# Equipment for rural ambulance service



## bushinspector (Dec 26, 2014)

In the process of attracting Paramedics to our rural ambulance service. Before you would consider to work in rural EMS, what equipment would you want in place? Transport times would be between ten minutes to our local hospitals, up to 90 minutes to our only trauma center in the state. In the near future we will have a helo service 45 miles away and will transport by them if needed.


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## TRSpeed (Dec 26, 2014)

Pay, shedules, benefits, retirement, rigs, protocols are gonna be your most frequently asked questions. Post them here and you won't get repeat questions.


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## RocketMedic (Dec 26, 2014)

You need power cots, waveform capnography, sensible epcr and vents capable of cpap or bipap.


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## RocketMedic (Dec 26, 2014)

Spend money on good supplies and reap rewards.


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## johnrsemt (Jan 12, 2015)

Make sure that people understand the transport times; I love long distance transports, but a lot of EMS people get scared of them; and helicopter services have been known to laugh at some calls from rural services due to nervous medics.  I have seen helicopter crews refuse to waste their time with a patient, and make ground crews transport them


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## savemachine (Jan 13, 2015)

Here is a "crash cart" list for in the hospital, but basically the same equipment list applies for medical transport.

*Equipment*

Airway (oral and nasal) all sizes
McGill forceps, large and small
King Airway Set (3) Eliminates the need for Laryngoscope and Endotracheal tubes
Bag Valve Mask (Adult and Pediatric)
Nasal Cannula
Non Rebreather Oxygen Face Masks (3 sizes)
IV Start Packs
Normal Saline Solution (1000ml bags)
IV Tubing
Angiocaths (various sizes)
10ml Normal Saline Flush Syringes (3)
Gauze
Alcohol Preps
Monitor with Defibrillator (preferred) or AED
*Drugs*

Aspirin 81mg Tablets
Nitroglycerin Spray or 0.4mg tablets
Dextrose 50% (Dextrose 25% if treating pediatrics)
Narcan 1mg/ml (2)
Epinephrine 1:10,000 Abbojet (3)
Atropine Sulfate 1mg Abboject (3)
Amiodarone 150mg Vial (4)
Epi Pen (2)
Epi Pen Jr (2)
Solumedrol 125mg Vial
Benadryl 50mg Vial (2)
Adenosine 6mg (4)
Lopressor 10mg (2)
Cardiazem 20mg Vial (2)

Basically stolen from 
https://www.acls.net/acls-crash-cart.htm


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## pwt57896 (Jan 19, 2015)

I work in what we consider a semi rural service, my transport times range from ~15 minutes to upward of 45-60 minute transports sometimes.  

If you spend a little money on quality equipment up front to make the job easier, you'll end up with happier employees.

Vent capable of multiple modes
EZ IO
Video Laryngoscopes
Disposable CPAP
CPR device


All of that's in addition to a typical ALS loadout on an ambulance, and a set of very progressive protocols will hopefully attract a decent group of Paramedics.  And you can't forget to have nice boxes to work out of.


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## RocKetamine (Jan 19, 2015)

I would look into getting a LUCAS device if your service doesn't allow for backup to arrive quickly. They're very expensive but running a code with two people sucks. After that I'd get a vent, as bagging someone for a prolonged time also sucks and not in the best interest of the patient.


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## Underoath87 (Jan 22, 2015)

Bear mace.  Wait, how rural are we talking, here?


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## bushinspector (Jan 23, 2015)

RocKetamine said:


> I would look into getting a LUCAS device if your service doesn't allow for backup to arrive quickly. They're very expensive but running a code with two people sucks. After that I'd get a vent, as bagging someone for a prolonged time also sucks and not in the best interest of the patient.


We just put Lucas (1st generation) on our primary trucks along with vent on the paramedic trucks. We saved HUGE $$$$.


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## bushinspector (Jan 23, 2015)

IF we had trees, bears would be a issue. Instead we have rattlesnakes.....and NO we don't allow our medics to pack!!


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## NomadicMedic (Jan 23, 2015)

bushinspector said:


> We just put Lucas (1st generation) on our primary trucks along with vent on the paramedic trucks. We saved HUGE $$$$.



The compressed air Lucas? The battery powered LUCAS 2 is a huge improvement. Expensive, but worth every penny.


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## RocKetamine (Jan 24, 2015)

DEmedic said:


> The compressed air Lucas? The battery powered LUCAS 2 is a huge improvement. Expensive, but worth every penny.



I didn't even know you could still buy the first generation!


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## WestMetroMedic (Feb 1, 2015)

RocKetamine said:


> I didn't even know you could still buy the first generation!


I think that some guy in Philly is selling the used LUCASs out of the trunk of his Cadillac.


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## DrankTheKoolaid (Feb 27, 2015)

Pre-existing good relationships with volunteer fire and local law enforcement. Comfortable seating InThe front of the box with cup holders.. Your going to spend a lot of time in your home away from home. 

Solid mapping of the area 

Progressive protocols due to lack of communication via radio/cell if in a truly rural/frontier area

A very strong FTO period to train people especially if taking urban medics as this is a worlds apart from the 15 minute medic job 

Monthly CE offerings and a strong QA process with the medical director included and include volly fire in these training


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## medicaltransient (Feb 27, 2015)

succinylcholine, vec or roc please. 

Anyone read the research on using vec or roc without sux in the pre-hospital environment?


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## STXmedic (Feb 27, 2015)

medicaltransient said:


> succinylcholine, vec or roc please.
> 
> Anyone read the research on using vec or roc without sux in the pre-hospital environment?


Are you talking about using Succ _with_ Roc? Or comparing depolarizing against non-depolarizing?


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## medicaltransient (Mar 1, 2015)

STXmedic said:


> Are you talking about using Succ _with_ Roc? Or comparing depolarizing against non-depolarizing?


I read some research on facebook that said you don't need succ at all it should only be used in the OR and is pointless in emergency situations.


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## NomadicMedic (Mar 1, 2015)

medicaltransient said:


> I read some research on facebook that said you don't need succ at all it should only be used in the OR and is pointless in emergency situations.



Who wrote that? Tor Eckman?

You have a much better chance of a successful intubation with both an induction med and paralytic.

During the great succinylcholine shortage of 2010, we used roc in it's place with no difficulty.


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## STXmedic (Mar 1, 2015)

medicaltransient said:


> I read some research on facebook that said you don't need succ at all it should only be used in the OR and is pointless in emergency situations.


Haven't read that. You're saying Succ specifically, right? Or are you saying paralytics have no place prehospitally?


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## chaz90 (Mar 1, 2015)

medicaltransient said:


> I read some research on facebook that said you don't need succ at all it should only be used in the OR and is pointless in emergency situations.


Wanna elaborate a little bit? A quote like this needs some serious context. Then again, research on FB...Hopefully it was a link from FB to something real.


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## savemachine (Aug 18, 2015)

bushinspector said:


> In the process of attracting Paramedics to our rural ambulance service. Before you would consider to work in rural EMS, what equipment would you want in place? Transport times would be between ten minutes to our local hospitals, up to 90 minutes to our only trauma center in the state. In the near future we will have a helo service 45 miles away and will transport by them if needed.



The most strong equipment of attraction is your services. Provide best services to maximum without any benefit and provide best care and treatment services at large scale with honesty and  sincerity.

Regard: Sumera


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## Underoath87 (Aug 18, 2015)

savemachine said:


> The most strong equipment of attraction is your services. Provide best services to maximum without any benefit and provide best care and treatment services at large scale with honesty and  sincerity.
> 
> Regard: Sumera



Huh?


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## NYBLS (Aug 20, 2015)

-A quality monitor (12 lead, CO2, CO, Met, etc)
-Pump
-Vent capable of CPAP and BiPAP
-Strong RSI program (Don't forget the Ketamine)
-Ambulances with room to work


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## NUEMT (Apr 20, 2016)

where is this?


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## TransportJockey (Apr 20, 2016)

NUEMT said:


> where is this?


Which post are you asking about?


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