Kingvision Videoscope:

Sold by AMBU. We love this device, for several reasons. Pros: The scope is light-weight, less than $2000, and has an adult and pediatric adaptor. Further, the blades are all disposable, and cost less than $15. Finally, the blade is hyperangulated as well as channeled, making all the stress of airway management dissipate (channeled means you simply load an endotracheal tube without a stylet into the side channel of the blade and it delivers it through the chords). For emergency situations and crash airways it is very easy to assemble. Qualms: The monitor is prone to cracking, especially for the true locums emergentologist that lives between airports covering ERs in multiple states.

The monitor is also not-repairable (confirmed with Ambu). It would also be desirable for the monitor to be larger compared to other scopes, but for this price this is a mute point.

KATZ Retractors:

Our device of choice to remove pediatric foreign bodies in the nose and ears. It is safe, easy to use, and our go-to before moving onto an Alligator. Often works well with a bit of atomized intranasal Versed prior to performing the procedure (with an atomizer of course). These are very cheap for a box, and easy to store in the suitcase.

Alligator Forceps:

We are always appalled how many emergency departments lack this simple but handy device. Excellent for foreign body removal, particularly pediatrics and ears (when Katz fails).

The Butterfly IQ:

The newest bad boy on the block. We work in so many hospital systems that each purchase their own ultrasound machine (I didn’t even realize half these companies were invested in ultrasound technology). Often they do not start-up. Or it might be easier to guide a satellite into space to dock with the international space station rather than figure out how to get to M mode. Or fit the enormous ultrasound contraption into a tiny patient room. More often than not it is simply gone, because ICU or Anesthesia “needed it.” The IQ is affordable, fits in your hand, and travels well. All probes are magically put into one. It plugs directly into the IPhone or IPad, and allows a HIPAA-secure cloud to save images. Ultimately, community realities are that we do not do as many ultrasounds as our academic colleagues, simply because of the strong drive for speed and metrics. With IQ, I can do ultrasounds faster, and - despite slightly poorer image quality - work in a modality that I find comfortable and consistent.

Cons: IQ gets you by requiring a yearly subscription of $420. Guess when you’ve got such hot technology you have to find a way to keep making that money. The probe is slightly heavy, and as noted image quality won’t be as sharp. But did I mention you can do almost all types of ultrasound - including M/B mode and Doppler - on your PHONE?!

Design for Vision: Surgical Loupes:

Emergency medicine is often bread and butter: COPD exacerbations, CHF flairs, cellulitis. The sexy: MIs; the not-so-sexy: STD checks. Lacerations fall in that mix. And I find no better way to improve my performance in this regard than with the Design for Vision Loupes. I can’t tell you how many dental loupes I purchased off Amazon. So many issues arose using them: too heavy, awkward lighting, low-battery, durability, etc. What I needed was a light-weight, custom-fit pair of magnification lenses, 2x, with a portable wire-free LED light (with several settings), and no adjusting of the lenses.

Simply put: pull them out, pop-them on, and go. Design for Vision achieves that. I had a representative come out to educate me and fit me for my pair, and, though the price was steep (close to $1800), the payoff was well worth it. I absolutely love using these. From complicated abscess, to complex laceration repair, to specifically doing plastics repair and needing that fine approximation, especially executing SubQ suturing. Barring the price, I have no other complaints about these, and per industry standard they are leaders in their field.

The T-Ring "The One-Size-Fits-All tourniquet for digits":

When you’ve got a bleeding digit, you really need some hemostasis to see what you’re dealing with before any action can be taken. This is where the T-RING comes in. Easy to slide over fingers and even toes, this bright red tourniquet applies the appropriate amount of pressure (<300mm Hg) regardless of the size of the injured digit. There’s no measuring, searching for a Penrose drain or rolling up a surgical glove, just adequate visualization of the injury! It’s even easier to take off once finished, a couple snips of the flexible outer rings and you can remove it without worry of damaging the underlying tissue. With the TRING in place, you won’t forget the bright red tourniquet is there and you know a safe amount of pressure is being applied on the tissue below!

Cons: Single use. “One size fits all” does normally translate to one size fits most. But for ED purposes, it normally does the job.

The I-GEL : Easiest to Use Rescue Airway Device

What:

- I-GEL is a temporizing supraglottic airway that is easy to insert to ventilate patients.

- Individually packaged, color coated by size, with lubricant and suction tubing for gastric channel

Pros:

- Some studies have show it is easier to use than the classic LMA.

- Cuff is pre-inflated and there is a tough “bite block” section to prevent possible occlusion

- Each tube has a separate ‘gastric channel’ that runs the entire length of the tube and can be suctioned through as a further prevention of aspiration events.

Cons:

- Single use. This is NOT a definitive airway