It started with meeting a friend at an upscale tavern in Denver. James Manson, our VP of Strategy at Cascade Training was in town and he wanted to catch up with a few of his friends. We were waiting to meet up with Stephanie Haley-Andrews, the Director of Trauma Services for HCA Continental Division and oversees trauma centers in Colorado and Kansas. “Jimmy” and “Steph” have been friends and were colleagues for years, and it shows every time they get together.
Having been recently included in their group, I’m just happy to listen and learn; and boy, do I learn. Sitting with industry experts and learning from their experiences while listening to them cast a vision for the future is amazing. Jimmy and Steph have a rare combination of wisdom from their experience and intelligence that wraps itself in humility.
While waiting to meet Steph, she texted and asked if she could bring her friend as she thought we would really like him. Of course we would! A friend of Stephanie is a friend of ours!
Steph walked in and introduced us to “Steve.” Dr. Steven Moulton is the Director of Pediatric Trauma and Burn Services at Children’s Hospital of Colorado and the co-founder and Chief Medical Officer of Flashback Technologies.
Before you stop reading, the purpose of this blog is not to name drop, rather it is intended to share a bit of their knowledge with you. Jimmy, Steph, and Steve bring considerable experience and intelligence to bear on the complexities that hinder patient care and good outcomes both in the field and in the hospital.
A Gathering of Experts
Jimmy has experience with active shooter incidents from his time in Denver, and along with Dr. Peter Pons, is a co-author of the Hartford Consensus paper that advocated for tourniquets. This study is the basis for the federal Stop the Bleed campaign, and it is well worth your time to read. Jimmy wants a world where tourniquets are with every LEO, on every ambulance, and next to every AED.
Steph has a passion to tie law enforcement and EMS with pediatric trauma education to reach a goal of recognizing and preventing child abuse. She believes that even though we cannot save every child, we can provide justice. Justice can be found in documentation and recognition of child abuse, which saves generations of children by allowing prosecutors to put offenders in jail.
Steve co-founded a company that created a device that just might change everything in health care. Yes, everything. The Compensatory Reserve Index (CRI) is an algorithm running on a small device that performs a miracle; it uses the pulse ox waveform to continuously measure how well an individual is compensating for volume (blood) loss, from normovolemia to collapse. Yes, you read that right, and pictured is the CRI device developed by Flashback Technologies.
Compensatory Reserve Index
Think of the gauge on the right as a “gas tank,” and fluids can be titrated and pathology recognized ahead of typical lab values. A CRI of ‘1’ represents replete central volume or a “full tank of gas” and ‘0’ is empty. Values between ‘1’ and ‘0’ indicate the compensatory reserve of the patient, or how much fuel is left in the tank. Total game changer, right?
Possibilities for use and treatment. Are. Endless.
Dr. Moulton says the Army has supported development of the technology through grants and collaborative work at the US Army Institute of Surgical Research. The device has been with the FDA for two years, and they are hoping “something” will happen this year.
Also, Dr. Moulton sent studies showing the CRI in use. Nerd on, friends:
Note that these accomplishments are in addition to Dr. Moulton being a renowned pediatric burn and trauma surgeon. No, he doesn't wear a cape. At least not from what we could see.
Margaret Mead once said, “Never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it’s the only thing that ever has.” Jimmy, Steph and Steve may change the world, but they are humble enough to know that shared knowledge is powerful to change the outlook of patient care and improved outcomes. They want to change it with you, and for you.
After nearly five hours of dreaming, thinking and collaborating, we said our goodbyes as most of us had to work the next day. Leaving the meeting, we thought “How can we get this information to the new EMS provider as well as the experienced nurse or doctor?” Trust me, we are working on it, and Jimmy, Steph and Steve are willing to share their knowledge for our benefit.
What questions would you ask Jimmy, Steph, or Steve? Leave your question in the comments below, and we’ll do what we can to get you an answer!