# How do you make up your cot?



## InkaHootz (Sep 16, 2012)

We all (mostly) have one.  We all work with them. How do you make up your cot post-call?  Considering it's used on nearly every run, whether you transport or not...The cot is a workhorse of the industry. How you put yours together, what you leave on it, and how you 'dress' it, may say a lot about you.

In this thread, I'd like to open an exchange where we share our peeve's regarding cot making. 

Myself:
After the call at the hospital begins with a thorough decontamination of the entire cot.  Messier calls require some disassembly to get in those nooks and crannies below the cushion, and on the bottom wheel-frame. A clean cot is a happy cot!

Making the cot-
Supplies required: 2 sheets, 2 blankets (maybe more in heavy winters), 1 towel (2 in the winter) and one hospital gown. 
1: I like to get the sheet squared away. Hospitals never seem to fold them properly in half.  So I usually unfold and refold on the line, and tuck the corners hospital-fold style under the cushion. 
2: At the head of the stretcher I lay a folded blanket.  I place a towel over this, and then tuck it under the cushion. This creates an extra 'pillow' for the patient's head to rest on.  I'm the only person I know that does this.  (The cushion on top of the oxygen cylinder at the head doesn't provide any degree of comfort.  I think it's just a skull-saver, honestly.)  I leave the pillow under the bench seat, and prefer it over the vacuum splints for those ankle/wrist traumas.  
3: Place the sheet down on the foot of the cot, blanket on top of that, and then the hospital gown on the top.  I button all the sleeves together (<10% of which are buttoned to begin with) and lace the seatbelt throught the arm sleeves. This rapidly identifies the arm holes on a folded up gown, and prevents confusion on the call when utilizing the gown on the patient.  Don't forget to make sure your IV pole is on the "outside" of this seatbelt.  Nothing sucks more than having an unstable multiplesystemstrauma with right lower extremity and having to fiddle-f&#@ with the belt to get the IV pole jiggled up to transfer out of the ambulance and into the ED. 
4: The monitor and the portable oxygen cylinder are placed on the  center of the cot, and the middle seatbelt laced through their handles.  
5: Fold up the head of the stretcher, place my in-bag on the rear platform behind it.  
6: Optional in the wintery areas, place a towel on the foot of the stretcher in similar fashion (minus the pillow-blanket). This way, your patient's muddy shoes (or gangrenous toes) can be covered up by SOMETHING if nothing else.  


Ok....enough of my ranting. 

What are YOUR 'tricks' to cot making?


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## Anjel (Sep 16, 2012)

We use the pole stretcher(without the poles) on the stretcher for every single call. 

And we have the stryker cots. 

SO it goes like this. 

1. Open pole stretcher and lay flat. 
2. Take paper sheet pack from the cupboard. 
3. Take bottom sheet and lay over the pole stretcher. 
4. Fold the pole stretcher so it folds the sheet with it. 
5. Take pillow and place in pillow case. Place pillow at the head of the stretcher and secured with top strap. 
6. Fold up loose end of strap and tuck. 
7. Take top sheet and place at the head of the stretcher. 
8. If time for a blanket. Fold Blanket in two. Then fold in 3's. So it looks kinda like a log. Then secure with bottom belt and tuck. 

Wah Lah.


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## NomadicMedic (Sep 16, 2012)

Are you all familiar with the two blanket rule?

Every patient gets a blanket. If its chilly enough that I'm wearing a job shirt or long sleeves, every patient gets two blankets. 

And everyone gets a pillow. 

And now that I'm on a squad and not an ambulance, I never have to make up a stretcher. One of the best parts of the job.


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## JPINFV (Sep 16, 2012)

Supplies: 1 cloth sheet, 2 disposable sheets. Add additional sheets and blankets as needed for weather. Add pillow and pillowcase for comfort. 

Base sheet that can double as an emergency draw sheet if need be. Also if you get caught without a made gurney for whatever reason. 
1. Take the mattress off. Drape the  linen sheet over the frame.
2. Place mattress upside down on the gurney on top of the sheet. 
3. Knot the top and bottom corners together using a square knot. to secure the sheet. 
4. Flip the mattress/sheet combination over. 
5. Tuck in sides. 

Now add the disposable base sheet. 

6. Drape disposable sheet over mattress and linen sheet.
7. Knot the corners on the top of disposable sheet. 
8. Insert head of mattress into the knotted area. 
9. Lift the foot of the mattress and knot disposable sheet. 
10. Tuck into make it look nice. 

Top sheet:

11. Fold disposable sheet width wise until it's small enough to fit under the foot of the gurney for storage until patient is ready to be packaged.


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## JPINFV (Sep 16, 2012)

n7lxi said:


> Are you all familiar with the two blanket rule?
> 
> Every patient gets a blanket. If its chilly enough that I'm wearing a job shirt or long sleeves, every patient gets two blankets.
> 
> ...




Every patient gets covered, but I don't think that everyone needs a blanket when it's 100 degrees outside.


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## DesertMedic66 (Sep 16, 2012)

Get a hospital sheet and place in on the gurney so it lays flat with no wrinkles. Tuck the ends of the sheet under the gurney cushion. Monitor gets belted in at the foot of the gurney. Main bag goes anywhere on the gurney and that's all. 

No need for extra stuff. We don't keep pillows in my unit. Takes about 5 minutes to clean the gurney and make it back up. We normally get another call as soon as we hand over patient care so our hospital turn around time is 9 minutes on average.


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## JPINFV (Sep 16, 2012)

Why doesn't your company provide any pillows?


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## Tigger (Sep 16, 2012)

The bottom sheet covers the entire mattress. No exceptions, none of the half folded sheet down the middle crap.

On top of that, a towel at both the foot and head ends. The head end towel is a useful emergency vomit catcher, the foot one just looks nice. If available, a chuck (non-pink in color) will be placed in the middle and folded under the mattress. On top of that, a folded blanket and a pillow secured with a seatbelt with the straps folded and tucked. All the other strap ends will be folded and tucked as well. The shoulder harness ends get slipped under the waist belt and tightened. 

In the net I try to keep an NRB, NC (there's a D tank on the cot), my sized gloves, an emesis bag, a sheet, and blanket. Some crews keep cravats for improvising restraints, I think that's lame. For a while I kept the transfer sheet under the bottom sheet so it could always be used but was told to stop as it "has to be kept in the truck."

In the winter, company policy dictates the stretcher. Bottom sheet like normal, then the "company blanket" (wool blue plaid blanket with service patch sown on at the top) gets laid unfolded on top of the bottom sheet. Then you put another unfolded blanket on that and then a sheet and then fold into thirds so it looks pretty. Most know it as a burrito wrap apparently. I'm not sure if we will keep doing this, I think there is a serious cross contamination risk with reusing the same top blanket all day and our contracted hospital network also does and was on the way to banning its use.


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## DesertMedic66 (Sep 16, 2012)

JPINFV said:


> Why doesn't your company provide any pillows?



They do. Our unit may go a couple of days before we get cleared to our main station to restock so instead of wasting room with pillows we have other supplies. If you were to take everything out of our ambulance you could almost fully stock 2 ambulances. 

Honestly the only time I've ever seen pillows used in my area are for long distance IFTs.


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## Joe (Sep 16, 2012)

They dont need pillows. Ill put up a video of my making the gurney style in a while


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## truetiger (Sep 16, 2012)

1) Unfold sheet and place on cot
2) Tuck sheet in
3) Place pillow in middle and buckle seat belts


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## fast65 (Sep 16, 2012)

I don't usually make the cot unless I'm on an IFT. We carry disposable "heavy duty" fitted paper sheets for our base sheet. When I make the cot it goes as follows:

1) Decontaminate the cot.
2) Fitted paper sheet.
3) Pillow in the center. 
4) Blanket
5) Sheet
6) Lap belt to secure the pillow, sheet, and blanket.
7) Buckle leg and chest/shoulder straps.


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## Trashtruck (Sep 16, 2012)

I'm speechless.
A touch of OCD around here, perhaps?
Just sayin'...

However, I do like the sheets that are longer(only certain hospitals have them) so you can easily cover feet.


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## usalsfyre (Sep 16, 2012)

After cavi decon, disposable sheet goes on. On arrival at the call, monitor, bag, vent, pumps, sheets, blankets, ect get piled on.

The fun really doesn't start till it's time to get the patient, monitor, vent and two pumps secured to the cot...


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## Tigger (Sep 16, 2012)

Trashtruck said:


> I'm speechless.
> A touch of OCD around here, perhaps?
> Just sayin'...
> 
> However, I do like the sheets that are longer(only certain hospitals have them) so you can easily cover feet.



Just a touch. There's not a lot I can control at work, but the way the cot is made as well as how the truck and bags are stocked is and that is somehow reassuring to me.


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## JPINFV (Sep 16, 2012)

Trashtruck said:


> I'm speechless.
> A touch of OCD around here, perhaps?
> Just sayin'...
> 
> However, I do like the sheets that are longer(only certain hospitals have them) so you can easily cover feet.



It's all about presenting a professional appearance. It doesn't take much energy, or time (especially if the driver is resetting the gurney as the attendant is giving report, finishing up the PCR, and getting signatures) to get the gurney set up in a neat manner.


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## bahnrokt (Sep 16, 2012)

That sounds like a lot of work.

My cot is:
Sheet
PeePee Pad
Sheet

Lay the sheet across cot, add pink pad, lay 2nd sheet across.  Grab ends of sheets and flip over cot and fold back neatly, repeat on other side.  Strap jump bag to foot of cot.
Takes about 30 seconds.


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## the_negro_puppy (Sep 16, 2012)

Sheet on neatly, tucked in, pillow on top secured by harness, leg straps clipped up. extra folded sheet or blanket resting on top depending on weather.

I see a trend that most EMS in the US take their cot/stretcher in straight away with every call?

Unless we are going up a building or into a nursing home we generally take the gear in, work out whats going on, where the patient is. Many of our houses have stairs and steep driveways, so I like the idea of doing a recon before dragging the stretcher in every call.

We tend to stay and play more than you guys- longer scene times, start treatment on scene like IVs, 12 leads etc


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## Epi-do (Sep 16, 2012)

Sheet on the cot, tucked under the mattress.  Then, a towell at the head, also tucked in.  If it is cooler outside, a blanket roll in the center, secured by the strap.  If not, then the extra sheet/blanket is tossed underneath the head of the cot.


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## Trashtruck (Sep 16, 2012)

Hey,
Don't get me wrong...I'm very particular about many things and am self-diagnosed OCD. I, too, organize the $&^% out of supplies and equipment. My little world is a tightly run ship, despite what's unraveling around me.

Yes, the driver makes up the stretcher after the call. I take a sheet and spread it nicely over the mattress to make it as wrinkle-free as possible. I tuck the edges of the sheet under the mattress on all four sides. A sheet goes on the back to cover people. We don't have disposable sheets or chucks or pillows. No equipment on the stretcher.

Like puppy said, we go in first with gear and decide if we need the stretcher.


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## Tigger (Sep 16, 2012)

the_negro_puppy said:


> Sheet on neatly, tucked in, pillow on top secured by harness, leg straps clipped up. extra folded sheet or blanket resting on top depending on weather.
> 
> I see a trend that most EMS in the US take their cot/stretcher in straight away with every call?
> 
> ...



If I am going into a handicap accessible scene (nursing home, storefront, etc), I bring the cot in with all our gear on it simply because I don't like carrying all of it and would rather roll it around.


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## frdude1000 (Sep 17, 2012)

Wipe down cot with sani-wipes after all calls.  If bodily fluid exposure occurs, decontaminate properly.  

Next, I put 1 hospital sheet folded over on cot.  Then I place an extra sheet at the foot of the cot and strap it in. If its a friday or saturday night, I will usually put a towel over the area in which the patient sits for a bit of extra protection.  We carry a blanket when it is cold.


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## medicdan (Sep 17, 2012)

Interesting... I never thought about it, but I am a bit specific about my stretcher setup. 

Flat sheet folded once on the bottom (never a stretch or fitted, they leech more if a spill, and much more difficult to transfer. 
Bath Blanket/fitted sheet at feet (secured with strap) for wrap/burrito
Monitor secured to middle straps

Extra fitted sheet or two on shelf or between mattress and frame (behind head). 

At the first department I worked with, they preset their wrap/burrito by folding into concentric wraps on the stretcher (hard to describe), so once they loaded the patient, they could just pull the sheet around. I have yet to find a partner patient to set it up with me properly...


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## Tigger (Sep 17, 2012)

emt.dan said:


> At the first department I worked with, they preset their wrap/burrito by folding into concentric wraps on the stretcher (hard to describe), so once they loaded the patient, they could just pull the sheet around. I have yet to find a partner patient to set it up with me properly...



That's what the "Company Wrap" is, and it's fairly difficult to put into words. You need fairly large blankets to make it work especially if the patient is of the large persuasion.


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## NomadicMedic (Sep 17, 2012)

JPINFV said:


> Every patient gets covered, but I don't think that everyone needs a blanket when it's 100 degrees outside.



Our local bls crews set the AC on arctic during the summer and either forget to turn the heat on or leave the doors wide open in the winter. It's always cold in the ambulance. 

Our patients, especially trauma Patient's, are arriving at the ED borderline hypothermic. Cover em up... And hey, when you didn't feel well as a kid, didn't a tucked in blanket always help? 

Read Thom ****'s "People Care". It'll change your customer service for the better.


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## leoemt (Sep 17, 2012)

Working IFT we don't store equipment on the cot. The pillow and blanket ride in with us.

Making the cot we use a standard cot sheet (not the fitted ones). Using the two person fold it takes about 2 seconds to make the cot literally. 

Depending on the call will determine if the cot is deconned. Any blood, body fluids or communicable diseases and the cot gets deconned. 

Once a week the cot and ambulance go through a deep clean decon process. 

We have Oxygen mounted to the cot as well. 

When we work standby's (football and MMA fights) the cot is prepped with a backboard, BLS jump kit, and spinal immobilization / fracture kit. 

Every patient gets a pillow and blanket. We actually see the majority of our hypothermia calls when it is hot out.


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## Bullets (Sep 17, 2012)

Summer
Folded sheet tucked around cot

Winter
Folded sheet tucked around cot
Wool Blanket at foot

OR

Hospital Blanket unfolded and laid on cot, Sheet unfolded and laid ontop of Blanket, Fold one side so fold is at edge, the fold back upon itself, repeat for other side. Should have a stack folded like "Z" on each side of cot. The pull "Z" out and place patient on, wrap patient. However the hospital has changed linen supplier and the blankets arent big enough for this anymore


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## VCEMT (Sep 17, 2012)

A cot? Well, it's folded with the straps buckled together and tucked away in its compartment.


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## WolfmanHarris (Sep 17, 2012)

Flat sheet tucked around mattress. Two sheets or sheet and blanket folded at foot of bed. Pillow on (we have custom one that are impermeable with clips to hold it on the bed) with a pillow case. A towel; always know where your towel is at. 

Monitor stays on the pole mount and oxygen bag stays buckled on the bed. Our main symptom relief bag is on the monitor. Back pack with airway bag, IV set, ALS drugs and suction stays in the truck unless needed. 

More and more though we're going in with monitor only, assessing the patient and then deciding what else may be needed.


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## mike1390 (Sep 17, 2012)

VCEMT said:


> A cot? Well, it's folded with the straps buckled together and tucked away in its compartment.



agreed... although we should make a thread about how people make their gurneys... that would be interesting.


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## TechYourself (Sep 17, 2012)

WolfmanHarris?  Now there's a frood who really knows where his towel is.



Couldn't resist.


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## DesertMedic66 (Sep 17, 2012)

Freshly made gurney (sorry for my finger haha). 






Gurney ready for next call.


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## truetiger (Sep 17, 2012)

Do a lot of you take in everything for every call?


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## mike1390 (Sep 17, 2012)

is that M405?


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## DesertMedic66 (Sep 17, 2012)

mike1390 said:


> is that M405?



Noooo.... h34r: (how did you guess that?)

And if we are first on scene everything goes in. If we arrive same time as fire everything goes in. If we arrive after fire we call them over the radio and see if they need anything (most of the time they don't need anything so we just take the gurney).


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## mike1390 (Sep 17, 2012)

Psshh a magician never tells. -_-


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## DesertMedic66 (Sep 17, 2012)

mike1390 said:


> Psshh a magician never tells. -_-



:blink: don't know if I should take cover or not lol.


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## DrParasite (Sep 17, 2012)

the_negro_puppy said:


> I see a trend that most EMS in the US take their cot/stretcher in straight away with every call?


In my experience, suburbanites do this all the time, as well as most volunteers.  It's a bad habit, and many urban personnel have learned a better way.  We bring it with us on calls at apartment buildings with elevators, large commercial occupancies (large stores, malls, etc), or healthcare facilities.  But for a 1 or 2 or 3 family home, or any multi story without an elevator, the cot stays in the truck.  The stairchair comes in, but the cot stays in the locked ambulance (unless the call is for an unconcious, than the cot stays at the front door, and the reeves get brought in, and we hope/pray no one steals/moves the cot).

My cot is pretty simple.  flat sheet over the mattress, with the ends all tucked in under the mattress.  1 blanket gets buckled at the bottom, 1 sheet gets bucketed at the middle, 1 pillow (if we have one) gets buckled at the top.  typically a spare blanket and sheet is kept on the back of the cot.

during the colder times, a second blanket is applied, in a manor very similar to what is described here: http://chovesh.blogspot.com/2012/01/cocoon.html

I can't believe this thread has gone 4 pages....


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## JPINFV (Sep 17, 2012)

DrParasite said:


> In my experience, suburbanites do this all the time, as well as most volunteers.  It's a bad habit, and many urban personnel have learned a better way.
> 
> ...
> 
> I can't believe this thread has gone 4 pages....









Like OMG, how dare someone else has a different opinion than mine and try to share it. Like, my opinion is, like, the only one that counts and everyone else is totally wrong.


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## DrParasite (Sep 17, 2012)

JPINFV said:


> Like OMG, how dare someone else has a different opinion than mine and try to share it. Like, my opinion is, like, the only one that counts and everyone else is totally wrong.


wow, are you really a 12 year old girl?  because that would explain sooo much

oh wait, let me ask this: have you ever had a stretcher stolen?  ever had it roll down the street? or equipment stolen from your truck?  I have.  how about had the entire truck stolen while you were inside on a job? that didn't happen to me, but it did happen to a coworker of mine.

Let me ask you think, if you bring the cot to the front door, how are you getting the patient out?  bedrooms are typically upstairs, you going to bring the cot upstairs?  

I can bring a stair chair almost anywhere.  it goes with me.  i can carry a sick patient to the back of the truck if I need to, from almost any location.  i can't always bring the cot to the patient.  

Maybe it's time you learn a better way to do things?  I know I did, and that's why I operate the way I do.


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## JPINFV (Sep 17, 2012)

DrParasite said:


> wow, are you really a 12 year old girl?  because that would explain sooo much



...or it's mockery. 


> oh wait, let me ask this: have you ever had a stretcher stolen?  ever had it roll down the street? or equipment stolen from your truck?  I have.  how about had the entire truck stolen while you were inside on a job? that didn't happen to me, but it did happen to a coworker of mine.



I can say that I've never had a gurney roll down the street or have one stolen. I understand how to put it into a position to prevent the first and I don't work in a ghetto like the second. 


> Let me ask you think, if you bring the cot to the front door, how are you getting the patient out?  bedrooms are typically upstairs, you going to bring the cot upstairs?
> 
> I can bring a stair chair almost anywhere.  it goes with me.  i can carry a sick patient to the back of the truck if I need to, from almost any location.  i can't always bring the cot to the patient.



...because I'm limited to either removing the gurney  or removing the stair chair/scoop? I can't stair chair or scoop the  patient down the stairs to the waiting gurney?



> Maybe it's time you learn a better way to do things?  I know I did, and that's why I operate the way I do.



Hey, I'm not the one going, "OMG, I like so can't believe this conversation has lasted this long because I'm like super awesome and am always right, and everyone else is totally super-duper wrong."

On the other hand, have you looked in a mirror recently?


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## VCEMT (Sep 17, 2012)

firefite said:


> Freshly made gurney (sorry for my finger haha).
> 
> 
> 
> ...



You secure the monitor on the gurney? Why not the jumpseat, like in the flashcards?


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## abckidsmom (Sep 17, 2012)

DrParasite said:


> wow, are you really a 12 year old girl?  because that would explain sooo much
> 
> oh wait, let me ask this: have you ever had a stretcher stolen?  ever had it roll down the street? or equipment stolen from your truck?  I have.  how about had the entire truck stolen while you were inside on a job? that didn't happen to me, but it did happen to a coworker of mine.
> 
> ...



Us rural hicks have grown accustomed to working with two and only two on the scene.  We have learned that to save time and trips across the yard to the truck, we bring the cot, loaded with the bag and oxygen, to the door.  We enter the house ready to do our work, and with the assumption that the people called the ambulance because they do, in fact, want us to drive them somewhere.

I can carry anyone out from anywhere too, and I'm happy to serve people who wouldn't dream of stealing my ambulance, or my cot, or a bandaid from my bag.

I've worked in an urban system too, and I have those skills, but let me tell you that I have seen plenty of excellent urban medics not be able to handle the job out here in the sticks.  There is NO Only Right Way.  Not even a Better Way that applies in all circumstances.

If we made a big todo about checking to make sure that the truck was locked in the yard of a farmhouse a half mile off the road, the people would wonder what was wrong with us.

Don't go judging people who don't do it your way.  There are many ways to acceptably get the job done out there.  Of course there are a few deal breakers, but for the most part you just have to let people be and do stuff their own way.  Ya never know, you might just learn something...I know I did when I stepped down off my high horse.


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## usalsfyre (Sep 17, 2012)

Funny, I've worked suburban, urban, rural, CCT, flight, career, volunteer, fire based, hospital based and private and can honestly say I've always brought the stretcher in...

Guess I need to learn how to do my job better.


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## bigbaldguy (Sep 17, 2012)

We've left our stretcher out front of some sketchy buildings and it's never walked off. I like taking everything in that we might need. We just have those blue plasticized sheets. Then put monitor and bag on top with o2 strapped to bottom. If nothing else by bringing the cot with you to the door or bottom of stairs it saves a few minutes of running back to the truck if you need it.

We also keep a couple of cotton sheets a gown and maybe a towel under the head of stretcher.


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## Aidey (Sep 17, 2012)

We don't always pull the gurney our of the amb, but that is only in special cases. Mostly, if the outside of the house is trashed or there is no easy access to the door we will leave it and ask if there is a different door we can get to, or if the pt is ambulatory. If the weather is really nasty we will leave it some times too. I've never heard of a gurney disappearing from outside a call.


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## DesertMedic66 (Sep 17, 2012)

VCEMT said:


> You secure the monitor on the gurney? Why not the jumpseat, like in the flashcards?



Jumpseat = having to get in the ambulance and move the monitor to the gurney. Also if we have a student then they are in the jump seat. 

Monitor strapped down to the gurney along with all the gear = get on scene, open up the rear doors, pop out the gurney and you are all good to go. 

We like to make patient contact quickly so we can cancel fire.

EDIT: what flash cards?


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## abckidsmom (Sep 17, 2012)

Aidey said:


> We don't always pull the gurney our of the amb, but that is only in special cases. Mostly, if the outside of the house is trashed or there is no easy access to the door we will leave it and ask if there is a different door we can get to, or if the pt is ambulatory. If the weather is really nasty we will leave it some times too. I've never heard of a gurney disappearing from outside a call.



Bad weather is the only time I wait until we have made a transport decision to bring the cot out.  That means actual precipitation, or wind bad enough to mess up the sheets.


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## Tigger (Sep 17, 2012)

DrParasite said:


> In my experience, suburbanites do this all the time, as well as most volunteers.  It's a bad habit, and many urban personnel have learned a better way.  We bring it with us on calls at apartment buildings with elevators, large commercial occupancies (large stores, malls, etc), or healthcare facilities.  But for a 1 or 2 or 3 family home, or any multi story without an elevator, the cot stays in the truck.  The stairchair comes in, but the cot stays in the locked ambulance (unless the call is for an unconcious, than the cot stays at the front door, and the reeves get brought in, and we hope/pray no one steals/moves the cot).



Never had any problem leaving the stretcher outside a walkup. We leave it outside at a transfer height so we can get patient transferred over quickly from the stairchair and loaded into the truck. Funnily enough Boston EMS does the same thing, but they're not urban professionals and full of bad habits so I should probably stop. 

Not to mention that it is quite a chore getting the stairchair out with the stretcher loaded. I also do plenty of dialysis runs into crap neighborhoods, when we do carryups we always leave the stretcher out since we need to make it up anyway and one person needs to stay with patient.



> I can't believe this thread has gone 4 pages....



Why not? This job is full little things that make it easier, this is the kind of thread that gets those ideas some light.


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## Aidey (Sep 17, 2012)

We have some streets where the houses are built into a hill, and have 10-20 steps up to the front door. Often there is back alley access, but usually the alley is accessed off the street 3 blocks away, down one alley, and back up another. Those are the type we leave the gurney on, since we know we will probably be moving the amb once we talk to the family. 

I forgot, we also leave the gurney on cardiac arrests unless they are in a facility. We generally don't transport without ROSC, so most of those calls aren't transports.


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## DrParasite (Sep 17, 2012)

JPINFV said:


> I can say that I've never had a gurney roll down the street or have one stolen. I understand how to put it into a position to prevent the first and I don't work in a ghetto like the second.


I think everyone should work in a ghetto at least once in their career.  it can be an eye opening experience (not good or bad, just eye opening).  But you don't, so you have no idea what I'm talking about.


JPINFV said:


> ...because I'm limited to either removing the gurney  or removing the stair chair/scoop? I can't stair chair or scoop the  patient down the stairs to the waiting gurney?


well, If i'm carrying someone down the stairs, there is no way i am using the scoop.  Reeves, Reeves Sleeve, or back board if I have to, but not the scoop.  You aren't wrong, I just would never do it, because I feel the other ways are much more secure.  But that's just my 0.02





JPINFV said:


> Hey, I'm not the one going, "OMG, I like so can't believe this conversation has lasted this long because I'm like super awesome and am always right, and everyone else is totally super-duper wrong."


that was because there are 4 pages of how you make up a cot, while my question about CHF and intubation only had 8 replies..... nothing to do with right or wrong.


JPINFV said:


> On the other hand, have you looked in a mirror recently?


I have, and a very handsome man looked back at me.



abckidsmom said:


> Us rural hicks have grown accustomed to working with two and only two on the scene.  We have learned that to save time and trips across the yard to the truck, we bring the cot, loaded with the bag and oxygen, to the door.  We enter the house ready to do our work, and with the assumption that the people called the ambulance because they do, in fact, want us to drive them somewhere.


do you have multistory houses?  I haven't worked in the sticks, maybe it's all ranches.  most of suburban area was 2 story hourses.  with the equipment you listed, cot, bag, and oxygen, which is what you bring to the door, how do you get them downstairs, especially without making another trip to the truck?


abckidsmom said:


> I can carry anyone out from anywhere too, and I'm happy to serve people who wouldn't dream of stealing my ambulance, or my cot, or a bandaid from my bag.


yeah, I guess my coverage area's locals aren't as nice as yours.





abckidsmom said:


> If we made a big todo about checking to make sure that the truck was locked in the yard of a farmhouse a half mile off the road, the people would wonder what was wrong with us.


again, your locals are nicer than mine.  There are articles on the web about ambulances being broken into for narcs, as well as equipment being stolen.  A buddy of mine had the truck's GPS stolen from truck while he was on a call.  Different areas I guess.


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## abckidsmom (Sep 17, 2012)

DrParasite said:


> I think everyone should work in a ghetto at least once in their career.  it can be an eye opening experience (not good or bad, just eye opening).  But you don't, so you have no idea what I'm talking about.
> well, If i'm carrying someone down the stairs, there is no way i am using the scoop.  Reeves, Reeves Sleeve, or back board if I have to, but not the scoop.  You aren't wrong, I just would never do it, because I feel the other ways are much more secure.  But that's just my 0.02that was because there are 4 pages of how you make up a cot, while my question about CHF and intubation only had 8 replies..... nothing to do with right or wrong.
> I have, and a very handsome man looked back at me.
> 
> ...



I guess I just figure that if people are going to be dumb enough to steal the ambulance, I'm going to let them.  If they are going to break into the ambulance to steal the narcs, they are usually bright enough to break out a window to get in just as well.

We have 2 story houses, but more often than not they can walk down or they have already come down.  Our biggest stair issues are on the porches.  Sometimes we need to get the stair chair or reeves, sometimes we just physically carry them, two-person style, to the stretcher.  Not having daily experience with the stair chair makes it slower than if we did have that regular practice and muscle memory.

I never had a real problem with people stealing, but then our stuff wasn't really nice anyway, when I worked in the city.  It was extremely functional, the best tool for the job, but it looked like it went on 10,000 calls a year.


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## Aidey (Sep 17, 2012)

I don't know about Dana, but we generally ask them if they are able to walk. Very simple and doesn't require anyone to run and get anything.


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## abckidsmom (Sep 17, 2012)

Aidey said:


> I don't know about Dana, but we generally ask them if they are able to walk. Very simple and doesn't require anyone to run and get anything.



I say "Can I help you walk out to the ambulance?" unless it's very clear that they shouldn't be or can't be walking.


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## DesertMedic66 (Sep 17, 2012)

DrParasite said:


> I think everyone should work in a ghetto at least once in their career.  it can be an eye opening experience (not good or bad, just eye opening).  But you don't, so you have no idea what I'm talking about.
> well, If i'm carrying someone down the stairs, there is no way i am using the scoop.  Reeves, Reeves Sleeve, or back board if I have to, but not the scoop.  You aren't wrong, I just would never do it, because I feel the other ways are much more secure.  But that's just my 0.02that was because there are 4 pages of how you make up a cot, while my question about CHF and intubation only had 8 replies..... nothing to do with right or wrong.
> I have, and a very handsome man looked back at me.
> 
> ...




We have a lot of multistory houses and some of our response areas are the ghettos (there will be drug deals going on across the street literally). Gurney goes to the front door of all houses. If gurney can fit inside the house then it goes in if it can't then it stays outside. Most patients are able to walk down stairs with a little bit of help (ABCs Ambulate Before Carrying) making it a lot easier for us. If not its normally quicker to just carry them down.

I have never seen a crew bring in only the stairchair and leave the gurney in the ambulance.


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## truetiger (Sep 17, 2012)

We usually take the dispatch info into account before we start packing in equipment or the cot. Nursing home call? Yup, cots going in no question. Sick case? Cot is probably staying in until we go in and determine its necessary.


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## Bullets (Sep 17, 2012)

DrParasite said:


> well, If i'm carrying someone down the stairs, there is no way i am using the scoop.  Reeves, Reeves Sleeve, or back board if I have to, but not the scoop.  You aren't wrong, I just would never do it, because I feel the other ways are much more secure.



If you feel the scoop is not as secure as a LBB, you are using the scoop wrong. The scoop curves at the bottom, so the feet can rest on the bar and prevent the patient from sliding down like on a backboard. 

In suburban NJ, i tend to take the cot in to dialysis, SNFs, Apartments with elevators. SRO "hotels" and homes get a stairchair unless its a unconscious, OD, or something similar. Falls and CPRs get a LBB unless our disatchers do a great job and let us know its a leg, hip, or lower body injury, then the scoop

Times are tough, and ive had the wheels stolen off the cot because they had copper in them and we left it at the door. I dont leave the stretcher out anymore. Ive had another end up in a pawn shop, thankfully the patient was able to sit on the bench.

A gurney is the thing i put the patient on at the hospital
A stretcher it the thing in my ambulance
A litter is the thing that has two poles with canvas between and folds
A cot is the thing i sleep on


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## VCEMT (Sep 17, 2012)

firefite said:


> Jumpseat = having to get in the ambulance and move the monitor to the gurney. Also if we have a student then they are in the jump seat.
> 
> Monitor strapped down to the gurney along with all the gear = get on scene, open up the rear doors, pop out the gurney and you are all good to go.
> 
> ...



Yes, that is the standard... I just don't care to secure it.

You work for AMR, no? 

You never look at the safety crap they plaster everywhere?


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## DrParasite (Sep 17, 2012)

Bullets said:


> If you feel the scoop is not as secure as a LBB, you are using the scoop wrong. The scoop curves at the bottom, so the feet can rest on the bar and prevent the patient from sliding down like on a backboard.


I should have been clearer.  The only time I use a LBB to carry is if I am using it for spinal precautions, and then they are very well secured to the board (6 cravats is not uncommon for me to use depending on the distance we are carrying).  Reeves sleeve is even better if the agency has the money for them (only one that I have worked as had them, and they were awesome when needed), but my primary carrying down the stairs device for people who can't sit up is the Reeves.

and yes, if they can walk, and there is no medical reason why they shouldn't, they do.  But in my experience (since it's not universal everywhere, so I won't assume), people who are really sick and need help are unable to ambulate.


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## DesertMedic66 (Sep 17, 2012)

VCEMT said:


> Yes, that is the standard... I just don't care to secure it.
> 
> You work for AMR, no?
> 
> You never look at the safety crap they plaster everywhere?



Nope. I clock in then go to my rig haha


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## Tigger (Sep 17, 2012)

abckidsmom said:


> I say "Can I help you walk out to the ambulance?" unless it's very clear that they shouldn't be or can't be walking.



http://www.telegram.com/apps/pbcs.dll/article?AID=/20090719/NEWS/907190373/

And now we have to carry everyone. Seriously. Company policy is not quite as extreme as to say "no one ambulates in our care ever" but it's close. I don't know the details of the case referenced above, but the state EMS office made a real big stink about it and now if you called us and the stretcher cannot be brought to you, the stairchair will be instead and you will be encouraged to not exert yourself despite having met us at the curb with bags packed.


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## JPINFV (Sep 18, 2012)

That's because Massachusetts hates the ABCs...

Ambulate Before Carry.


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## ecampvet (Dec 29, 2014)

I had no idea there would be FOUR pages of responses to this question.  Some of us need to stop being so neurotic about something so simple.  I Do agree with Ambulate Before Carry.  Benn practicing that acronym for years.  Fat people make my back hurt.  This includes fat EMS personnel.


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## Ewok Jerky (Dec 29, 2014)

ecampvet said:


> I had no idea there would be FOUR pages of responses to this question.  Some of us need to stop being so neurotic.



Oh the irony


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## PotatoMedic (Dec 29, 2014)

I don't know if I have replied to this or not, bust since it is a few years old here is my answer "carefully."


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