Interesting interview question popped up today... Remove one piece of equipment

[usafmedic45]

No kidding I agree. If their blue they need more O2. LOl

Cyanosis is a poor indicator of existence of hypoxia. To put it in scientific terms, the specificity is pretty high but the sensitivity leaves a lot to be desired. Otherwise you're correct, although your approach would leave a lot of people with hypoxia untreated and people without hypoxia overtreated.

 

[Momof7]

I was joking.

 

[JPINFV]

Oh I have one. Teddy bears and OB kits in our B rig. Thats the rig we use for the nursing home runs.^_^

...and what happens when the unit is on the way back to base and gets flagged down for an OB call?

 

[Momof7]

Lol Ok OK well then, I would punt. If the babies coming it is coming with or without an OB kit.

 

[usafmedic45]

Ah, sorry....it's a real pain in the backside to judge humor on forums even with an LOL. What you said is such a common misconception among EMS personnel that I saw a teaching point and ran with it.

 

[EMT-G36C]

Discard:

Stretcher, workdays just got a whole lot easier!

All kidding aside, Powered suction unit.

Weighs a bit, and not as useful as onboard or the manual portable.

Keep:

Dash mounted computer with NOMAD.

 

[usafmedic45]

Powered suction unit.

not as useful as onboard or the manual portable.

Just out of curiosity, how many calls have you had where you've actually had to suction someone?

How do you figure it's not as useful? The fact that it's a little bulky does not mean it's not worth it's weight in gold when you have a difficult airway. I don't see how the manual portable is a big advantage over them in a patient with copious amounts of secretions or blood in the airway and I have a lot more experience with secretions than most people on this forum. The only manual suction devices I've ever seen that work even passingly well are bulb syringes and turkey basters. All of the commercial designed manually powered units intended for EMS (such as the V-Vac, etc), seem to be lacking in power to deal with thick secretions or coagulated blood or are too tiring on the hands to be of much use.

 

[EMT-G36C]

Just out of curiosity, how many calls have you had where you've actually had to suction someone?

How do you figure it's not as useful? The fact that it's a little bulky does not mean it's not worth it's weight in gold when you have a difficult airway. I don't see how the manual portable is a big advantage over them in a patient with copious amounts of secretions or blood in the airway and I have a lot more experience with secretions than most people on this forum. The only manual suction devices I've ever seen that work even passingly well are bulb syringes and turkey basters. All of the commercial designed manually powered units intended for EMS (such as the V-Vac, etc), seem to be lacking in power to deal with thick secretions or coagulated blood or are too tiring on the hands to be of much use.

10-20, probably on the lower end of that spectrum.

The way I see it though (working mostly IFT for a private) the hospitals or nursing homes have a good suction unit. My rig has a good unit.

The V-Vac will suffice in the short time between those two places.

Anytime I have a pt. that needs to be suctioned, I do it before I leave, and will follow up en route as needed.

Anyone with a trach, I ask if they feel like they need suctioning before we do anything else.

Airway is important after all.

Also, we have really $#!77* electric portable units.

We actually are in the process of getting rid of them lol.

I have one today, and was totally surprised.

 

[usafmedic45]

The way I see it though (working mostly IFT for a private) the hospitals or nursing homes have a good suction unit. My rig has a good unit.

Ah....that explains it. However, I've been surprised by walking into nursing homes and finding nothing useful so I would always rather have my own equipment at hand and not put my faith in institutions that may or may not have the patient's best interest at heart. Also, I look at it from the perspective of what happens if you find yourself stumbling upon a critical accident where the patient is trapped and needs suctioning and you can't move them. It's all too easy to overwhelm a V-Vac.

The V-Vac will suffice in the short time between those two places.

I would rather have a turkey baster. Much more effective for much less work. There's a reason why I carry one in the jump kit I still keep in my car.

Anyone with a trach, I ask if they feel like they need suctioning before we do anything else.

Smart move.

 

[djmedic913]

I would get rid of the the toilet paper...yup NH Dept of Health makes toilet paper mandatory on an Ambulance.

I would also get rid of the seran wrap...LMAO...I tried to use it once on a someone who slit their own throat (training/protocol so I said why the hell not) and it was a mess...hysterical tho...LOL...

the 3 things I would absolutely keep (it is not exactly 3 but it is 3 categories anyway)
O2
appropriately stocked first in bag
backboard/collars/head blocks

I can work any call with these things...the other toys are nice and helpful and fun...I don't need a monitor to tell me an irregular rhythm or fast or slow or dead. (it helps to treat properly I know)...

 

[reaper]

But, a portable power suction unit is the most needed thing on a truck. You will see this, when your truck unit stops working in the middle of a trauma intubation! The hand units are pretty much useless.

 

[djmedic913]

But, a portable power suction unit is the most needed thing on a truck. You will see this, when your truck unit stops working in the middle of a trauma intubation! The hand units are pretty much useless.

those hand squeeze suction things...LMAO...those are great you can even flip a piece of plastic or something to make it suction for peds...

was my response dripping with sarcasm too much?

 

[Sasha]

I would get rid of the the toilet paper...yup NH Dept of Health makes toilet paper mandatory on an Ambulance.

The company I used to work for required bedpans to be on the truck.. I never knew of anyone who successfully placed a bed pan while driving down the road, and that's what their diaper or little paddy thing is for.

 

[EMT-G36C]

The company I used to work for required bedpans to be on the truck.. I never knew of anyone who successfully placed a bed pan while driving down the road, and that's what their diaper or little paddy thing is for.

:lol::lol::lol::lol:


Also, if I worked for a service where I had trauma and all that, I may change my answer.

Hopefully I'll let ya"ll know in a year or two.

 

[djmedic913]

The company I used to work for required bedpans to be on the truck.. I never knew of anyone who successfully placed a bed pan while driving down the road, and that's what their diaper or little paddy thing is for.

we have those too. had that at my lst company as well over 500 miles from here...lol

it is not like I'm gonna wipe anyones butt on a call...lol...

 

[Sasha]

I could see bedpans on longer trips, I know of a company here that will transport to any state within the contential US providing insurance clears but for run of the mill everyday trips? Nope! Hold it or use the diaper!

 

[Seaglass]

Care to explain why you would get rid of tourniquets? They are a low use item but are extremely useful in some situations.

Because it's possible to improvise, I'd get rid of them if I were asked to pare a kit down to the bare minimum. In reality, though, I'd prefer a tourniquet made for that purpose.

 

[Shishkabob]

Because it's possible to improvise, I'd get rid of them if I were asked to pare a kit down to the bare minimum. In reality, though, I'd prefer a tourniquet made for that purpose.

TQ's take up minimal space and weight in a bag... and considering the NR just changed their testing to push TQs forward quicker, I highly doubt they are going anywhere soon.

 

[JPINFV]

The company I used to work for required bedpans to be on the truck.. I never knew of anyone who successfully placed a bed pan while driving down the road, and that's what their diaper or little paddy thing is for.

Bedpans were on the state required list in both OC, CA and Massachusetts. While I've never had the pleasure of using the bed pan, I have had to use a urinal a few times.

 

[usafmedic45]

Because it's possible to improvise, I'd get rid of them if I were asked to pare a kit down to the bare minimum.

Improvisation of tourniquets (short of using your BP cuff as a pneumatic tourniquet which is less than ideal for at least a couple of reasons) is not a good idea. It often fails to stop bleeding as has been cited again and again in the literature. I recommend you read the article I posted.

If anything, I would advocate for a purpose built tourniquet as a part of any standard "bare essentials" kit. There is a reason why they are in the bare bones kit issued to US combat troops.

In reality, though, I'd prefer a tourniquet made for that purpose.

I would expect that to be a standard. Trying to improvise a tourniquet- as outlined in the literature- in an emergency is a very bad idea. Given the number of purpose built tourniquets available, I can't see why anyone would carry anything else.