# What have you packed or carried which was useless? What d'you leave OUT!



## mycrofft (Aug 4, 2008)

OK, lets' do it backwards:
Bossycow, Traumateam and Ryd have replied elsewhere that the longer you do this the less you really use. (Would you come talk to my nursing supervisor please?).
Mycrofft's List of Krapola to Leave OUT:

2X2's..."burn cream"...S-tube airways...scissors under four inches long and/or costing over twelve dollars...tape under one inch wide...Ace or similar cloth bandages (use ripable self-adherent bandage like MediRip, unless it's is GOING to get wet every time)...Minimag flashlights (you can't change their teeny bulbs in the dark after they burn out; but do have a small intense incandescent light)..."bite sticks" for seizures...combine dressings bigger than 5X9 except to pad splints, and consider forgetting that..any "bulk" supply (get individually wrapped, or pairs like gauze sponges)...chemical hot packs unless you are above the 50th parallel...pre-made ankle, wrist, knee or other braces unless they are for you...big bottles of sterile normal saline (carry ten of the little 3cc inhaler pillows of it, and a fresh unopened bottle of a name brand drinking water without flavoring etc)...v-blade knife (use the serrated shears)...etc etc.
I have used my ring saw once in twenty years, but tetrasnips just won't substitute.

So, what's NOT in YOUR "wallet"? (Any military vets or current members have input?


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## MMiz (Aug 4, 2008)

I used my minimag flashlight all the time!  My list:
1.  Handheld Manual Suction - It sure sucked, and took up valuable space.
2.  Cold packs - They lasted all of 30 seconds.
3.  Tiny Medical Tape - Give me an inch or go home!


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## firecoins (Aug 5, 2008)

I always took patients from scenes but I found that was alot of work.  Now I just leave them there.


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## ILemt (Aug 5, 2008)

the short board 
and any commercial follower (example: KED)
MAST pants
activated charcoal  (so unused, my state doesnt require it anymore)


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## MedicPrincess (Aug 5, 2008)

MMiz said:


> Give me an inch or go home!


 
Oh boy..... 




> I always took patients from scenes but I found that was alot of work. Now I just leave them there.


 
You, sir, are my hero!  LOL!



> and any commercial follower (example: KED)


 
You consider the KED useless????  Whys that?


I too LOVE my Mini-Flash light.

I'd like to do away with Next-Hell.  Some other form of more reliable communication would be fabulous.


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## traumateam1 (Aug 5, 2008)

Tape under 1 inch, chemical hot packs, and small trauma scisssors.. I'm sure theres more, I just can't think of anything else right now.


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## BossyCow (Aug 5, 2008)

With me its a quantity thing. I don't need 13 nasal cannulas in a rig that can only transport 4 pts (if I pack them in like sardines). I don't need 8 acorn nebulizers, 250 2 x 2s, and 27 eye patches.

Ditto on the handheld suction! 

Tape, just the 1" please, smaller than that is useless and if I need anything bigger, I'll use duct tape which in my opinion should be listed as mandatory equipment on all rigs.

I will never let go of my chemical hot packs. I see a lot of hypothermia. But, I prefer the little handwarmer packs to the bigger medical hot packs. They stay warm longer and seem to have a longer shelf life. Nothing worse than having a hypothermic patient watch you thump on some stupid paper bag whose chemicals have turned to concrete.


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## traumateam1 (Aug 5, 2008)

> I'll use duct tape which in my opinion should be listed as mandatory equipment on all rigs.


Can I hear an AMEN?
We stock duct tape and I won't ever let it go.
I was a little confused there for a while, I thought we were just talking about jump kits but if we are talking about rigs then I got some more.
Handheld suctions, over stocking the ambulance with anything - a million 2 x 2 gauze, 17 packages of 1" tape, 50 chest seals, etc etc.
The only time over stocking, in my opinion is good, is if you are working a shift where you know you wont see much of the station due to a high call volume. But if you are working a shift where you have the time to go back and stock up before another call than do so.. don't try and pack everything into the ambo.


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## MedicPrincess (Aug 5, 2008)

> if I need anything bigger, I'll use duct tape which in my opinion should be listed as mandatory equipment on all rigs.





traumateam1 said:


> Can I hear an AMEN?


 
*AMEN!!!!!*

But about the 14 NC... overstock... ect....

I tend to have a little extra stashed is my special hiding spots, simply because getting to our HQ where our main supply room is or getting a supervisor around to us some days is impossible.  There is nothing more nerve racking that getting down to my last bag of NS and only 4 electrodes and getting put on another call when we are in site of our supply room.


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## JJR512 (Aug 5, 2008)

Doing commercial BLS transports, I could pretty much leave the ambulance empty, except for O2.


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## daedalus (Aug 5, 2008)

JJR512 said:


> Doing commercial BLS transports, I could pretty much leave the ambulance empty, except for O2.



I felt like that before too. Just wait until a trached patient stops breathing and you need one of those french suction catheter doo bops. And than getting sprayed in the face with secretions when your patient "coughs" it all out in your face while you are searching for equipment.

Needless to say I would rather her just kept not breathing until I fixed it.

I like to keep a fully stocked rig and bag. I have had some time to calm my newbie whackerish tendencies, but even so I have found so many uses for tapes and finger splints and the whole nine yards.... on things other than patient care.... but hey.


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## reaper (Aug 5, 2008)

daedalus said:


> but even so I have found so many uses for tapes and finger splints and the whole nine yards.... on things other than patient care.... but hey.



You do know that they make ED meds for that problem!:unsure:


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## mycrofft (Aug 6, 2008)

*Dear Lord IN Heavan, Make It STOP!!! (No, no it's fun!)*


Hey, ambulances are just big kits you strap onto your fanny but with doors!

How about....
floppy polyethylene suction collector liners...umbrellas...opened but unused sterile supplies...the trash from the prior run...the FOOD from the prior run...a lone #11 scalpel, not in an OB kit..."build-a-board"...soft cervical collars...crib notes to use in emergencies in case you forget what you're doing... the twenty by seventy-two inch combine dressings they stuck in my trauma bags!

PS: I'm a KED fan also, I need a whole-body one with little wheels for snatch and runs in case of a riot./FONT]


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## ILemt (Aug 8, 2008)

Let me clarify myself..
Im not a fan of the KED for its intended use.
(In fact some Med Directors in this area forbid their use and require the long board no matter what)
But I LOVE using it for something I see quite often: HIP TRAUMA
Everyone knows how painful a hip fx can be. Throw a KED around the hip upside down, cinch the straps TIGHT and bingo, 99 times out of 100 the pain is instantly relieved and granny starts calling me a hero.


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## reaper (Aug 8, 2008)

I think you just don't get to use it much. It is an excellent piece of equipment, for exactly what it was intended for.

Those Md's need some training. You should use a LSB with the KED, unless the pt refuses the LSB.


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## BossyCow (Aug 8, 2008)

ILemt said:


> Let me clarify myself..
> Im not a fan of the KED for its intended use.
> (In fact some Med Directors in this area forbid their use and require the long board no matter what)
> But I LOVE using it for something I see quite often: HIP TRAUMA
> Everyone knows how painful a hip fx can be. Throw a KED around the hip upside down, cinch the straps TIGHT and bingo, 99 times out of 100 the pain is instantly relieved and granny starts calling me a hero.



Have you seen the SAMS splint for this? Much cheaper than a KED, and designed to stabilize a hip fracture. I think there's a thread on it here somewhere.


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## mycrofft (Aug 9, 2008)

*Yes there is a thread now about hips*

.................


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## medicdan (Aug 9, 2008)

UGH, dont get me started. My service has it's annual OEMS inspection coming up very soon, so I have spent the last few days inventorying a LOT of ambulances, and have seen what I consider severe pack-rat-itis. The following are exact counts from various units: 
You DONT NEED 32 boxes of Large gloves, hidden in different places on an ambulance, neither do you need 13 cloth chucks along with 26 blankets and 14 sets of flat sheets. When you have filled the "linen cabinet" and piled 3/4 of the bench with linen and 8 pillows (in varying places), there is something wrong.

There is something wrong when you have 116, yes, that is ONE HUNDRED and sixteen 4x4 packs (2 each) all in the same cabinet. What are you waiting for when there are 33 c-collars in varying sizes? How about 74 NRBs or SIX spare suction canisters (but only one set of spare tuning and one Yankour (sp?))?

I have a picture on my cellphone of three entire shoping cart-fulls of supplies I removed from one truck--- I will try to post it here. 

</rant>


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## Airwaygoddess (Aug 9, 2008)

*WHY????????  I don't get it!*

I have V-vac hand held suction in all of our jump bags, they work well and easy to set up.  Now having every size of ace wraps, ( yes even the 2 inch size = worthless!) at least 5 of each that is as bad as the 1/2 inch tape!  :wacko:  2x2's, burn gel, every type of bandaide, (please do we really need 3 sizes of each, knuckle and fingertip!)   I guess it could always be worse....... ^_^


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## mycrofft (Aug 9, 2008)

*Where I work...*

Metal finger splints.
(Duh-OH!).


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## Ridryder911 (Aug 9, 2008)

ILemt said:


> Let me clarify myself..
> Im not a fan of the KED for its intended use.
> (In fact some Med Directors in this area forbid their use and require the long board no matter what)
> .


??? You do use the LSB in conjunction with the KED ... right? Since the KED is ONLY an extrication device and should never be placed alone for adult treatment. 

R/r 911


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## metivierm (Aug 12, 2008)

I'm with Rid on this one, Keds arent used to immobilize, they are only used to extricate a stable patient onto a bacboard or a vacmat (up here in QC we use those too unfortunately). Even at that, our local protocal says if you have to extricate a patient, you should rapid ex instead of using a ked.


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## mycrofft (Aug 13, 2008)

*Airwaygoddess, about V-VAC..*

I was saddled with twenty of them when the trauma bag system I govern was set up by non EMS folks six years ago. Many of our little nurses could not hold the device properly. Furthermore, recently I discovered that the one way valves had gone bad, so you would have to aspirate, then shoot it to the aside when you relaxed your grip, because it had gone from one-way airflow to two-way. (Test by working an UNUSED one next to your cheek, feel for the air rushing back out).


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## seshan (Aug 13, 2008)

MMiz said:


> I used my minimag flashlight all the time!  My list:
> 1.  Handheld Manual Suction - It sure sucked, and took up valuable space.
> 2.  Cold packs - They lasted all of 30 seconds.
> 3.  Tiny Medical Tape - Give me an inch or go home!



would you carry a portable (rechargable) suction instead of the handheld?


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## MMiz (Aug 13, 2008)

seshan said:


> would you carry a portable (rechargable) suction instead of the handheld?


It really depends on the call.  At the BLS level I can count the number of times I've used the portable suction on one hand.


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## MikeRi24 (Aug 13, 2008)

well, since all of our rigs are the Van type, we can;t really pack-rat too much because theres not  much space to begin with. I do agree with the person that said sometimes actually getting back to home-base to restock is harder than it sounds. Usually, the way we work it is we will stock up the rig at the beginning of our shift with enough stuff to handle whatever we may come across in the next 12 hours. If the crew on the rig before us is nice, they will say "hey I used 4 NRMs, 3 bags of sailene, a few 4x4s, and a backboard, collar, and a set of block. you're M tank is good and you will need a D tank on the stretcher soon though but the spare is good" so basically this avoids us having to go through the WHOLE ambulance. 

In response to the suction thing, we have the re-chargable portable units on the rig. do I use it? well, I used it on a code ONCE and the only reason I think it even made it into the house was because one of the firemen needed something to do lol. could I have lived without it? yeah....

Stuff I have leaned away from carrying on my person:
-seatbelt cutter/o2 wrench combo thing (when i worked at my previous job i used the O2 wrench part quite often, the enw place supplies them on every set of rig keys so i dont need it)
-small EMS field guide (i keep it in the rig...not gonna be on scene long enough to need to look something up)
-Tape hanging of the little straps on the pants pocket

Stuff we have on the rig I don;t think we need:
-tin foil. there is an industrial sized box of tin foil on every rig. please, find me something to do with it other than make funky looking martain helemts to put on my partner while he's asleep.
8 boxes of 4-pack monitor electrodes. this is in addition to the 5 or 6 packs we have in the monitor. 
-the pulse-ox thing thats about the size of a small laptop computer. 
-and finally the most useless thing that we carry on the rig IMO: the Zoll Autopulse


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## marineman (Sep 1, 2008)

MikeRi24 said:


> -and finally the most useless thing that we carry on the rig IMO: the Zoll Autopulse



There are times I agree with you and times I couldn't disagree more. I've been on calls where they went through 3 different batteries trying to get it to work before scrapping it. Those calls I'd say set it up once if it doesn't work get it out of here I know how to do CPR for gods sake. Other times they have it on and running within a minute of pulling on scene and I feel like it's a godsend. 

I've been an EMR for 5 years and never used 75% of the gear in our bag because I either can't find it or don't have a need for it. They make us carry so much just in case gear now that some of the smaller members of the squad can barely carry their bags.


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## ILemt (Sep 1, 2008)

As for tin foil... in most systems its a required part of the OB kit 
(used as a heat wrap for the newborn)


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## mycrofft (Sep 1, 2008)

*Foil is a good heat conductor if in contact with the skin.*

How about a nice warm blanket?


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## mycrofft (Sep 1, 2008)

*Here's one...slim jim or other car entry tool.*

Nothig like carrying burglary tools. Some states require a license to carry them.

(My wife's Windstar was opend by a professional...BP cuff with just the bladder in a nylon cover, two plastic wedges, a wooden yardstick  and the tow operator's hands.


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## MMiz (Sep 1, 2008)

Can't get a slim jim without a license... I've heard.


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## Jon (Sep 2, 2008)

MMiz said:


> Can't get a slim jim without a license... I've heard.


you don't need one here!

I worked security. My job was to break into people's cars... at their request.

Fun skill to have.


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## Airwaygoddess (Sep 3, 2008)

*Where's my car????*

Ah Jon,..... Where are you going with my car!!!!!!!   YikES!


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## BossyCow (Sep 3, 2008)

ILemt said:


> As for tin foil... in most systems its a required part of the OB kit
> (used as a heat wrap for the newborn)



Real tin foil or the emergency blankets? Because you won't be able to pry that emergency blanket from my cold dead fingers because I'm taking it with me when I die! Costs less than a buck, weighs less than an ounce, fits in my SAR pack, glove box, backpack. Is a blanket, tent, signaling device, can be torn up and used to flag a trail. I've used them on pts while waiting for the stokes to be packed in to their location. I've even used it as a triangle bandage for a sling. What else has such versatility at such a low price. That and duct tape and you can McIver anything


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## Jon (Sep 3, 2008)

Actually... I know PA requires either a pack of "sterile aluminum foil" or a emergency blanket baby swaddler.

Jon


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## KillTank (Aug 16, 2009)

ILemt said:


> the short board
> and any commercial follower (example: KED)
> MAST pants
> activated charcoal  (so unused, my state doesnt require it anymore)



We used a short board the other day. It was rather useful for a little girl who dove into a shallow pool and broke her neck and back. her parents transported her to the ER but could not get her to walk out from the suv. we extracted from the vehicle using the short board and I explained to the father of the danger and harm he may have cause by not calling 911 in the first place.


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## mycrofft (Aug 20, 2009)

*WHy are short boards so maligned?*


Item I'm going to stop carrying: spare oxygen "O" ring gasket.
Item I carry but can never find: spare stethoscope ear tip.


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## KillTank (Aug 20, 2009)

mycrofft said:


> Item I'm going to stop carrying: spare oxygen "O" ring gasket.
> Item I carry but can never find: spare stethoscope ear tip.



I'm always in need of those lol


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## ki4mus (Aug 22, 2009)

pedi-nasal cannulas, they are pointles....they rip them off....all you end up doing is blow-by


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## skivail (Oct 1, 2009)

*Ear Tip*

I agree on the spare ear tip. I can't count the number of times I have poked my brain because of a missing ear tip.


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## mycrofft (Oct 1, 2009)

*Spare bulb for a minimag flashlight*

As I've noted elsewhere:
1. Lights are out.
2. Turn on Minimag unless it is stolen.
3. Fails to work.
4. In the dark, fumble batteries out and change them.
5. Still no light.
6. Still in the dark, unscrew end of battery compartment, keep batteries in light, use fingernails (have some?) to extract end spring.
7.Switching to second set of tinier fingernails, extract tiny finned plastic spare bulb holder from endcap withot losing the spring, the cap or the bulb.
8. Without dropping or damaging the two little wires on the new bulb, and without losing anything else (see above) unscrew other end of light, then extract presumably used up bulb.
9. Find new bulb, insert two 2 mm wires into their tiny little socket holes without getting "dirt or oils from skin" on it and without bending or breaking the wires, dropping the rest of the assembly, etc.
10. Reassemble light head and butt end, and try it.


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## dewd09 (Oct 1, 2009)

I see the aluminum foil as more of a hazard, if using around infants. - Plus for the price of a roll of foil, you can buy ten Mylar blankets. My earliest memory, of school, is cutting my index finger on the foil wrapped over my cup of grape juice. Gam makes a swaddler w/ an adhesive strip for putting around infants. We have our own packs made up for OB kits. Including the clamp device with the handles, clamp then cut type deal; swaddler, infant cap, wrist bands, etc.. Used one last year, my first delivery. Woot blue stork. It was then, I discovered that what's in the OB kit, isn't good enough. Throw out the scalpels, get some $2 OB scissors. Keep the preemie and newborn OPA's and BVM masks near the kit.

I find air splints to be undependable. I'm not a big fan of the SAM Splint either. I'm more of a corrugated plastic splint guy.


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## Fox800 (Oct 14, 2009)

Tegaderms. We never use them. I use Venigards every time.

Hospital IV hubs (not loops, just the hubs). No one here uses them. It's a line 95% of the time, or a saline lock loop the other 5%.

Regular nasal cannulas. We use the Oridion nasal cannulas with capnography capabilities...yet we still carry the regular nasal cannulas. No one uses these, either.

We stock 21ga AND 22ga needles. Do we really need both? This is in addition to 19ga needles and twin-packs.

Things I WISH we had:
Transport ventilators
Quick-Trach
Real IV pumps (though realistically we hardly ever hang drips and we have 30+ trucks)
Adjustable CPAP...right now our CPAP only has 2 settings...5cm and 10cm. I want the one where I can dial it in exactly where I want it, from 0-20cm.


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## mycrofft (Oct 14, 2009)

*Santa is listening...*

Gotcha!


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## Fox800 (Oct 14, 2009)

We have short backboards on the truck. I suppose you could rig it up with webbing/cravats/tape to make a shady looking KED. We never use it, ever. I saw one service (Washington County, Texas EMS) that kept them behind the head of the stretcher...if a patient arrested, they would just slide it behind the pt.'s torso for chest compressions. Not a bad idea.


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## mycrofft (Oct 15, 2009)

*Shortboards used to be de rigeur*

KED much better but anyone with access to an auto junkyard, some 3/4 ply and basic tools can make short boards.


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## mycrofft (Oct 15, 2009)

*Oh, I know.*

Scanners.


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## Coretana (Oct 17, 2009)

firecoins said:


> i always took patients from scenes but i found that was alot of work.  Now i just leave them there.




rofl <3


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## Jeremy89 (Oct 27, 2009)

Fox800 said:


> Hospital IV hubs (not loops, just the hubs). No one here uses them. It's a line 95% of the time, or a saline lock loop the other 5%.......



My RN's appreciate it when there is a saline lock though.... Then they don't have to spend an extra 5 mins switching it over to a saline lock, allowing them to finish their online shopping...


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## mycrofft (Nov 21, 2009)

*I don't carry roller gauze/Kling whatever you call it.*

Medirip I(lioke Coban but better and cheaper) is infintely more versatile as long as it isn't wet.


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## mycrofft (Nov 21, 2009)

*I don't carry roller gauze/Kling whatever you call it.*

Medirip (like Coban but better and cheaper) is infintely more versatile as long as it isn't wet.


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## Cake (Jul 5, 2010)

mycrofft said:


> Medirip (like Coban but better and cheaper) is infintely more versatile as long as it isn't wet.




how do you substitute that for kling when it only comes as wide as 1.5"?  do you just use more?


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## mycrofft (Jul 5, 2010)

*MediRip comes in up to 6 inches width*

https://www.medco-school.com/Supply/Product.asp?Leaf_Id=27506M
I like carrying three inch and one inch. Yes, use more wraps but it fits in a shorter space like my kit bag. The 1 inch is good for digits, making carpal tunnel grips on pens, nonskid feet on little fans, bundling computer cables...


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