Westchester EMS - Emergency Medical Equipment

A Guide to Our Emergency Medical Equipment

12 Lead Cardiac Monitors - Monitoring of heart rhythms during transportation of the cardiac patient is routinely performed with 4 electrical leads placed on the patient's chest. In cases of a cardiac event during patient transportation, a 12 lead electrocardiogram (ECG) can be performed. 12 lead ECGs are more detailed and take "pictures" of the heart rhythm from multiple angles, allowing for more precise diagnosis of a cardiac event such as heart attack. These 12 Lead ECGs can speed the treatment of cardiac problems on arrival at the receiving facility and allow paramedics in the field to more accurately treat a patient's condition. We were one of the first agencies in Westchester County to carry PhysioControl Lifepak 15 monitor/defibrillators. These state of the art monitors are fully equipped with external pacing, pulse oximetry, end-tidal carbon dioxide (ETCO2) capnography, noninvasive blood pressure (NIBP), LifeNet telemetry modules, and Pulse CO-Oximeters.

Westchester EMS is the first, and currently ONLY provider in the Westchester region to be REMAC approved to transmit ECGs to medical control facilities for consultation and possible diversion to specialty care centers. Patients who meet certain criteria can thus be directed to facilities with the ability to provide acute coronary care for heart attack patients and speed their access to definitive care.

Defibrillators - Ventricular fibrillation is a lethal heart rhythm and a leading cause of sudden death in the prehospital setting. Defibrillators are electrical devices which, through the use of pads placed on a patient's chest, deliver a shock to the heart to reverse this lethal rhythm. At Westchester EMS, we carry two types of defibrillators - automated and manual. All of our basic life support ambulances, carry automated external defibrillators or AEDs. Approximately the size of a laptop computer, AEDs can be operated with minimal effort and training. Our advanced life support ambulances and paramedic response vehicles (flycars) carry manual defibrillators which are meant to be operated by the more highly trained personnel that staff these vehicles. Paramedics receive specialty training in emergency cardiac care and are able to utilize the manual defibrillators to treat a wider range of heart problems. We carry PhysioControl Lifepak 15 and Lifepak CR Plus defibrillators.

Electric Inverters - Inverters are devices used to convert the standard automotive electric current of 12 VDC to standard household electric current of 110 VAC. This allows us to use devices such as personal ventilators, BiPAP Devices, neonatal isolettes, and other medical equipment during transportation in the ambulance, thus reducing the reliance on batteries and extending the potential distance the patient can travel.

Emergency and Cardiac Drugs - Our advanced life support units (ambulances and flycars) carry a wide range of emergency drugs for various medical problems. Angina/chest pains, asthma, allergic reactions, uncontrolled high blood pressure, cardiac dysrythmias, seizures, diabetic problems, drug overdoses, obstetrical emergencies, and toxic exposures are just a few of the emergencies we can treat in the prehospital setting. Additional specialized medications can be administered during intrafacility transports allowing for treatment initiated in the hospital to be continued.

End Tidal CO₂ Capnography - End tidal CO₂ capnography is used to measure the amount of carbon dioxide exhaled from a patient's lungs. Their primary use is to verify the proper placement of breathing tubes in patients requiring breathing assistance. They also make an excellent tool in determining the efficacy of ventilation/respiration in patients with breathing troubles. All of our Lifepak 15 Cardiac Monitors feature Oridion end tidal CO₂ capnographs.

External Pacemakers - Pacemakers are devices that use an electrical stimulus to maintain a normal heart rate in patients whose hearts are unable to maintain a normal heart rate on thier own. Use of external pacemakers is a first line choice in treating Asystole (complete lack of electrical activity in the heart) and severe Bradycardias (Slow Heart Rhythms) in the emergency setting. External pacemakers are also used to transport patients in need of an implanted pacemaker, to hospitals that are capable of performing the procedure. Our external pacemakers are a built-in feature of our Lifepak 15 Cardiac Monitors.

First Aid Supplies - All of our ambulances carry a wide range of supplies for various injuries including gauze dressings, burn dressings, tape, bandages, cold and hot packs, saline, sterile water, and trauma dressings.

Intravenous Medication Transfusion Pumps - Several of the medications we carry need to be administered to the patient slowly and accurately over a period of time. We carry triple channel transport infusion pumps from Alaris to facilitate appropriate and efficient administration of these medications.

IntraOsseous Infusion - In many cases, establishing peripheral intravenous (IV) access for fluid and medication administration can prove difficult if not impossible. Our paramedics are trained to establish access to the cardiovascular system through alternate means, including through the IntraOsseous (IO) route, in both adults and pediatrics. In addition to carrying manual IO needles, we also carry the revolutionary EZ-IO drill from Vidacare, which greatly speeds access in critical patients while also decreasing complications.

Non-Invasive Blood Pressure Monitors - Blood pressure is an important vital sign and is best used in patient care when monitored frequently. Our Non-invasive blood pressure monitors can be set to take a patient's blood pressure reading at various intervals and gives the caregiver the freedom to tend to other patient care issues. Our non-invasive blood pressure monitors are integrated into our Lifepak 15 Cardiac Monitors.

Obstetrical Kits - Childbirth most often occurs in the hospital setting. Occasionally, an ambulance is called for a woman in labor. In the event childbirth needs to take place in the home or ambulance, EMTs utilize an obstetrical (OB) kit. OB kits come with all the equipment needed to assist the mother in delivering her baby: Drapes and sterile gloves for protection against infection, wrapping and silver foil for keeping baby warm, clamps for the umbilical cord, and suction bulbs to help baby take their first breath.

Oxygen Supplies - Oxygen is the most essential element in respiration and metabolism. The air we breath typically contains 21% oxygen. Those in need can receive greater concentrations of oxygen during treatment both in home and in transit. We carry portable and large capacity oxygen tanks along with various delivery devices including oxygen "bears" for children too scared to wear a mask, cannulas that go in the patients nose for people too claustrophobic to receive oxygen by mask, and non-rebreather face masks for those requiring the maximum amount of oxygen available. We use Bag Valve Masks (BVMs) which are used instead of mouth to mouth respirations for people who can't breath adequately on their own. Using BVMs is safer and prevents transmission of disease between caregiver and patient.

Patient Moving Devices - We utilize several devices to facilitate moving ill and infirmed patients. Our ambulances use Ferno ProFlexx 35-P stretchers which are capable of handling patients and equipment up to 650 pounds and make loading and unloading easier and less strenuous on the caregiver. We have special "stair chairs" that enable two EMTs to carry a patient up and/or down flights of stairs. If the patient is unable to sit up, we carry special flexible stretchers that make carrying the supine patient down stairs and over rough terrain easier. We also have orthopedic stetchers for moving patients with painful injuries as well as long and short immobilization devices for patients with suspected spinal injuries. We utilize special extrication devices for children who often experience a high level of anxiety when immobilized.

Pulse Oximeters - Pulse oximeters are devices that non-invasively monitor the percentage of oxygen saturation in the blood. A probe placed on the finger nails, toe nails, or ear lobe of a patient, shines a beam of light through the capillary beds to determine how red the blood is. In simple terms, the brighter the blood, the more saturated with oxygen the blood is. Pulse oximetry is a useful tool in treating patients with respiratory illnesses such as Asthma, Emphysema, Bronchitis, and Congestive Heart Failure. All of our Lifepak 15 patient monitors are equipped with pulse oximeters.

Splints - Broken bones (fractures) are often painful and can even be life threatening. The definitive field treatment for fractures is to stabilize the bone using splints to keep the fracture from becoming worse and to reduce the pain of the injury. We carry many types of splints that can be used to stabilize most fractures. Padded board splints are used to splint long bones. Traction splints are used to maintain stabilization of painful femur (the thigh bone located between the knee and hip) fractures. Spine boards are routinely used to protect against paralysis, when neck or back injury is suspected. Kendrick Extrication Devices (KED) and short boards can be used in conjunction with long spine boards to facilitate moving injured patients from a sitting position (most commonly used in car accidents).

Suction Supplies - Suction is basically a vacuum used to clear an airway of mucus and respiratory secretions. Patients with tracheostomies (holes or tubes in their neck to help them breath) often need frequent suctioning to keep secretions from building up in their airway. Unconscious patients who are unable to control their own airways may need mucus, secretions, and/or vomitus cleared. We carry both in-ambulance and portable electric suction units with various sizes and shapes of catheters for oral and deep tracheal suctioning. Certain medical devices such as nasogastric or chest tubes require suction to operate effectively.

Ventilators - Ventilators are used to assist the breathing of patients either through face masks or breathing tubes placed in the patient's air passages. We carry state-of-the-art CareFusion LTV-1200 ventilators that pack the power and flexibility of a full sized ventilator into a portable, lightweight unit.