The Unwired Medic

Teaching EMS providers & other public safety pros about using mobile tech to improve their practice, patient care, continuing education, scene safety, general entertainment, & productivity.

November 14, 2016
by The Unwired Medic
2 Comments

Product Review: Magnum Response III 6.0 Boots

I see this question often on Facebook and Twitter: “What boots should I get for EMS?”

About a year ago, Magnum was looking for wear testers and I signed up to see if I could join in. It’s a neat program that allows you to check out a few Magnum product and you can keep them. They do put out requests for wear testers on their social media pages, so make sure to follow Magnum on Facebook and Twitter.

A few months ago, they sent me a welcome package with a t-shirt, water bottle, some decals, a guide book, and my first product to test and review.  I was asked to review the new Response III 6.o boots.

 

Magnum Response III 6.0 BootsThe last time I wore Magnum/Hi-Tec boots was in the Marines in 1995.  I only got to wear them on duty for about 3 months, then the regs changed and we couldn’t wear them any more. In that 3 months, I completely wore them out. They were comfortable, like tennis shoes. They were very popular among Marines (at least at MCB Pendleton). Since then, I have worn Danner, almost exclusively. Other brands were just not comfortable and able to handle the daily grind of working in EMS and for recreational hiking.

Get Kilted - Get Checked

Get Kilted – Get Checked

That I was able to review these boots was perfect timing for me, with my latest Danners wearing out. I have been wearing these boots for about four months now. They have proven to be quite durable and very comfortable as well. I have even worn them with my kilt during the annual September Kilted To Kick Cancer campaign.

What’s this all a-boot?

I wear a 10.5 to 11.0 boot and these boots fit like a glove right out of the box. I found them comfortable to wear, with good padding throughout the footbed, and they provided me with good arch support. The sole is flexible, but firm. It appears to be a non-replaceable rubber/plastic hybrid. There is a good amount of grip on them with broad grooves (great for channeling water away) and even walking across wet surfaces, I found I didn’t lose even a little traction. The other nice thing is that they don’t collect junk, which is important for me, as I work full-time in our area’s local L2 Trauma Center’s IT Data Centers. One of the two sites I work at has two retention ponds and a creek between them. So, it is blessed with a large flock of annual resident Canadian geese. They leave mushy poo everywhere, and as good as the facilities team is about keeping walkways clean, they are simply outnumbered. It is important not to track stuff into a data center. We keep the rooms as clean as a high-end hospital’s trauma bay. Not quite sterile, but exceptionally clean. Anti-static also is important, and the rubber compound does not disappoint. I walk across sticky mats before each entry to the data centers, and when I step on them, I look at the footprints left and they are pretty clean… moreso than the Vibram soles I have on other boots.

You may think that doesn’t reflect what we do in EMS, but I can tell you that I am frequently kicking freight boxes and pallets, climbing in and out of raised floors and metal server racks, running carts, climbing ladders, and much more. I often catch the toes on snags of metal and server rack doors. I’m pretty rough on my boots.

As far as EMS goes, I have worked a couple shifts and found them to be very supportive for the ankle, easy to quickly put back on when the tones drop. They have one catch on each side for speed lacing. I would prefer true speed lacing loops over the catches, personally. Splashing through decent puddles (1-2″ deep) is no challenge and no water leaks into the boots. When I wear them for 12 hours at a time, my feet come out dry and cool. (Note, I usually wear Under Armour boot socks with any boots.) By the end of the 12 hours, I am ready to take them off for a while, but I’m now in my 40’s, so that seems to be the case with any footwear for me.

I think my Magnum Response II 6.0 boots are more durable than the Shadow Trooper's!

I think my Magnum Response II 6.0 boots are more durable than the Shadow Trooper’s!

The toes are not reinforced on these boots, so if I had the option, I would prefer at least a reinforced toe, or a steel toe option. Ankle support is less than an 8″ or 10″ boot (which I prefer), but not bad for a 6″ boot. I haven’t rolled an ankle on a hike over semi-rough terrain. Aesthetically, they look like black work boots. I’m finally at the point where I feel a good polishing is due. They have held up well to scuffing so I haven’t needed to do that yet.

The Verdict:

Overall, I’d give them an 8/10. I am not sorry I got my hands on these boots. They are comfortable, durable, and attractive. I wear them at work and off duty. They provide good support and protection. They are comparable in quality and durability to much more expensive boots, like Danner. If the speed laces and reinforced/steel toe were available, they’d have scored a perfect 10. Not bad for a MSRP of $79.99.

Learn more about the Magnum Response III 6.0 boots and the Response Boots series at http://us.magnumboots.com/response-series.html

Do you have a favorite work boot? Share yours in the comments!

November 3, 2016
by The Unwired Medic
0 comments

I’m tired of Facebook EMS forums

Most Facebook Forums

It is more than a little disheartening to find so many EMS forums on Facebook that are focusing on less important issues. You can find hundreds or even thousands of posts with essentially what amounts to gore porn, and asking about the best boots to wear, which stethoscope should I buy, and, literally, “I failed my exam twice. Do you have any tips to pass the exam?” By the way, about every five posts is an advert for Teespring or some other shirt maker hawking stupid slogans like, “I’m here to save your ass, not kiss it!”, and “Being an Emergency Medical Technician is not a career, it’s a post apoloclyptic survival skill!” Give me a break.

What I don’t see much of is EMS pages on Facebook that talk about clinical excellence, best practices, evolutionary tactics and treatments in EMS, alternative uses of medications, expanding our knowledge base and clinical aptitude and competency. So when I do come across groups like that, I tend to stick around, and occasionally I even help admin them. My blog and Facebook followers are higher caliber providers and I know that most, if not all, of you want to learn and be the best medics you can be for your patients. I’m going to give you a list of pages worth checking into for more about actual medicine and less about hero worship and people too lazy to research questions before posting yet another redundantly redundant, no-skill, knowledge-less, drivel ridden post.

Where to look to learn and contribute to the improvement of your care and all of EMS:

Believe me when I say that these pages are chock full of the latest peer-reviewed science and medical evidence. There are some real superstars of EMS lurking in these forums. Big national names, quiet, unassuming medics, flight medics, post-secondary educators, biologists, attorneys, expert witnesses, ER nurses, EM physicians and medical directors, public health people, and yes, there are some egos that tend to bump heads, but there really should be all of that. Without some vigorous discussion (that doesn’t decay into a childlike tantrum), we may never see improvement. It’s fun. It’s the stuff you’ll need for ACLS EP/CCEMT-P/FPC/CCP preparation, protocol and guidelines development, tips to improve your presentations, and oh so much more. Closed groups are closed to keep the average time-clock puncher out of the way. If you can be serious about what the forum exists for and use it to sharpen your sword, then ask to be let in. Most likely, you’ll get in. Be prepared to see far more than anything you’re likely to encounter in an ordinary EMS CE course.

September 18, 2016
by The Unwired Medic
0 comments

Kilted To Kick Cancer Campaign 

Kilted To Kick Cancer LogoSeptember is Prostate Cancer Awareness Month. I volunteer my efforts to support a 501(c)3 nonprofit organization called Kilted to Kick Cancer. All of September, an army of men wear kilts when practical to start the conversation, because people are naturally inquisitive about “what’s going on under there?”

This conversation starter opens the door for us to proselytize about male-specific cancers, including Testicular and Prostate Cancers. People openly talk about Breast Cancer, and you see pink ribbons and shirts all over. Rightfully so. 1 in 7 women will be diagnosed with Breast Cancer in their lifetime and 1 in 30 will die from it. The PR machine for raising awareness and funds is tremendous. A few women in my family have died of breast cancer, which can put my own daughter at risk.

As serious as those statistics are, we pay attention to them, but men don’t really talk enough about their own sex-specific risks. 1 in 7 men will be diagnosed with Prostate Cancer in their lifetime and 1 in 30 will die from it. You read that correctly. The statistics are the same as for Breast Cancer.

Get Kilted - Get Checked

Get Kilted – Get Checked

What can you do about it? 

First, talk about it! Let’s make it as conversational as Breast Cancer! It is no less or more serious.

Second, get checked. The PSA blood test is far too unreliable, so you need to get the gloved finger treatment. Don’t like it? Suck it up! Women have mammograms done annually and they’re uncomfortable. Women also have pap smears annually. They endure. Man up and get in to your doctor annually and get it checked. If found early, it is very treatable.

Third, visit www.kiltedtokickcancer.org and make a tax-deductible donation for Prostate Cancer research. Click on the “Donate Now” button. You can make a one-time donation, and new this year, you can make a monthly donation. The donation billing form has a place to select a team at the top and I’d appreciate it if you select “Team Unwired Medic” so I can get some bragging rights with other fundraising teams. Thank you!

Fourth, make your own team! Get Kilted! Become a champion of this cause! Then go forth and spread the word and fund raise!

 

F.A.Q.:

Do I have to be Scottish to wear a kilt? Not at all. In fact, utility style kilts, like the ones found at Alt.Kilt are getting to be quite fashionable and a regular sight! They’re extremely popular at fairs and events, like Burning Man. There are other, inexpensive ways to get kilts, but they are not made as durable as a traditional Scottish kilt. Economy kilts can be found at many places on the web, and they’re great for wearing for less formal occasions and for daily wear. I got my Leatherneck Tartan kilt as a package with sporran, sock flashes, kilt, and shirt at Sport Kilt. The royal blue utility kilt (seen in picture above) was a project my mother-in-law helped me make and we found patterns with a quick search on the web.

What’s the difference between a kilt and a skirt? A kilt has an apron in the front and is pleated all the way around. A sporran (the bag that sometimes has tassels on it) is commonly worn with a kilt, but not always. For the rest, I will have to leave that to your imagination. 😉

What do have going on under there? It’s a kilt, not a skirt! 😉 Also, see the previous question.

Can I start my own fundraising team? Absolutely! Either use the contact form on the KTKC website, or e-mail justin@kiltedtokickcancer.org

Do you play the bagpipes? Not yet. They’re a bit pricey, at least $1400 for a decent set and I have my eye on a custom Marine Corps edition for $5,800, but I’d be happy to learn if I could get my hands on one. Playing the bagpipes is not a prerequisite for wearing a kilt, and in fact, when playing the pipes, a different style kilt specifically for pipers is worn.

 

More articles to read about male-specific cancers:

Note: My blog links will include other links to kilt makers, D-I-Y kilts instructions, and much more…

“Man up, Marines!” https://unwiredmedic.com/2015/09/03/man-up-marines/

“Let’s Talk About Your Dangly Bits” https://unwiredmedic.com/2015/09/03/lets-talk-about-your-dangly-bits/

“Are You Kilted?” https://unwiredmedic.com/2014/09/18/are-you-kilted/

The Ambulance Driver (Kelly is a great sport about all this, even helping out the underdogs, like me): http://www.ambulancedriverfiles.com/kiltedtokickcancer/

August 25, 2016
by The Unwired Medic
0 comments

EpiPens too expensive?

So it’s all over the media and social media platforms. EpiPens have jumped in price more than 400% in recent years. I was advised by my allergist to carry them in 2007, and I did for about 4 years. Then they became too cost prohibitive, and that was when they weren’t in the $400/set range. I had to stop buying them every year.

Fast forward to last year, and I suddenly have an episode of anaphylaxis and status asthmaticus. I spent a few days in the hospital and was on high-dose steroids for a couple months.  Those EpiPens were looking like a bargain now. I was able to get a set of Auvi-Q epinephrine autoinjectors, but they were later found to be ineffective at delivering full doses so they were recalled and I got EpiPens, which were now (again) without competition in the marketplace.  Lack of competition means that their dollar and fifty cents worth of drug in an auto-injector could be priced at whatever they want to price it at. Even with insurance from my primary employer, they were cost prohibitive, so I went to the EpiPen website to see if they had a copay savings card, and they did. My card reduced my copay to only $5. This year, the makers of EpiPens made the copay card even better by reducing the copay to ZERO dollars and it is good for up to twelve EpiPen sets (the two-pack, not the singles) per year. Then the card expires and you have to sign up again.

EpiPen Copay CardThe only requirements are that you have a commercial insurance plan, and you are over 18. If that fits you, then go to their website and sign up and print your card, then take it to the pharmacy. The bad news is this is for individuals, not for organizations like volunteer fire and EMS, and if you have Medicare, Medicaid, or TRICARE, you are ineligible.

https://www.epipen.com/copay-offer

August 1, 2016
by The Unwired Medic
0 comments

TempTraq – Product Review

TempTraq is a wireless temperature monitor for consumers, but it has the potential to be quite useful for healthcare applications and for prehospital/perihospital care.

How does it work:TempTraq by Blue Stacks Technologies

TempTraq by Blue Tracks Technology is a single-use device for wireless temperature monitoring that is compliant with ASTM E1112-00 (standard for accuracy in digital thermometers).  It uses a simple push-button activation on the temp probe that activates it and then it has a life-span of 24 hours after initial activation.  You connect to the wireless temperature monitor via a smartphone app for Android or iOS and your device’s Bluetooth connection and can configure the app to display Fahrenheit or Celcius.  The wireless temperature monitor connects with the app and your smartphone using a unique identifier.  The app has the ability to allow the user to configure parameter alarms, for instance, in case a temperature spike is encountered.  The app gives digital and graphical readouts of the monitoring results.  No patient identifiable info is transmitted via the temp probe, so if an eavesdropper comes in to range with several of these devices in operation, there would be no way for them to know which device belongs to which wearer.

Although the technology is still confined to the consumer workplace, it could be of value to us in EMS even now.  Temperature monitoring with a full capability monitor is not always feasible.  Think of Foley temp probes, for example.  Invasive and expensive.  This would be useful in monitoring a febrile child with seizures or an infection and could be transferred to the receiving hospital upon transfer of care.  If a patient were to be seen in an Urgent Care or ER, then they could be monitored periodically by staff to see if their fever has broken or spiked.  Oncology units could use this to monitor patients receiving chemo infusions.  Long-distance transfer patients could also be monitored for temperature spikes.

My product evaluation:TempTraq Wireless Temperature Probe

TempTraq wireless temperature monitoring was easy to get going.  I downloaded the free app from the Google Play app store and got it running with Bluetooth active on my smartphone.  I simply followed the directions on the packaging for the wireless monitor and applied the temp probe to my left axilla.  I connected it by performing a search in the app for the unique “Patch ID”, which you can customize with a personalized name (perhaps a child’s or patient’s name).  You can monitor several devices at a time, so let’s say you have a house (or waiting room) full of sick kids and you need to track all their temps, you shouldn’t have any problem as long as you are within a few yards of the person wearing the TempTraq, which should be easy to achieve in a waiting room or in a typical single-family home.  It is removable and re-applicable for bathing and should not be applied over any open skin wounds.

TempTraq App ScreenshotIt would be easy to see first responders and prehospital care providers use a system like this.  Say a first response crew arrives on scene, they could add this device to the patient’s axilla in a clinically appropriate situation, and then activate it, documenting the findings.  When the patient care/transporting crew arrives, they can assume monitoring and collect all the temperature recordings logged to that point, and continue monitoring throughout transport.  When care is handed to the hospital staff, they can keep using the system and uploading the temp logs into the patient’s chart.

I wore the monitor for a full 24 hours.  It was noticeable, but not uncomfortable.  I can imagine a toddler absent-mindedly picking at it.  The adhesive seems to be consistent with hypoallergenic tapes, making it usable for sensitive skin.  The monitor collected readings of my temps throughout the night while I slept and when I reconnected the app and phone, it downloaded all the data from the time of my last connection.  In short, it worked exactly as described.  I did not attempt to induce any false temperature elevations during my trial of the TempTraq.  The app allows custom alerts to be sent and allows the user to add notes, like when a medication is given to the wearer (for example, if Tylenol is given to the wearer with a fever).

What would I make different:

I think the product documentation could be slightly improved by explaining the normal ranges of temps for axillary temps versus oral or rectal temps.  The company is already working with various health partners in the US to integrate readings into EMR systems, like Epic.  I had to perform a hard reset of my Android device after using the TempTraq and as a result, I lost all the data from my product trial, so there is no cloud account to retain information.  The simplicity of the app is a strong benefit to using it, giving a very small learning curve to the user, which helps eliminate confusion in usage.  Otherwise, I don’t see any need to improve or modify the system.

I wish to thank the reps at TempTraq for giving me this opportunity to review the TempTraq wireless temperature monitoring system.