12/11/2016 Review of the S-Cut
Evaluated by Kurt Eifling, MD, Washington University in St. Louis School of Medicine resident, Zachary Hafez, MD, Washington University in St. Louis School of Medicine resident, Jason Wagner, Assistant Residency Program Director, Assistant Professor Washington University in St. Louis School of Medicine, faculty member.
Since starting my career in emergency medicine, the trauma shear has been emblematic of our role at the point where people change from regular community members and become patients. They arrive unstable, traumatized, scared, and almost always clothed. Yet before we can change them to resuscitated, collected, and reassured, they must also become naked. The need to make people immediately naked is unique to our specialty, and the devices we use for that daily purpose are just as ubiquitous as stethoscopes and smart phones. Shears are everywhere, but does that mean they are the best tool for this every-day job?
Other industries that have faced the same question, ”what’s the safest, fastest way to make this one piece of fabric into two pieces?” do not elect a scissor-type design. Escaping from an entangled seatbelt in the US Marine Corps, for example, is typically done with a horseshoe-shaped blade on a single-piece tang, such as this one made by Benchmade. As devices intended for self-rescue, these are often Spartan in design and not designed for daily carry or comfortable use with the ungloved hand. Most products designed for rapidly cutting fabric in an emergency agree that the operator is advantaged most by pulling a blade closer; not by pushing a scissor away.
The S-Cut is a Swedish product that combines the safe hand-feel of our familiar trauma shears with the strap-cutting approach of a pulled blade, making nakedness happen more rapidly and safely than ever before. Though originally designed for equestrian and veterinary applications to cut straps, cords, and ropes quickly and safely, first-responders have adopted this device in Europe. We tested the S-Cut QE (short for ”quick and easy”) as a way of making clothed people into naked patients in our level-one trauma center in urban St. Louis.
The experience of using the S-Cut QE in the clinical setting is overall excellent. The first time I used this device, I was amazed at how quickly and effortlessly it laid open a pair of denim jeans and the patient’s belt. Moreover, I was certain I would not have the shears open and nip the patient’s skin folds nor any one of the providers’ dozen hands darting all over the patient’s body. It glided neatly through multiple layers of clothing, leather belts, and synthetic boots. It was not tested specifically on cutting through a metallic zipper, but traversing the zipper is not necessary when a flick of the wrist gets you to the waistband instead. The S-Cut QE fits neatly into a lab coat pocket, has a tether point for a lanyard, and it weighs no more than shears. It also performs well taking down bulky gauze dressings with the patient’s skin feeling a smooth plastic anvil instead of the blunted steel blade of traditional shears.
The only drawback I found was my own anxiety in having something so exquisitely sharp in my pocket during shifts. I feared I would jam my own hand thoughtlessly into my lab coat pocket and onto the light-saber blade, but this anxiety proved to be unfounded in my case. The mouth of the cutting area is narrow enough, and the protective anvil broad enough, that to insert one’s finger the device would be difficult to achieve deliberately, and even harder by accident. A holster is available.
In professional kitchens, it is considered common knowledge that part of knife safety is keeping your knives very sharp. A blade sliding easily through a medium will not tempt the user to press or mash into the act of cutting with force that is difficult to control. If you like your scalpels sharp, you’re cutting easy, and your trauma patients exposed, then the S-Cut QE may be just the upgrade you need from traditional shears.
I have used internationally branded clothes cutters for years but none of them compare to the "S-Cut". I no longer need to carry trauma shears. The ‘S-CUT’ does it all. Bullet-proof when you need it!
The S-Cut Swedish Cutter is a premium grade European-engineered cutting instrument, with an innovative circular blade.
It just cuts and cuts, with a safe and secure recessed blade that can make short work of even the heaviest fabrics. The rotating numbered dial allows you to easily rotate to a fresh cutting edge with a twist on the dial.
A rotary blade is many times more useful than any straight edge blade can possibly be. When you are finally done with the circular blade, you can easily replace it with a fresh one.
If I did racecar track work, or was on a light rescue unit serving a major high speed interstate, the S-Cut might be on my short list of new basic essentials. It is a high-performance, rugged hand tool with serious cutting power.
Insights on innovation by Dan White
A patient was lying in the middle of the road after a motorcycle accident. When I arrived, EMS was on the scene fighting with the old standard trusty "trauma shears" to remove the patient's thick and heavy sweatshirt. I retrieved the S-CUT and in a total of three smooth sweeping motions, I opened the front of the sweatshirt as well as the sleeves. In a matter of seconds I had the patient's body exposed from the waist up. He also wore heavy jeans that are always hard on the fingers with the trauma shears; however the jeans were easily cut and removed with the S-CUT. This has to be the absolute best cutting device I have ever used in my 20 years as an EMS provider!
"Doctor, even if we never get to use S-CUT again, it was worth every penny just for this single patient"
S-Cut: The New Emergency Cutting Tool
At the last Emergency Services Show I met with Adrian King and Jeremy Williams, very knowledgeable purveyors of something I had been trying to get my grubby mitts on for some time: the S-Cut emergency cutting tool.
I have competed against, and respect greatly, the Swedish Extrication Team, namely West Coast Rescue. Their Team Medic, Jens Hammer, is an anaesthetist and pre-hospital nurse, as well as a great practitioner, competitor and friend. Jens introduced me to this new emergency cutting tool, the S-Cut, which he had been given to promote. I wanted one badly, but it was not yet available in the UK, so I would have to bide my time.
However, at last it has arrived and was formally launched at the Emergency Services Show last November.
The S-Cut emergency cutting tool was developed by Bjorn Ahlen, a Swedish paramedic, with the simple concept of being able to cut through thick or heavy materials fast, to enable a medic to fully expose a casualty whilst minimising any need to move the patient. The intention it to increase the speed at which treatment can start, so improving survival chances. As a design brief it has definitely been achieved. The end product is a perfectly balanced, speedy to use, one handed, well crafted tool with no moving parts and autoclavable, which really is unique and unmatchable.
Basically, the S-Cut is a lightweight, hook shaped steel handle with a razor sharp disc located within the hook and is used in essentially the same way as a seatbelt cutter. For optimal performance the tool is drawn directly across the materiel. There is also a version with a retractable blade added to make an initial hole to place the tool in, which is very useful when exposing car seats.
In use the S-Cut will slice its way through all the usual garments you would expect to encounter: shirts, leather belts, zippers, protective outerwear jumpers, suits and the like, not forgetting that an initial cut and ripping action is the commonest way to remove clothes. However, the tougher the garment the more traditional shears struggle and fail. What makes this even more troublesome for us as first responders is the fact that these materials are not rip-able (try tearing a leather motorbike jacket).
After extensive trials by Hampshire FRS , the S-Cut does not miss a beat on this test. Boots, belts, bras, climbing/access harnesses, motorbike leathers, Fire Kit, Personal Protective Equipment and body armour have not put up any significant resistance, even military webbing, Osprey armour and attachments. This really is where this tool stands head and shoulders above the rest. At Hampshire FRS we are complete converts in the Extrication Team and I also use it in my role as a TA medic and will be taking it with me on deployment to Afghanistan in February 2011.
I am a firm believer that when a job starts off in the right manner it sets the tone for the rest of it. Struggling to hack your way to uncover and expose an unstable trauma patient with a set of limited use shears causes undue movement and pain to your casualty, with possible neurological implications and just as importantly takes up precious time before you can even begin your treatment with a now heavily sweating brow. This is not a 21 st century approach to patient care. Quick effortless and painless exposure, inspiring patient confidence and quick progression should however be the norm, affording you as a care provider, your team and the patient the best possible advantage.
The S-Cut is not an obviously cheap tool, although prices are competitive for volume orders, but let’s put this in perspective. Remember the cost of transport (especially helicopters), perishable items, analgesia, pelvic slings and other adjuncts that are the usual for trauma patients and are unchallenged in terms of cost, although they are just as much a part of the life saving mix as the S-Cut.
Let me also say that if you expect to encounter your patients robed in tough materials such as in motor sport, military, police ballistic teams, rope teams, Fire Services and other organisations that routinely use enhanced levels of Personal Protective Equipment, to give your patients the best possible chance, and as a professional, you would seriously consider the S-Cut emergency cutting tool to overcome these obstacles to starting treatment as early as you can.
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