# Wanna help? I'm revising our big trauma bag system.



## mycrofft (Aug 14, 2008)

I've pretty-well scoped out the changes to the bags and d/c'ed some of them. Now I'm deciding what to do with the five excellent Iron Duck orange duffles, long enough to carry a 250L O2 cylinder in the main compartment with eight inches to spare.
So far:
2 with materials for ad hoc Booking medical screenings (one for each gender).

1 with bulk storage of dressings SNS etc for use as an augmentor in event of mass casualty, including OB pack.

1 for riot control agent decon (anyone know of special bags labelled to contain stuff loaded with CS, CN, MACE, OC, or whatever?).

One is left. I'm leaning towards comunications/lighting and clerical material (clipboards, pencils and pens, markers, stapler, punch, paper, forms, phones with long cords, extension cords, clip lamps, lightsticks, batteries and lanterns, plus ??).

YES, every one of these ad hoc kits has gallon ziplock baggies, duct tape and plastic sheeting, and tetrasnips. I'm considering overwrapping with heavy duty large clear plastic trashbags then securing each to a folding chair for warehouse storage, then set up a product rotation file back at Medical.

So pitch in, it's due tomorrow by 1600hrs. I'm open to suggestions on ANY of these kits. If I adopt your suggestions, I'll seal a slip of paper thanking you by EMTLIFE nickname in each kit affected, which will mystify my successor to no end!


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## mycrofft (Aug 14, 2008)

*Who said "Beer"?*

.........


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## mycrofft (Aug 15, 2008)

*Clock's ticking....*

Any ideas for entirtely different set of bags? Nice big strong orange duffles yearning to be loaded.


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## ILemt (Aug 15, 2008)

Going along with the MCI idea-- A butt load of Nebs, NRBs cannulas and BVMS
and staff vests: Incident command, Traige, Transport etc...
also... 
the idea for extra Comm is great, but be sure to lean toward field 
requirements... (AE no landline phones... but maybe a cell phone or two)


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## ILemt (Aug 15, 2008)

Also an extra hand-radio or two with batteries (and maybe programmed to cover other local agencies in addition to your own: Fire, Sherriff, HAZMAT, city planner, esda etc...


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## mycrofft (Aug 15, 2008)

*Wow, thanks!*

The nebulizer and O2 accessory items were a wrinkle that fites right in and I failed to think about, we have lots of asthmatics.

Most likely scenario is ad hoc expansion to another part of the same facility (say, the staff cafeteria), but we have had issues with balky alternate power on occasion. These are all good suggestions; even if they don't fly past Admin this time I'm bringing them back when I start nudging for real disaster prep, not just "surge-prep".
Thanks!


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## mikie (Aug 15, 2008)

How about sterile water & saline?  For irrigation purposes...?


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## mycrofft (Aug 15, 2008)

*Thanks Mikie*

That's the "SNS", sterile normal saline. I hesitate to include it because it oudates, but it's a bummer to try to round it up and transport uunless the means is dedicated. Thanks!!
I don't use "sterile water " per se because it is hypo-osmotic, potentially causing tissue maceration on wet to dry dressings. However it has one excellent use...drinking water!


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## Ridryder911 (Aug 16, 2008)

mycrofft said:


> That's the "SNS", sterile normal saline. I hesitate to include it because it oudates, but it's a bummer to try to round it up and transport uunless the means is dedicated. Thanks!!
> I don't use "sterile water " per se because it is hypo-osmotic, potentially causing tissue maceration on wet to dry dressings. However it has one excellent use...drinking water!



Actually for irrigation H2O and NSS has no difference for short term usage. Even good old plain tap water is fine for most irrigation of MCI and acute injuries. 

Personally, I am not in developing "big trauma" bags. Check with other agencies on what is already developed. There are so many  "what if" project homeland agencies, most equipment and medical products will expire way before used. I know that most FD, regional EMS, MRC, DMAT and so on have equipment that will expire way before used. So much waste & money.. try not to re-duplicate and use funding more where it might be needed.


R/r 911


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## KEVD18 (Aug 16, 2008)

mycrofft said:


> That's the "SNS", sterile normal saline. I hesitate to include it because it oudates, but it's a bummer to try to round it up and transport uunless the means is dedicated. Thanks!!
> I don't use "sterile water " per se because it is hypo-osmotic, potentially causing tissue maceration on wet to dry dressings. However it has one excellent use...drinking water!



with all do respect sir, that argument is right up there with "no more than 2lpm O2 for copd patients". while technically accurate, in practical application its hogwash. the situation your describing would require constant, long term wtd dressings to cause tissue maceration. for I&D purposes, there isnt enough exposure to cause any sort of problem.


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## mycrofft (Aug 16, 2008)

*Ridryder, Agreed, and even worse...*

I received two of the red backpack style California "Preparedness kits" at a conference. Each had a flashlight with one dead D cell battery. Each had a folded up "water cubie", which in my experience develop pinholes at the fold's corners when folded too long.The first aid kits were the usual too little to small...
Some C.E.R.T.'s are preparing and maintaining "neighborhood ark's", Conexes or trailers with many supplies like shovels, tarps, prybars, etc., and probably water and some foodstuffs.
My goal is to come up with supplements to the current system which will be aimed at buttressing it through a rough patch while resupply takes it usual length of time.


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## mycrofft (Aug 16, 2008)

*KEVD18 , your tone is rough and your point is correct... for field EMS.*

..but this is being designed to maintain our level of care (and if there's any part of it that's level, I'm a little afraid to put an inclinomter on it!) which includes weeks long W-D dressings. The price for SNS is not much more at all in our quantities and through our supplier.
I carry it in the little 3 ml squeeze pillows used for nebulizers, only in my jump kit where there is no permanent room for a 500ml bottle or bag. I can very promptly and quickly rinse/wet a small open wound or dilute/rinse materials in a person's eye, enough to buy a little time get em to a real water source like a faucet. 
I have seem wound maceration due to non-saline (tap water or sterile water) dressing changes. I've seen much worse from using TELFA, and the bloody doctors seem to be in love with it.


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## Jon (Aug 17, 2008)

Mycrofft,

I think you are spot-on in your plan to store equipment to help in the short-term in the event of an MCI or "surge" situation. As FEMA likes to say... it can take 72 hours for outside help to arrive. That is also the mindset behind the neighborhood supply caches.

For the NSS (and if you are looking for sterile irrigation fluid, NSS/Sterile H2O cost the same... so who really cares). I guess my sugestion would be to try to figure out how often you turn over your stock... then when you get new stuff, that goes into storage, then the "older" stuff, still in date, gets used in Medical.


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## lilbeddoe (Aug 20, 2008)

on the topic of jump /trauma /medical bags
should i make my own or buy one

and i want to get an 02 tanks where should i look for one ?


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## NJN (Aug 20, 2008)

You are about to be asked many times by different people why you would want personal O2 in a jump bag that i assume will be in your car. so......

WHY DO YOU WANT YOUR OWN O2???????????:wacko:

O2 is RX only, although you could find some welding supply stores but we wont get into that. 

I'm assuming your some form of EMT and not an MD, because EMTs, when off duty, are normal citizens, who have the training to perform interventions that a normal person would not know how to do, but can only do what is covered usually by the good Samaritan act or state duty to act. So unless you can find a med director to operate under while off duty, complete with documentation, there is no real reason to have anything other than a first aid kit with you.

I may be wrong in some of my statements but all i have is a year in the field to work on. EMT class starts the second of next month WOOOOHH!!


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## mycrofft (Aug 21, 2008)

*Whoa whoa hold your horses and be nice!*


There's another thead about personal kits, what's on your belt, what NOT to carry, etc. already going on. This is about managing a twenty station trauma bag system in a sprawling correctional facility. 
I've had very good and well-considered advice, and due to administrative foot dragging at work my deadline has become infinite. There's nothing I like more than a power vacuum when there's budget to spend!


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## ILemt (Aug 22, 2008)

mycrofft said:


> There's another thead about personal kits, what's on your belt, what NOT to carry, etc. already going on. This is about managing a twenty station trauma bag system in a sprawling correctional facility.
> I've had very good and well-considered advice, and due to administrative foot dragging at work my deadline has become infinite. There's nothing I like more than a power vacuum when there's budget to spend!



Since you are at a correctional center: a lot of quik clot and the chemical spray that negates the OC burn. (I'm thinking a riot)


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## mycrofft (Aug 22, 2008)

*ILEMT, don't get me started about OC.*

Our official decon agent is Johnson and Johnson (not generic) baby shampoo. US Army says baking soda. Last time they used OC, the floor was so slippery that an officer fell and had a severe concussion. Would have to watch outdates.

But the point is a good one. I think I included long hoses and adjustable garden sprayers in one kit.


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