Here's a look at 15 of the more interesting and innovative products that were on display at this year's American Society of Anesthesiologists' annual meeting in San Francisco in October. Many of these items might already be on our anesthesia providers' wish list, but you'll want to know how they can improve your OR efficiency.

NOT FLYING BLIND SonoSite's X-Porte lets you learn as you go with regional blocks.

1. SonoSite X-Porte
Your Own Regional Block Simulator
This is a great way to cheat when performing regional blocks— like flying a plane with a flight simulator next to you. The machine has onboard visual guides that direct you through the process. You can watch a video on a touchscreen, listen to instructions, freeze the video when you want to duplicate the image on the screen and confidently move forward at your own pace. Sure beats watching an instructional video and then trying to remember everything while you're working with the patient. If the patient is a little nervous, wondering why you need instructions? Just plug in the headset and he'll never know. How cool is that?
sonosite.com/products/x-porte

X MARKS THE SPOT Analogic Ultrasound's GPS system shows you exactly where your needle should be.

2. Analogic Ultrasound SonixTablet with SonixGPS
Let GPS Technology Guide Your Blocks
The breakthrough here is GPS technology, which gives an extra level of confidence by decreasing the potential for nerve injuries (and malpractice suits). A sensor in the transducer, which is placed on the patient and emits an electro-magnetic field, talks to a sensor in the needle tip, providing a display on a high-resolution touchscreen. A red schematic on the ultrasound image represents the needle and an X marks the intersection point. When the needle tip is in the right spot in plane, it turns green and lets you know you're there. For tougher patients who require out-of-plane approaches, you can line up your target before you enter the patient's skin. Again, when you hit the X, that's when you know you're in plane. It comes with a 19-gauge needle that has clearance in every country except here in the United States, but it's very close to having FDA approval, says the company.
analogic.com

BREATHE EASIER GE Healthcare's Avance Carestation senses when patients stop breathing for 30 seconds.

3. GE Healthcare Avance Carestation
Smart Anesthesia Machine
This compact, integrated Carestation features advanced anesthesia therapy, patient monitoring and ventilation capabilities. Patients who are coming out of sedation tend to go in and out of apnea. If they stop breathing for 30 seconds or more, it's up to us to squeeze the bag and get them going again. Instead, this machine does it for us. A patient who stops breathing is automatically switched over to mechanical ventilation. Once the patient starts breathing on his own again, the machine switches him back over to pressure support. A GE rep says a "stripped-down" version will do the same job with a small footprint and a lower price.
gehealthcare.com

AIR OF EFFICIENCY Maquet's FLOW-I promises to save between 25% and 35% on anesthetic agents with its 're-breathing' technology.

4. Maquet FLOW-i
An Anesthesia Delivery System Filled With Innovations
This machine requires a significant investment, but it's like buying a hybrid car: It pays you back in gas savings. And the more cases you have, the sooner you make your money back. The savings? Between 25% and 35% on anesthetic agents, says the company. How? With a mechanism that recirculates exhaled gases and allows partial "re-breathing." Instead of being scavenged out, gas circulates back to the patient. That's where the savings happens — up to 35% with low flow. FLOW-i is easy to transport. The company says it brings "ICU-quality ventilation" into the operating room.
maquetflowi.com

IN AND OUT Phillips' IntelliSave AX700 helps patients recover faster by giving them only the amount of breathing help they need.

5. Phillips IntelliSave AX700
A Safe Anesthesia Workstation
This helps get patients up and out after procedures. The special feature is a vent mode with targeted tidal volume. You set the volume you want your patient to get with each spontaneous breath. Then it adjusts up and down accordingly, depending on how much the patient is breathing on his own. As patients emerge and take larger breaths, it starts dropping that pressure. That way you're always giving them the lowest pressure needed to achieve their targeted tidal volumes. Another plus: It's small, portable, and easy to disassemble — it takes just a few seconds — and it's all autoclavable.
healthcare.philips.com

OUT FRONT Airtraq's Avant guided video intubation device lets you face the patient with difficult intubations.

6. Airtraq Avant
Guided Video Intubation
Video-guided intubation continues to make difficult intubations a little easier. Instead of intubating from behind, you face the patient. After inserting the guiding channel, you look through the eyepiece — a small built-in video monitor — to identify the airway structures. Once you're in front of the glottis, you align the vocal cords and slowly push in the endotracheal tube. The channel stays in place while you connect the circuit. Then you pull the tube away toward the side and gently pull the channel back toward the patient's chest and out of the mouth.
airtraq.com

GOOD CALL The Clarus Cell Phone Endoscope Adapter uses your iPhone, Droid or iPad as a monitor.

7. Clarus Medical Cell Phone Endoscope Adapter
Fiber Optic Scope on Your Smartphone
Got a smartphone? That's all you need with this fiber optic scope. You can take pictures, record video — all the things you'd normally want to do while intubating — but you do it by attaching your own phone, instead of having to buy a separate monitor or looking through a monocular eyepiece. It works with iPhones, Droids and iPads.
clarus-medical.com

LESS STRESS Ambu's aScope 3 is a lightweight, user-friendly alternative to regular bronchoscopes.

8. Ambu aScope 3
Single-Use, Flexible Videoscopes
This single-use intubating scope might remind you of Wii video games with its user-friendly design. It's also very light, which is a nice contrast to regular bronchoscopes, which can start to feel very heavy after a while. The toggle switch lets you rotate the distal tip 130 degrees forward and back. It has auto focus and auto light balance. You can take pictures or video, set up file systems or download via USB.
ambu.com/ascope

INSIDE OUT Pajunk's E-Catheter takes an outside-the-needle approach to address an ongoing challenge.

9. Pajunk E-Catheter
Place a Catheter With Ease
When placing a continuous nerve block, it's hard to get the catheter to stay in the right spot once you remove the needle. With this clever device, the catheter goes over the needle instead of the other way around. You do a single shot, then slide the needle out while leaving the introducer in place, and you have a fixed catheter that ends up right where the needle tip was. The sheath that goes over the needle grips the tissue, so it should be very stable and consistent.
pajunkadvantage.com/ecatheter.php

SAFE START The JMS WinFusion Closed IV Catheter Device does away with needlestick injuries and exposure to blood.

10. JMS WinFusion Closed IV Catheter Device
For Successful IV Starts
Three of the biggest concerns when you're starting an IV are needlestick injuries, exposure to blood and first-stick success. This product addresses all 3. When you begin to cannulate, a flashback tells you you're in. Then you hold the tubing with one hand and advance the catheter with the other. Once you're in as far as you want to be, you pull back on the tubing and the needle retracts into the safety hub. Remove the stopper, apply your dressing, flush the line and you're ready to go. It also comes with removable wings that can make it easier for the anesthesia provider or nurse to succeed with challenging patients on the first stick.
jmsna.net

GOING GREEN Christie's Vein Viewer Flex turns veins into can't-miss targets.

11. Christie Medical Holdings Vein Viewer Flex
Easy to Locate Hard-to-Find Veins
This portable vascular access imaging device makes it easy to find veins. You won't need it for every patient, but for the tougher ones, it's a way to prevent the hunting and pecking that results in miss after miss and shaken patient confidence. It projects near-infrared light that's absorbed by blood and reflected by the surrounding tissue. That info is captured, processed and projected digitally onto the surface of the skin, providing a real-time image of the patient's blood pattern. The result: Veins glow green like a funhouse goblin.
christiemed.com

EASING THE PAIN The Teleflex AutoFuser disposable pump is versatile and cost-effective.

12. Teleflex AutoFuser
Disposable Pain Pump
This cleverly designed pump saves money and makes life easier for your staff. Like expensive non-disposable pumps, its delivery rate is adjustable and it comes with or without a bolus function for breakthrough pain, but at a much lower cost. It's top-filled and incorporates an elastomeric balloon wrapped around the inside of the case, so it takes 3 times less pressure to fill than most pumps.
teleflex.com

ONE-STOP SHOPPING Dräger now offers 18 pre-packaged anesthesia kits in various configurations.

13. Dräger Anesthesia Circuit Kits
Convenient Pre-Packaged Kits
Instead of piecemealing together a mask, a bag and a circuit to fit the patient and procedure, Dräger lets you choose from among 18 pre-packaged anesthesia kits in various configurations. That can be a speed booster when you're doing turnover. Instead of going different places for different items, you open up 1 bag and it's all there. The company used market research to determine what it says are the 18 most popular configurations. All you have to do is answer 3 questions to know which kits are appropriate for various cases.
dr??ger.com

WARM MEMORIES Stryker's gown keeps patients warm from pre-op to PACU while still allowing full access for providers.

14. Stryker Warming Gowns
Innovative Warming Gown
We all know that when patients are cold, it's bad news. They need more oxygen to deal with the shivering and other stress responses. Worse, when it comes to evaluating your facility, they're a lot less likely to remember the whole experience very fondly. So there's a lot to be said for a product that keeps patients warm from pre-op to PACU while still allowing full access for anesthesia providers and surgeons. These gowns do a nice job of replacing the tattered cloth gowns that provide little protection and keep backsides exposed. The material isn't cheap, but it doesn't feel cheap either. You can put them on patients in pre-op and keep them on until the patient is ready to be discharged, because they separate in the middle and split completely from neck to wrist, which provides full access for cuffs and line placement or for checking the patient during the case. One big reason people stick around in the PACU is they're cold, so anything you can do to prevent that from happening makes sense. This feels like first-class treatment and is likely to get people up and on their way that much faster.
stryker.com/medical

TRIPLE THREAT Codonics' SLS 500i helps with charting and billing in addition to double-checking medication.

15. Codonics SLS 500i
Medication Labeling System Can Now Do More
Codonics, the labeling system for syringes and other devices, has upped its game, so you can now accomplish a lot of things when you pass a bar code under that light: charting, billing and double-checking to make sure you have the right medication. The machine gives you audio and visual confirmation of the drug, along with how much time you have left until it expires. Its compatibility has been upgraded, so along with the 2D bar code on the SLS labels, the system now includes a 1D barcode, which can integrate with an entire facility system by scanning it into BCMA, EMR or AIMS systems like EPIC or McKesson. For high-traffic facilities, with one scan it can also now print between 1 and 999 labels for syringes, IV bags and more. At ASA, the system was shown being used with CareFusion, Omnicell ?and Plexus anesthesia carts.
codonics.com