of it, I actually found myself turning to the field guide before using any of my other resources. While the guide simply can’t compete with the volume of the nurses drug reference, I had no trouble finding any of my patient’s home medications in the field guide. Not to mention the fact the drug guide in the back is simple and to the point. I don’t have to read through 2 pages of information to get what I’m looking for. Definitely EMS friendly.

I tried out the Radio Report sheet found on the first page of the guide a couple times. I found it to be pretty handy but I ended up using my custom one that I have printed out on a 3×5 card. This wasn’t at the fault of the field guide, I’m just used to using my own format. One thing that was really neat was the ability to reuse the page by wiping it down with an alcohol prep. I wrote on it with a standard ball-point pen and had no trouble wiping off what I had wrote. The content never completely wiped away, but it didn’t bother me as the writing was so faded that it didn’t get in the way. Here are some before and after pictures.

before

The 2nd picture demonstrates how it looks after wiping it down with a single alcohol prep.

One section that I found to be the most useful was the poisons. While this certainly couldn’t replace calling poison control, I did find it to be really handy. I basically lists several different types of poisons and then explains recommended treatments (given that your protocols permit) and tells you what symptoms to expect. I can honestly say that this is my favorite section in the whole guide. I found more use out of this than I did anything else.

Other features not tested in the field

There is tons of great information in this book, however I did not test all of it in the field. In some cases this was because I simply didn’t run any calls that could apply to those sections. In other cases, it was because I don’t believe in relying on guides for doing things like ACLS.

The emergency medications listed in the book are pretty handy, but I think it should be used more as a study guide / refresher and not necessarily something that you turn to before administering a medication. I firmly believe that this information should be drilled into our heads so that we don’t lock up when we leave our field guide at home. Having said that, we are humans (well most of us) and we do forget things from time to time. Especially when we don’t use the knowledge on a regular basis. So having the information in your back pocket could save you from doing harm.

The pediatric medication chart looks extremely promising. It’s like a Broselow tape but only a fraction of the size. This is something that I actually would use in the field if given the opportunity. While I still believe in knowing your doses, I think having the ability to check your work is extremely important when it comes to weight-based doses. I typically do the math, draw up the med then, quickly check my guide / Broselow Tape to make sure that my dose is correct. This way I’m confident that I’m giving the right amount of medication, and yet not screwed when I forget my field guide.

I found absolutely no in-field use for the ACLS section. However I did find myself refreshing my memory while sitting on street corners or while sitting in quarters (given the Dodgers weren’t playing).

The MCI / Multiple patient section is pretty cool as well. When responding to an MCI (especially if you are the first unit in) it would be great to review the algorithms and refresh on the unit leader rolls before getting on scene. The information is brief and to the point. My only suggestion for this section would be to add a spreadsheet of some sort to keep track of multiple patients. I realize that in an ideal situation, I would be “that guy” standing around with a clipboard and radio while everyone else works. However I typically have to assist with packaging and loading patients being that our resources are limited, so something that I can keep in my pocket would be worth it’s weight in gold.

Conclusion

I can honestly say that this guide will be permanently added to my arsenal of resources that I use in my daily responsibilities as a Paramedic. It’s small size is ideal for EMS responders and the information packed into the guide is priceless. I realize that there are smart-phone versions of this guide (which I plan on buying) but I would still recommend having this guide. Phones lose reception, batteries die and they are fragile. While I do consider myself to be a proponent of high-tech gadgets, I still enjoy the old-school reliable method of having a paper copy when it comes to this kind of valuable information.

If you don’t have this guide, I would highly recommend buying it. It’s inexpensive and you will be glad you did.

You can order it from Amazon or find it at your local book store.

Please feel free to contact with any questions or comments.



Field Guides – Crutch or Tool?

Before I even begin this discussion, I am going to come right out and say that I carry an EMS field guide with me on every single call. Now I’m going to spend the rest of this article defending my position on it!

I heard many people argue that field guides or “cheat sheets” are crutches. I can certainly understand how someone could become dependent on having the information in their back pocket. I have heard plenty of stories of medics flipping out after getting on scene only to realize that they forgot their field guide.

I will say that I have been that guy. The first time I forgot to pack my guide, I ran an infant cardiac arrest. Even though I got nervous, I was still confident that I knew my dosages. I treated the kid without delay and the call ran as smooth as it would have if I did have it.

Even if you carry a guide, it shouldn’t replace your core knowledge. You should have no problem figuring out a dosage or doing drug math. Carrying the guide should be a way to double check your work. You shouldn’t have to rely on it 100%.

The popular field guides that are on the market now have tons of useful information. Poison information and prescription drug information are just 2 examples of things that are nearly impossible to accurately keep in your memory bank. Having the information in your back pocket will be extremely beneficial.

My personal favorite guide is the “ALS EMS Field Guide” by Infomed. I never leave home without it. I also carry a nurses drug reference book and a medical dictionary in my backpack. If nothing else, they can be used to research a patient’s medical history and medications during long transport times and learn something new.

In conclusion, I feel that the field guides are a great tool, but can easily turn into a crutch if you don’t stay on top of your core knowledge. The guides should be used to add to your existing knowledge, not replace it.

If anyone knows of any good field guides that I didn’t mention, please let me know. I’m always looking for new tools to use at work.


Search for the ultimate EMS-related Android app

*****Update******

Since I wrote this post, I have done several reviews on EMS-related Android apps. Check them out under my “Reviews Section”.

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Being the geek that I am, I am constantly on the lookout for digital alternatives to things like calendars, checkbooks, and paramedic field-guides. Of course, being the not-so-wealthy-EMS-salary guy leaves me looking for cheap, if not free solutions.

My search for EMS-related applications started when I bought my Motorola Droid phone last week. After downloading the metal-detector (yes metal-detector) and internet radio applications, I began searching for apps that would be useful to an EMT or Paramedic.

I did my initial search was done using the built in app-market app that comes with Android. I searched various keywords like “EMS”, “Paramedic”, “Paramedic field guide”, “ALS Field Guide”, etc. I came up with 2 applications, however the results are not so good.

Here is a rundown of what I found.

BLS Drug Profiles:

The application comes with 6 drug profiles (Aspirin, EPI Auto-Injector, Activated Charcoal, Albuterol Inhaler, Nitro, Oral Glucose). While the information seems to be accurate, it’s not a very useful application for in-field use. I guess if you somehow forgot your doses or contraindications, then this might might be of some help. This app has been removed from my collection.

USA Drug Reference:

At first glance, this seemed like an extremely useful application. It’s basically an electronic version of a PDR or Nurses drug reference book. It has a really neat scrolling feature that makes flipping through the different drugs a breeze. It seemed like the perfect drug reference. That is until I actually tried looking at the information on the individual drugs. The majority of the categories are empty or have missing information. The program is solid, but the information is definitely lacking. This is quite a shame as the app has huge potential.

There are some applications out there that cost money. Skyscape’s “Rapid Paramedic” reference is basically a digital version of their hard copy pocket guide. I guess I would spend the money if I didn’t already own the pocket guide. Unfortunately, Epocrates does not have an android version of their program. It is available for Blackberries, iPhones and Palm phones. This, of course, is a major bummer. Hopefully they will come out with a compatible version soon.

The built-in GPS navigator is far superior to any GPS device that I have ever purchased. It utilizes Google Maps, which means that it updates constantly. I suppose it could be used to route yourself to calls, however I would check to make sure you aren’t violating any policies before you do so. I happen to work for an ambulance service that prohibits using personal gps devices. However, I have looked up random addresses in my area and compared the recommended routing given by Google Maps and my personal preferred routing by just looking at a map. I must say that I am quite impressed.

I must say that I am a bit disappointed in the lack of EMS-related apps for Android, being that the platform has been around for a while now. I will certainly keep my eyes out and post when I find any. If anyone knows of any that I missed, please let me know!