# About to start a job at an industrial facility



## Cap'nPanic (Aug 11, 2005)

Ok I know this sounds like a whacker-type post, BUT I am about to start a job as BLS provider at an industrial facility. I am there to render basic medical care to anyone who gets hurt. Injuries that are common range from minor cuts to serious back injuries that require sugery. I have worked at this company previously as a production specialist and I have only seen one medical case occur on site. (it was cardiac), the rest were truamas.

So with that said what should I have in my jump kit as there are many buildings on this complex and I may have to go from one building to another to reach my pt.

Obvious things that go in are:
BP cuff
Stethoscope
trauma shears
trauma dressings of various sizes
tape
BVM w/ a reservoir
triangular bandage
pocket face mask
non-latex gloves.

anything I might need to add or take out?

Thanks,
Cap'nPanic


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## TTLWHKR (Aug 11, 2005)

Is the facility paying for the kit? I'd say if your working for them, they should be.  

In that case... 
	

	
	
		
		

		
			





Go all out man!

You're gonna need a Junkin Catalog, a V.E. Ralph Catalog, a Cushman Catalog, and the company credit card.

You need one, NO! Two... Cushman Ambulance Carts w/ a stryker power pro cot.

At least eight "E" Cylinders, ten "Jumbo D" cylinders, an MCI multilator, case of NRB's-forget the nasal cannulas-use masks.

Four HUGE jump kits, one folding stretcher for every 1 hundred employees, Triage kits, one Triage tag for every employee, and fifty extra just in case.

Tyvek suits, respirators, nomex suits, hard hats, goggles, etc.

Two stokes baskets

I'll think of more later.


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## SafetyPro2 (Aug 11, 2005)

I'd have to agree that if you're doing this in an official job capacity, the company should pay for the necessary supplies. FYI, my first exposure to EMS was in an industrial setting ...they had me set-up a Medical Emergency Response Team following the closure of the Medical Department. I was lucky in that I was able to "raid" the Medical Department's supplies in setting up jump kits for the team, so I didn't have to buy much. I don't think I'd go quite as overboard as TTLWHKR , but I'd recommend the following additions to your list:

a pair of safety glasses
splints (for a jump bag, probably the SAM Splint variety)
instant ice packs
saline
oral glucose (if its in your scope of practice...we used to get lots of diabetic emergencies at the job I mentioned)
a set of airways (OP at least, NP too if you can)

An O2 kit would be good too. They make some trauma bags that can incorporate a D cylinder...I've seen a couple that are backpacks for wilderness rescue that would probably work really well in an industrial setting.

Also, if you can talk your company into implementing a workplace AED program, that would be great. I've helped set up two such programs (the job I mentioned above and a subsequent one). Given your facility's past history of a cardiac emergency, it may be easier to convince the higher ups of the need than at facilties that haven't had one.


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## ipscscott (Aug 11, 2005)

Here's a few off the top of my head:
*Oropharyngeal & Nasopharyngeal Airways (Maybe even a Combi-Tube - you never know).
*Hand-operated suction device. Hard to maintain an airway when it's full of blood or vomit.
*Hand Sanitizer: get one of the alcohol-based gel types. They're great for use after an incident. Also just handy in general. 
*Eye Wash / (sterile saline). Available in a prepackaged form, useful for irrigating eyes, cooling burns, flushing minor wounds, etc.  (Might have these onsite already?)
*Dixie cups: not only for water, but can be used to stabilize objects impaled in the eye.
*Bio-occlusive dressing (vaseline gauze or foil). 
*Oral Glucose
*Cold Packs
*Space blanket
*Band-Aids


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## rescuecpt (Aug 11, 2005)

> _Originally posted by Cap'nPanic_@Aug 11 2005, 10:01 AM
> * Injuries that are common range from minor cuts to serious back injuries that require sugery. *


 Cool!  Do YOU get to do the surgery???  Hehehe...


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## TTLWHKR (Aug 11, 2005)

> _Originally posted by ipscscott_@Aug 11 2005, 11:48 AM
> *
> *Bio-occlusive dressing (vaseline gauze or foil).
> *


 No way... Case of Asherman Chest Seals. of course, I've only had one work right, most GSW's to the chest aren't 1/4" or less in diameter.


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## SafetyPro2 (Aug 12, 2005)

> _Originally posted by TTLWHKR+Aug 11 2005, 08:44 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>*QUOTE* (TTLWHKR @ Aug 11 2005, 08:44 PM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-ipscscott_@Aug 11 2005, 11:48 AM
> *
> *Bio-occlusive dressing (vaseline gauze or foil).
> *


No way... Case of Asherman Chest Seals. of course, I've only had one work right, most GSW's to the chest aren't 1/4" or less in diameter. [/b][/quote]
 If he has to worry about gunshot wounds in the factory, I think its time to find a new job.


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## Cap'nPanic (Aug 12, 2005)

Ok here is my revised list taking in from everyone's suggestions.

OPA/NPAs - combitube is out of my scope of practice but wish I had it, for just in case.   

BP Cuff

Stethoscope

truama shears

truama dressings

tape

BVM w/ reservoir

triangular bandage

SAM splints

Ice packs

saline

oral glucose

Hand - operated suction device

eye wash  - Im sure the Company carries these as they have an eye wash station every 1,000 or so feet, haha. Most cant leave the production line w/o supervisors permission which renders this useless.

Dixie cups for impaled objects (thanks for the tip)

Bio-occlusive dressings

space blanket.

Ok heres the specifics on this industry, they are a poultry production company which means there are various chemicals such as chlorine, ammonia, and CO2 (dry ice).  The temps in the production building ranges from -20 below to about 42 degrees. And yes there is ice on the floor in certain places, my butt has met the floor numerous times as I was unaware of it until after the fact, so as the "safety officer" I'll have to be much more keen on this. Sadly you must wear these flimsy "over-booties" that have little to no traction what so ever, for decon purposes.

On the flipside in the eviseration portion of the facility temps range from 50 degrees in the winter to well over 100 in the summer.

And 85% of the workers there weild knives to cut the chicken in to specified peices, as welll many machines that have sharp blades. I do know of TWO potential hazards we're a degloving of the arm could occur, where a production worker places breast meat into a skinner machine with their hands just mere inches away from the blade. There is a gaurd but offers little protection.

So potential injuries:
stab wounds
lacerations
amputations
deglovings
back injuries from falling
back injuries from heavy lifting.
hand injuries due to repetive motions
MVA vs. pedestrian with pallet jacks (I saw this occur once)

And of course with many workers aging and overweight I can forsee a few cardiacs and diabetic emergencies.

-Cap'nPanic


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## Chimpie (Aug 12, 2005)

A couple of questions I have are:

How many employees work there?
Are there any other employees there with medical training? (EMT, First Aid, CPR)


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## Cap'nPanic (Aug 12, 2005)

There is roughly 1,000 people on site at the peak of the shift. Night shift for production works from 10p - 7:45a Dayshift Eviseration comes in approx 5a-until done. As D/S production comes in, 80% of the company employees are in one building.

They have a hazmat team, but as far as medical personnel, there is one EMT per shift on site, which leaves me solely responsible for all these people until the D/S EMT comes in to relieve me of my duties.

I understand that this is alot of weight and responsibility for a greenie, but I am willing to take it. It wont be easy, but then again the "E" in EMS does not stand for easy either.

-Cap'nPanic

-The one, the only, the beautiful  B)


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## Jon (Aug 12, 2005)

> _Originally posted by TTLWHKR+Aug 11 2005, 11:44 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>*QUOTE* (TTLWHKR @ Aug 11 2005, 11:44 PM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-ipscscott_@Aug 11 2005, 11:48 AM
> *
> *Bio-occlusive dressing (vaseline gauze or foil).
> *


No way... Case of Asherman Chest Seals. of course, I've only had one work right, most GSW's to the chest aren't 1/4" or less in diameter. [/b][/quote]
 good point.... I'd had the same thought... thats why I keep my (1) next to the vasalene gauze (4)...

Jon


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## Jon (Aug 13, 2005)

> _Originally posted by Cap'nPanic_@Aug 12 2005, 09:01 PM
> * There is roughly 1,000 people on site at the peak of the shift. Night shift for production works from 10p - 7:45a Dayshift Eviseration comes in approx 5a-until done. As D/S production comes in, 80% of the company employees are in one building.
> 
> They have a hazmat team, but as far as medical personnel, there is one EMT per shift on site, which leaves me solely responsible for all these people until the D/S EMT comes in to relieve me of my duties.
> ...


 So.. does the dayshift guy have his own bag - or is it a company bag...

I wish I could start from scratch with the stuff at my job... too much crap in too many bags... I don't need 20 triangular bandages... or 5 bottles of sterile H20... or 4 Sam splints...


What are your other job responsibilities? at my Co... I'm a security officer unitl they call a medical... then I go play.....

Where would the bag be - do you drive a cart / car... have a centeralzed location where someone could bring the bag to you??? (say... security)

If you are going to be playing "safety" officer as well... that is a LOAD of training in all the OSHA BS I believe (correct me if I'm wrong, SafetyPro).

Other question... in the event of a medical emergency (where I work calls all EMS calls "medicals" KISS rule, I think  ) who will call 911... will 911 get called with every incident??? at my job... If it isn't Respirtory (SOB) / Cardiac (Chest pain) / code / severe trauma.... the EMT goes and sees what is going on... I see lots of sprained ankles.... icepack and sign my refusal please..

Who will bring the ambulance crew to you.... this needs to be thought of ahead of time.

Also.... PAPERWORK..... since we are an "unnoficial" program (not state certed) we don't have the same reporting requirements.... see what your Co's HR wants.... My site has a policy that after a call... a middle manager in HR is notified with all the info....


As for your gear

an AED would be nice... Nicer if they wall mounted them in every building, but even if you had one to share with day shift....

Forget about the combitube.... they are overrated... just know how to bag right (I'm pretty sure you were joking earlier... but that's there in case you weren't)

OPA's and NPA's - important

Adjustable C-Collar in the bag..... even without a backboard this gives you SOME control of the neck.. espicially since it will likely be an untrained co-worker holding C-spine. 

4x4's, trauma dressings, burn sheets

Backboard (and board splints)... if you have a place where they can be left and brought to you if needed)

O2...... very important if you will be playing for a while before EMS arrives.

Glucometer.... even if it isn't in your scope of practice... most diabetics know how to use one and can test themselves if they need to.

On top of everything else... see if you can talk your boss into getting you a nice jacket.... you are in VERY COLD for lots of the buildings.... like A nice Crosstech jacket that meets the NFPA 1999 EMS apperal standards.... with reflexite and "Safety" on the back 

Finally.... no bag is really waterproof..... package everything in ziploc baggies.... that way the 4x4's are always dry, and if a vasoline gauze pad leaks... it is contained... you don't have "goo" suprising you every time you dig through the bad..... I keep my alcohol preps in a little bag.... my glucose in a little bag, bandaids in a little bag (also...the box dosen't open and you have 100 band aids in the bottom of the bag)....

Jon


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## Cap'nPanic (Aug 13, 2005)

Interesting questions to think about Jon, thanks for asking so I start thinking ahead and being prepared like good little scout.

Some of these answers are going to blow you away so strap yourself in-

For one the D/S EMT is a she that somehow passed her NRs and state certifications, and she does not carry a jump kit. From what I have heard if there is a very serious truama or cardiac she freezes up and they end up calling for EMS (thank god they are less than a mile down the road) Ive also been told she is the former safety secretary that did mostly paperork and screwed with the safety manager (and still do) until the company decided to close the safety office and made her go through EMTB training which she barely qualified for.

The job is rendering BLS support while also doing clerical duties such as speaking with insurance reps, union reps, and following up with any injuries and medical care, writing safety reports, OSHA training (woohoo), safety inspections, etc. Basically one person is doing about 5 or 6 man job. Stressful but then again stress is my hobby.

They do not have company quick response vehicle, as spansive as the complex is I hope they do decide to invest in one, otherwise I have either sprint to my pt, or drive my own vehicle. A off-road mule would suit this purpose perfectly.

And yes I will be playing safety officer as well, I am in charge of all N/S safety aspects.

As for who is responsible for calling 911, I will likely have to get a company issued cell-phone for this purpose, if I find my pt in definite need of transport to the ER to get checked out this will help. As also if I am outside of my office and there is an emergency a supervisor can call me directly to the cell phone and thus I am "paged" out. I do not and I cannot sit in one spot all day and wait for someone to get hurt.

Yes, the Co has their own reporting reqs. We are required to write out an incident report sheet, put the information in a computer database and I must also send a copy of the report to HR as well as the shift supervisor.

As far as I know they do NOT have an AED on site. Once I find out for sure I will gather up some information and take it to management and push for an AED program. Once I am able to get it approved I plan on asking for a grant to purchase one, two if possible. AEDs are not cheap if given good reason to have one most federal or state agencies will grant the funds to purchase one. As you said having one mounted on every wall every 500 ft would be better, but as of right now Im not sure that is possible.

Yes I was joking about the combitube.

As I stated in my revised jump kit gear I included a complete set of both OPAs/NPAs. I once worked with a woman at this site that claimed to be 21 but did not look a day over 12, she was also hispanic, do your own homework.  

As for the C-collar and spine board the company has never had either one, and if they do it is probably actively collecting dust in a closet somewhere. I will check into this, but c-collars are a must at any facility of this type, due to the dangerous environment. I have seen a 240 lb man slip on some ice landed flat on his back on the concrete floor ended up cracking c4-c6 as well as bruising L2-3. Even though he got up and walked to the first aid station, painfully I might add, he was out for 6 weeks total, due to the required operation to repair the damage.

As far as untrained workers holding c-spine, I plan on pushing for ALL supervisors and line foremen to take and complete a CPR class and maintain CPR, it is hard working a code by yourself and even harder trying to explain the process in an emergency. I also want to push for the supervisors to complete a 1st Responder course, since it is most likely that a supervisor will be first on-scene. This can be done within a 4 week period given that everyone is compliant. Of course this all may fall on deaf ears as well. I will have to wait and see.

As for spine board when I am paged out to a call by supervisor I will first ask them the MOI and for pts cheif complaint. If they have fallen hard or from a great distance or of they complain of back pain I am taking the board. You cant and dont take chances with spinal injuries. If the person is standing and says they fell from a great distance or if they fell hard, and is complaining of back pain I will do a standing takedown. If they are standing and not complaining of pain anywhere, I will ask them to sign my refusal and follow me to the office to complete an incident report.

Now here is the part that will blow you away, they do have o2 but *gasp!* it is for the hazmat team only. Of course the D/S supervisor's BP bottomed out shortly after giving blood last spring, she was allowed to use the hazmat scuba mask and tank for o2 therapy, lol. Dumb but go figure. I plan on getting the existing policy changed and have the proper oxygen delivery systems available for o2 hook-up. (N/Cs, NRBs, etc.)

I believe the Co issues Co jackets, but mine needs to stand out, not just for whacker purposes but so that EMS personnel that arrive on scene can easily see me and that I am currently treating my pt. They dont have to "hunt" for me.
I would like to have a blue one w/ reflective stripping that has my name and level of certification on it. (They refer the D/S EMT as the nurse, my personal opinion is to NOT call her that as she has not earned that title, and niether have I, people need to know the level of care they are getting so they dont expect us to whip out a Macintosh blade and intubate on scene or to perform a crico)

Given that the inside conditions of the main building is either freezing and wet or hot and wet, I am sure I will have to buy stock in the Ziploc company.

Thanks for asking these questions Jon as you have further prepared me. I hope this gave a few clearer answers, and if anyone has any further questions, feel free to ask. 

Cap'nPanic

The one, the only, the chicken EMT  :blink:


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## Jon (Aug 13, 2005)

is there any site security?

if there is... perhaps they have other suggestions on equip. locations.

Cell phone or radio is really important.... at least a text pager if there was someone to dispatch you.

At my site.... I have a medical response form I fill out.... basic info - name, social, workstation /bldg, supervisor name and phone, CC, MOI/NOI, PMH, Meds, Allergies, space for Vitals x3 or x4... PE. and brief narrative... it is a 2 part NCR form.... copy to the BLS squad that responds with basic info and pass off info... and the original to the Health/Safety supervisor.

Also, on the form is a spot for a refusal signature with a quick "hold harmless" paragraph.... we don't really use that b/c PA changed refusal requirements and they have us using a copy of the states' "example" form.

After the call, I finish the medical response form and do an incident report on our computer-based software.


the big issue with a backboard is that if you use it, you might never see it again. suggestion here is that, with your boss's permission, you look into at least an unnofficial agreement... better would be a full "memorandaum of understading" signed by the rescue squad chief and your Health & Safety Co-ordinator. Have one of THE SQUAD's backboards onsite.... and the re-supply you with disposibles (o2 masks, 4x4s, tape, within reason.... they bill for it, you don't.... and they are benifiting by not using their supplys... now they "used" their supplies and can bill for them, and you aren't out of 4x4's and backboards....

As for the backboard... I'd try to leave it "wall mounted" and ready (straps and CID's with it) somewhere centrally located... you can send a runner to get the board after you've gotten there and evaluated the situation.... if it warrents a board.. apply a c-collar and have a bystander / first responder hold C-spine while someone gets the board.

As for first responders... my site uses them.. the health and safety person co-ordinates them, and they have CPR and first aid... I think 2 year certs on both.... 5+ responders in most of our buildings.... The same person coordinates all of this as the 1 contact point. Also, we have the building evacuation teams (help manage large office floor evacuations after  little training - they co-ordinate disabled evacuation, etc).

getting an instructor to come and teach the basic Heartsaver Adult + AED + first Aid is a very good idea... call them all first responders... give them a hat or pin... or a patch for the jacket, or something.... the course is a "8 hour" course, which means that it can be done in a short day - if everything goes right and everyone wants to get out early...

Jon


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## TTLWHKR (Aug 13, 2005)

You don't want to go overboard, so you wouldn't carry 20 cravats...but you'd carry an AED..?


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## Jon (Aug 13, 2005)

what I'm saying is that a small o2 kit (w/ BVM) and a small, but well stocked jump bag is all that is needed. an AED is a VERY good idea... I wouldn't carry a LP12, but a LP 500 is fine....

My Co. has a d cylander O2 clamshell and a "O2 + Trauma" bag... without the O2.... I don't need a case of cravats or 4x4's... that is what a supply closet is for.... PA says you need 12 on an ambulance... I've never used more than 8.. and that involved a viscious psycho diabetic  :huh:   


Jon


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## Chimpie (Aug 13, 2005)

Not sure about PA, or where ever this guy is, but you need a doc's signature before he can start administiring O2.


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## Jon (Aug 13, 2005)

In PA..... I've never heard that... I belive it is covered under the state BLS protocols.... you don't need command to be a BLS service.. I assume O2 in PA is covered under the state protocols signed by the the state Medical Director....

Jon


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## Cap'nPanic (Aug 14, 2005)

> _Originally posted by MedicStudentJon_@Aug 13 2005, 01:20 PM
> * is there any site security?
> 
> if there is... perhaps they have other suggestions on equip. locations.
> ...


 Good thinking Jon, but as far as the relationship between the EMS and the company is less than pleasant due to the D/S EMT. They just simply dont want to have to deal with her. Hopefully with time I can somehow establish a working relationship between the Co and the EMS to where we could share supplies as they would bill for it, not the Co. Saves Co money and the EMS makes an extra buck or two, and Im not out on supplies (unless well someone doesnt re-stock it and take inventory as needed.)

We really dont have a "dispatcher", which is why I am leaning towards a cell phone or radio that leaves me in direct contact with all the supervisors no matter where I am at on the complex. This will cut down on response time so that no one has to go look for me for medical attention. Often the D/S EMT does not carry a cell phone OR a radio whic means they have to go to the office, and hope she is there, if not then they are SOL until she returns. And get this even though she gets a hour long lunch break, she leaves the complex to go to town and pick up food.

Personally, if you are the only EMT there then you do not leave under any circumstances, which means if you want lunch, you bring it with you when you come to work or you can buy something out of the vending machine, but thats just me.

The only problem I see in a 8 hr FR course is this, it could bring the company under liability if someone were to sue a supervisor that was not officially trained and qualified to serve the FR capacity, which means we are better off having the supervisors go through the 4 week NR 1st Responder course and get their state certifications. If they have a FR patch on their jacket they had better have a card in their pocket to back it up. I think we can do this 2x week at 3-4 hrs at a time. Let the company pay for the training.

As I have always been told, always follow your local protocols. Yours may differ from mine as mine may differ from yours.

We have security on site but they are untrained in medical responses. they only serve as security in the gaurd shack, checking IDs at the gate, etc, etc. It would be nice if these people were also trained FRs or EMTBs, but they are hired from an outside security company which means my Co cannot say what training they must have.

Also can you give me an example of the medical form you fill out. Our Co has an incident form that the they must fill out stating CC, MOI, date, name, etc. This is not accurate as most people arent going be completely honest and try to find ways to get out of working and still get paid. Other workers have limited English capabilities thus inaccuarate report. I would feel much better taking my own assessment rather than let the worker state what is wrong. I think this will curb false complaints and would drop the insurance rates.

Thanks for all of your help the past few days in getting me prepared for this job. Im sure there will be many more questions in the future inregards to industrial EMS.

-Cap'nPanic

-The one, the only, the greenhorn.


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## Chimpie (Aug 14, 2005)

Well Cap'n, as you can see you've really hit a topic that myself, SafetyPro and MSJon know a lot about.  Since you didn't reply to my email I'll try to help here.

Jon has brought up some really great points.  I've printed off this entire thread (so far 18 pages) and did a quick read-through so if I ask a question that's already been answered please forgive me.

How do the managment on site (Team Leaders, Group Leaders, Production Manager, whatever you have) communicate with each other?  If it's by radio, then by all means you should have one as well.  
What about the security at your facility.  If there is more than one, how do they talk to each other?

If an ambulance arrives on site, who escorts them in?  
How do they know where to go?  
How often does your facility have an ambulance respond to emergencies?

In my eyes, since you have somewhat of an Emergency Response Team (ERT) starting here, I'd offer this about buying equipment:

*Have enough supplies on-scene to take care of a five victim emergency. * Does that mean you need to bring all of this equipment yourself?  Absolutely not.  If you are the only one truly responding then maybe a jump bag to take care of a three victim emerg. and maybe some portable first aid kits/jump bags stationed around the plant.  That way you can respond and a supervisor or runner can go grab the others.  If you have others responding as well (ex: at Toyota we had 10 ERT members that could respond at anytime, each with their own jump bag) then they could each bring a kit/bag.

*AED* TTLWHKR: And AED, spare battery, two sets of pads, razor, small cloth, all in a nice case can be purchased for around $2,000.  I see no reason why this plant doesn't have one, if not three.  Yes three.  Remember, every minute a man is down without an AED their chance of survival goes down 10%. The Cap'n could have a one, security could have one, and one could be kept in a central spot (managers' office, receptionist desk, etc.)

Cap'n, whether your plant has 200 people on site at one time, 500, or 1000, there is no reason why you shouldn't have an AED.  And at bare minimum, all supervisors (as they are the most mobile (not part of the production staff)) should have Adult CPR/AED and First Aid.  With the American Red Cross, an Adult CPR/AED class can be done in five hours, First Aid in about four.  Mixing the two together can be done in about 8.  Split that up into a two day course, four hours each day, there's no reason it can't be done.

I deal with these issues on a daily basis so any help that I can offer please let me know.

Chimp


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## TTLWHKR (Aug 14, 2005)

> _Originally posted by MedicStudentJon_@Aug 13 2005, 07:27 PM
> * In PA..... I've never heard that... I belive it is covered under the state BLS protocols.... you don't need command to be a BLS service.. I assume O2 in PA is covered under the state protocols signed by the the state Medical Director....
> 
> Jon *


Actually you do need your own medical director in order to operate a BLS Service or a QRS Services. In some regions, the regional medical director will sign off on QRS services, but BLS does need a medical director in order to operate. BLS services need several things that require you to have your own director in order to purchase. 

You need one in order to be stocked with and use the MAST suit, an AED, purchase a contract for oxygen supply, purchase EPI, purchase irrigation fluids (at least in 90% of the current catalogs). My company uses only Moore and BoundTree. Moore requires us to go to our MD and get sigs every six months on a list of items we purchase every month. Also you need an MD signature seven times in the state Ambulance Licensure packet to approve your 2nd due coverage areas, your mutual aid, your AED, your crew, your crews approval to use the AED, The EPI, and a paper citing his credentials.


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## Chimpie (Aug 14, 2005)

> _Originally posted by TTLWHKR_@Aug 14 2005, 02:19 PM
> * You need one in order to be stock and use (snip) an AED *


 Alex are you sure that's still the case today?  Cause I thought that requirement was removed over the last year or so.

 :unsure:


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## TTLWHKR (Aug 14, 2005)

> _Originally posted by Chimpie+Aug 14 2005, 01:23 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>*QUOTE* (Chimpie @ Aug 14 2005, 01:23 PM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-TTLWHKR_@Aug 14 2005, 02:19 PM
> * You need one in order to be stock and use (snip) an AED *


Alex are you sure that's still the case today?  Cause I thought that requirement was removed over the last year or so.

 :unsure: [/b][/quote]
 This is PA... You're in FL. It matters here.

You, personally, can buy what ever you want. But if you put it on an Ambulance, you need a medical director. Every individual on an ambulance, the EMT, anyone who will be using that AED, must have their own form, signed by the medical director that they are trained to use it. That's how it works in PA. I have the forms here still, from when I was an EMS Chief for the VOL. squad. I get them every 3 years when local ambulance licensure is due, just got them this past spring. Can't use an AED on an ambulance unless you have a medical director. Can't use the MAST w/ out a medical director, can't use EPI w/out a medical director, can't buy oxygen tanks or resuscitators from our supplier w/out a medical director. It all works out fine.

By the way, what you snipped was.. Can't stock or use the MAST w/ out a medical director. You don't need one to buy an AED, or MAST; But you can't have either on an EMS unit w/ out a medical director.

No snipping. <slaps mouse w/ a ruler>


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## Chimpie (Aug 14, 2005)

I snipped it because I was asking about the AED in particular.    

And since he is not running an ambulance, nor is he in PA, all of your points are mute.  He is asking about setting up a medical response kit and possibly some training for his industrial facility in Arkansas.


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## Jon (Aug 15, 2005)

> _Originally posted by TTLWHKR+Aug 14 2005, 02:19 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>*QUOTE* (TTLWHKR @ Aug 14 2005, 02:19 PM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-MedicStudentJon_@Aug 13 2005, 07:27 PM
> * In PA..... I've never heard that... I belive it is covered under the state BLS protocols.... you don't need command to be a BLS service.. I assume O2 in PA is covered under the state protocols signed by the the state Medical Director....
> 
> Jon *


Actually you do need your own medical director in order to operate a BLS Service or a QRS Services. In some regions, the regional medical director will sign off on QRS services, but BLS does need a medical director in order to operate. BLS services need several things that require you to have your own director in order to purchase. 

You need one in order to be stocked with and use the MAST suit, an AED, purchase a contract for oxygen supply, purchase EPI, purchase irrigation fluids (at least in 90% of the current catalogs). My company uses only Moore and BoundTree. Moore requires us to go to our MD and get sigs every six months on a list of items we purchase every month. Also you need an MD signature seven times in the state Ambulance Licensure packet to approve your 2nd due coverage areas, your mutual aid, your AED, your crew, your crews approval to use the AED, The EPI, and a paper citing his credentials. [/b][/quote]
 All the BLS transport squads i've seen... no AED, no Epi. My understanding is you don't need medical direction if you DON'T use pulse ox, AED, Epi... (I didn't think you needed command to stock / use MAST per state protocol.. air splint... you do need command to use mast as mast).

I can go to WalMart (example) or Galls and by a HeartStart Home .. the FDA approved non-perscription AED...

I can't buy a LP 500.. that is not a non-perscrition approved AED... and I can't use either in PA without a command doc to sign off.

O2 Tanks and Regulators aren't perscrption through Galls.... and VE Ralph usually dosen't require perscription for NSS or Sterile water for irrigation...

TTLWHKR... we will agree to dissagree


jon


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## Chimpie (Aug 15, 2005)

Cap'n ... the best advice I can give is to contact someone locally, such as the Red Cross.  They will be able to tell you exactly what you are allowed to do.


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## Cap'nPanic (Aug 15, 2005)

Luckily we do have a Red Cross offices within 30 miles of us.

Im sure they will get countless phone calls from me asking what is and what isnt OK. I would rather ask questions finding out what will be beneficial and will also stay well within my limits rahter than to blindly push for changes only to get laughed at because I failed to do my homework.

I was taught CPR through the AHA, but for layperson CPR classes which is more beneficial, ARC or AHA? I was given health care provider status for my AHA CPR card.

-CapnPanic


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## Chimpie (Aug 15, 2005)

The actual skills for CPR are the same whether it be AHA, Red Cross, or Joe's CPR School.  I believe that the Red Cross goes into "why" a little better and I enjoy how the class is set up.  Plus, every class supports the local chapter's other functions as well, including disaster response.

My suggestion would be that all management (or mobile staff) take Adult CPR/AED and First Aid.  Any responders, such as yourself, HAZ MAT team, etc., take the CPR For Professional Rescuers.  While you have may have the two-man skills down already, learning together with your fellow coworkers will help build teamwork.


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## Jon (Aug 15, 2005)

My facility, I belive, has a group of the county's EMT instructors (In business together to teach CPR, not with the county...sort of weird) teach CPR+AED and basic First Aid... The County EMS TI, run by the same folks, loves ASHI. They teach ASHI. I don't know if it is professional rescuer or layperson CPR....... I'll have to talk to my boss tomorrow and check his cards....

the big part is the First Aid part... stopping bleeding and managing shock can KEEP you from doing CPR.... 

Jon


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## ResTech (Aug 21, 2005)

Yeah, PEA from hypovolemia is a bad thing....


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## Cap'nPanic (Aug 22, 2005)

I wholeheartedly agree with the last two statements. This is one reason why there should be an injury PREVENTION campaign rather than an injury MANAGEMENT campaign. If you prevent it altogether you dont have to worry about managing it either.

-Cap'n


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## Jon (Aug 22, 2005)

As for "can't specify what training your security Co has" that is incorrect... when the contract is next up, you can specify whatever duties you want into that contract.. I work for a contract Sercurity Co.... pay stinks, but I've got more overtime then I could want....


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