2022-08-29 Standardization Committee Minutes

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We carry about 35-40 different medications on our ambulances. With new standing orders and having STEMI or the Cardiology Clinic here at Hilo Medical Center we have a lot of cardiac transfers, therefore the types of medications that are given has also evolved. Previously, EMS used a three -chamber pump (Alaris), they were great, but we can no Ionger get parts or have it repaired. There's an uptick of transfers and new standing orders which entail certain medications to be administrated. We must administer these medications especially to those with septic shock or in cardiac arrest where it's better to use a pump due to its accuracy. Too much too little is not good like any other medication. We viewed four prehospital pumps, and it came down to two. One was the Sapphire and the second was a Nimbus. The Nimbus didn't meet the minimum specs for how fast we need to get one medication in. Bodyguard was disapproved by the FDA due to its inaccuracy on how fast it was giving each medication and Sigma's battery life was short. Sapphire is the most popular across the country, with American Medical Response (AMR) a private ambulance provider in the state as well as with the air medical providers. The changeover of patients from ground to air or ground to ground is much easier. If we're coming in from Ka'u or North Hawaii and we meet up with AMR, we simply disconnect the tubing and connect to their pump. It's seamless. The Sapphire pump cost about $2,200 which is reasonable considering the type of medication pump it is. Mr. Kanae — The cost of the Alaris we purchased in June 2000 was $4,450. Mr. Honda - The Alaris is a three -chamber, and the Sapphire is a single -chamber. On the average transfer we see 2 pumps used. We'd like to provide and supply our busier transfer ambulances, S. Kohala, Captain Cook and Na'alehu with 2 pumps because they would be running multiple medications. Kilipaki did all the research and investigation of different pumps in the prehospital setting. We're looking at having two pumps for the busy units, one for the slower units, and a couple spares. The preventative maintenance for the units is about $100 a year per unit. It comes with a one-year warranty. Every year the units are sent to be calibrated to make sure it's providing the correct amount of medication. The difference between hospital and prehospital. Prehospital is more ruggedized and water resistant. Mr. Kilipaki — In the hospital setting, there are a lot more different types of medication pumps they offer but they do not relay over to our field of work. The pump must be flight rated for use on our air medical helicopter. By having the single type of pump used throughout; if at any time we must do a changeover with our air medical helicopter we can easily transfer over to our air medical crew, and they can continue to transport the patient to the hospital. Ms. Sako -- AMR and Hawai'i Life Flight both compatible? Mr. Kanae — Yes, Hawai'i Life Flight and AMR both utilize the Sapphire pumps. They are the two biggest cooperating agencies we do complete transfers with.