# everyone carries trauma shears, but...



## TraprMike (Jul 12, 2010)

how about the bandage shears. the stainless steel jobies that come in the sets I see advertised along with tweezers.
other then my rule of 2 is one and one is none.. 
why carry two different kind of scissors?? what can the bandage shears do that the trauma shears can't?? 

serious question here....


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## medicdan (Jul 12, 2010)

Can you please explain to me why some EMTs find it necessary to carry a hemostat? Is there some unnamed purpose I am not realizing in prehospital medicine? Outer whackerdom?

I carried metal bandage shears for a while when I worked in a clinic for short period-- they provided for smoother cutting of gauze, but otherwise I found no functional difference. Trauma Shears are serrated, and beside being cleaned with cancer wipes, versus sterilization (?) for the metal shears, I don't see any difference...?


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## exodus (Jul 12, 2010)

I actually wish I had a hemostat the other week. The RN was turning the ER upside down to try and find one we could take with is. they need to cap off this dudes dual lumen catheter that was leaking blood...


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## abckidsmom (Jul 12, 2010)

exodus said:


> I actually wish I had a hemostat the other week. The RN was turning the ER upside down to try and find one we could take with is. they need to cap off this dudes dual lumen catheter that was leaking blood...



Only there are at least a half dozen less destructive ways to clamp off a line than crimping it with a metal tool.  Just saying, a hemostat is not always the best thing for that purpose.

Once, on an extended extrication, I hung an IV bag from a hemostat clipped to the top of the vehicle.  Once.


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## LucidResq (Jul 12, 2010)

emt.dan said:


> Trauma Shears are serrated, and beside being cleaned with cancer wipes, versus sterilization (?) for the metal shears, I don't see any difference...?



My trauma shears say that they are autoclaveable... in different terms of course.


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## JPINFV (Jul 13, 2010)

LucidResq said:


> My trauma shears say that they are autoclaveable... in different terms of course.



I've actually autoclaved my sheers a few times. Unfortunately, I don't have unfettered access to an autoclave anymore.


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## clibb (Jul 13, 2010)

I have some for when I fly fish


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## mycrofft (Jul 13, 2010)

*Lister Bandage Scissors versus trauma shears*

BTW, we old guys call 'em "Tetrasnips" from the brand that popularized these inexpensivly made serrated stainless shears with plastic handles by selling them to the Dept of Defense during Nam.

Tetrasnips bring a lot more to the party, you can even open cans with them or sever a quarter if you don't mind ruining them, and if lost you can buy them on clearance at Ace HArdware for $4 sometimes. Lister scissors will not cut clothes, etc., as well.


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## Sasha (Jul 13, 2010)

> other then my rule of 2 is one and one is none..



Negative. One is three, three is five, five is four.


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## 8jimi8 (Jul 13, 2010)

exodus said:


> I actually wish I had a hemostat the other week. The RN was turning the ER upside down to try and find one we could take with is. they need to cap off this dudes dual lumen catheter that was leaking blood...



that's what small size needle nose pliers are for. A hemostat will just bend on a picc line cap.


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## jjesusfreak01 (Jul 13, 2010)

I would just keep some extra umbilical cord clamps around in case I needed to cut off a line. Just pop it on and you don't have to worry about it, and it can be removed later hopefully without damaging the line.


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## Shishkabob (Jul 13, 2010)

jjesusfreak01 said:


> I would just keep some extra umbilical cord clamps around in case I needed to cut off a line. Just pop it on and you don't have to worry about it, and it can be removed later hopefully without damaging the line.





I just keep an extra EMT around for that.  h34r:


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## exodus (Jul 13, 2010)

abckidsmom said:


> Only there are at least a half dozen less destructive ways to clamp off a line than crimping it with a metal tool.  Just saying, a hemostat is not always the best thing for that purpose.
> 
> Once, on an extended extrication, I hung an IV bag from a hemostat clipped to the top of the vehicle.  Once.





8jimi8 said:


> that's what small size needle nose pliers are for. A hemostat will just bend on a picc line cap.



Oh no... Not a picc line.

The dude was urinating blood, so there was a dual lumen cath inside his penis so they could have a *big* bag of NS running to flush out the clotted blood, and the other to drain. We couldnt tx the giant bag of NS because there was really no way to, and the ER didn't have the caps for the catheter. So once we unhooked the flush line of the catheter, it backflowed and blood came out.


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## Sassafras (Jul 14, 2010)

First off...YEOWCH to the dude with the dual lumen cath.  

Secondly, I never knew there was a difference in scissors.  I guess I have bandage sheers because mine are all metal.


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## Melclin (Jul 14, 2010)

Sasha said:


> Negative. One is three, three is five, five is four.



*Mycrofft*, you shouldn't log into Sasha's profile and post, we can tell when its you


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## PrincessAnika (Jul 15, 2010)

emt.dan said:


> Can you please explain to me why some EMTs find it necessary to carry a hemostat? Is there some unnamed purpose I am not realizing in prehospital medicine? Outer whackerdom?



we use them all the time to keep the iv bag from falling off on the way into the ER - clamp the bag to the sheet - other than that....can't really think of anything else, except its a great way to make the nurses in the ER happy when they are looking for one....ditto for trauma shears.  i hated the regular bandage scissors - never cut through the gauze very well at all....


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## mycrofft (Jul 15, 2010)

*Yes, Melclin............*

Tips on using tetrasnips: turn em upside down (unflanged jaw on the bottom) for fine work, just don't nibble into skin or ears ot whatever. And, although you can buy some fine smaller versions, those are highly pilferable.
The tiny one that come with Zoll defib electrodes by the way are not toys.


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## 18G (Jul 17, 2010)

One thing to keep in mind with trauma sheers.... most providers will use them to cut anything and everything (ie clothes, wires, metal, bandages, etc). How clean are these sheers really?

I bring this up only to provoke thought of cross contamination. It doesn't make sense to use trauma sheers you used to cut a persons chemically contaminated clothes (gas, oil) on one call and than use the same pair to cut a sterile bandage/dressing on another. 

So it does make sense to carry two separate pairs... although I don't personally.


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## NYBLS (Jul 17, 2010)

18G said:


> One thing to keep in mind with trauma sheers.... most providers will use them to cut anything and everything (ie clothes, wires, metal, bandages, etc). How clean are these sheers really?
> 
> I bring this up only to provoke thought of cross contamination. It doesn't make sense to use trauma sheers you used to cut a persons chemically contaminated clothes (gas, oil) on one call and than use the same pair to cut a sterile bandage/dressing on another.
> 
> So it does make sense to carry two separate pairs... although I don't personally.



Clean them off or throw them out between calls. Most of them are only a few bucks, and your company should provide them free, so you really don't lose anything.


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## AnthonyM83 (Jul 17, 2010)

JPINFV said:


> I've actually autoclaved my sheers a few times. Unfortunately, I don't have unfettered access to an autoclave anymore.



You would, JP.....


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## JPINFV (Jul 17, 2010)

AnthonyM83 said:


> You would, JP.....



At least when I go full wacker, I do it with style (e.g. I did take a backboard home once...).


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## boingo (Jul 17, 2010)

Hemostats have their place.  We use them when we apply tourniquets.  We use a long piece of surgical tubing, wrap it twice around the limb, pull tight and clamp where the two sections of tubing cross.  Also, when using a sheet to wrap a pelvis, once you pull the sheet tight, cross the two sides and wrap 180 degrees, and secure both sides with hemostats.  I wish I had pics, it would probably make better sense.


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## PrincessAnika (Jul 17, 2010)

18G said:


> One thing to keep in mind with trauma sheers.... most providers will use them to cut anything and everything (ie clothes, wires, metal, bandages, etc). How clean are these sheers really?
> 
> I bring this up only to provoke thought of cross contamination. It doesn't make sense to use trauma sheers you used to cut a persons chemically contaminated clothes (gas, oil) on one call and than use the same pair to cut a sterile bandage/dressing on another.
> 
> So it does make sense to carry two separate pairs... although I don't personally.



i always made it a point to clean them after every call i used them on, and once a wk.


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## PrincessAnika (Jul 17, 2010)

JPINFV said:


> At least when I go full wacker, I do it with style (e.g. I did take a backboard home once...).



ha, i had did that once - had a LBB riding in the front seat of my car for two days.....also have had a peds board in my truck for about a week.....the one co i used to run for was way out in the sticks and got very few calls....they flew a kid and an adult past the local hospital to the big hospital, and i took a transport up to that big hospital with my other company so i brought back the equipment since we rarely ever went to the big hospital....


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## Hemingway (Jul 20, 2010)

*Hemostats = bag hangers*

Hey everyone, totally new here. Enjoy the forum a lot.  I keep hemostats on me because I'm the new guy and I get crap no matter what. Haha, really though we use them to hang NS bags from our lapels or anything else possible. Very useful if you need a third hand to hold up that bag.


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## 18G (Jul 22, 2010)

It's nice a lot of ppl clean their shears (as they should) but I know first hand many more don't.


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## Bullets (Jul 26, 2010)

i carry all three. i use the trauma shears to cut off clothes and thicker stuff. the bandage shears are smaller, so i use them to in tighter spaces and for cutting, you know, bandages. i carry a hemostat for a whole number of things. Hanging bags from roof liners during extrication and when we bring pt's in, holding a roller gauze while i rip tape, hanging sheets at a DOA, tarps at a LSI or Fire, landing spot when we drop a bird in, keep nurses happy.

also, if my shears get dirty they take a trip through the hospital autoclave every time


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## LondonMedic (Jul 26, 2010)

exodus said:


> Oh no... Not a picc line.
> 
> The dude was urinating blood, so there was a dual lumen cath inside his penis so they could have a *big* bag of NS running to flush out the clotted blood, and the other to drain. We couldnt tx the giant bag of NS because there was really no way to, and the ER didn't have the caps for the catheter. So once we unhooked the flush line of the catheter, it backflowed and blood came out.


Stopping irrigation on a PU bleed is not normally the done thing, not until it's running rosé at least. Unless you fancy doing a few hours of bladder washout (or digging it out with a rigid cystoscope).

If they didn't have spigots for the cath did they not have catheter bags? :unsure:


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## Hellsbells (Jul 27, 2010)

> cancer wipes



Excuse me? ...the hell is a cancer wipe?


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## lightsandsirens5 (Jul 27, 2010)

JPINFV said:


> At least when I go full wacker, I do it with style (e.g. I did take a backboard home once...).



Oh really? Do tell.


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## l_one (Jul 27, 2010)

*Shears?*

I have tried EMT shears and Lister bandage scissors - they both do what they are supposed to do but there are pros and cons.

It is unreasonably hard to find EMT shears that have QUALITY MANUFACTURING.  The design concept is good, sure, but really they are all just stamped sheet metal with in-line bulb bends for reinforcement, not tool steel, not high-carbon steel - stainless, sure - but what grade?  They never tell you - certainly not the same grade stainless steel as a good blade.

What I've settled on after spending some time researching is good quality sewing scissors - $15 to $20 titanium, tightness-adjustable sewing scissors that can be sharpened (and come very sharp already).  They might not cut through quarters but for the purpose - cutting through clothes and maybe a belt here and there - they are perfect and cut quickly though long lengths of fabric instead of one cutting motion per 1-2 inches.  It's what I keep in my larger medical bag.


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## alphatrauma (Jul 27, 2010)

Hellsbells said:


> Excuse me? ...the hell is a cancer wipe?



Choose your poison


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## JPINFV (Jul 27, 2010)

lightsandsirens5 said:


> Oh really? Do tell.



When working at the waterpark, on a day I wasn't on duty there was a young guest who fell and suffered an open fracture. Responding crews initially transported to one of the local EDs who then transferred her to the main children's hospital on the other side of the county. Due to positioning and concerns over pain, they transported her on the backboard sans other immobilization. So, working at my ambulance job, I come across the head bed (the orange Ferno non-disposable type), call the supervisor, got the story, and end up checking the two trauma hospitals (the ER tech I talked to remembered the patient and thought she was transferred to a trauma center) that were on my way home. 

At next shift, I ended up at the hospital attached to the children's hospital (the children's hospital is a stand alone facility, but is attached underground to another hospital which includes emergency services) and came across it in the ambulance bay. Shoved it into the backboard compartment of the ambulance, back at the bay wiped it off with cancer wipes, and then it sat in my front seat over night until I could return it to the park.


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## Sassafras (Jul 27, 2010)

JPINFV said:


> When working at the waterpark, on a day I wasn't on duty there was a young guest who fell and suffered an open fracture. Responding crews initially transported to one of the local EDs who then transferred her to the main children's hospital on the other side of the county. Due to positioning and concerns over pain, they transported her on the backboard sans other immobilization. So, working at my ambulance job, I come across the head bed (the orange Ferno non-disposable type), call the supervisor, got the story, and end up checking the two trauma hospitals (the ER tech I talked to remembered the patient and thought she was transferred to a trauma center) that were on my way home.
> 
> At next shift, I ended up at the hospital attached to the children's hospital (the children's hospital is a stand alone facility, but is attached underground to another hospital which includes emergency services) and came across it in the ambulance bay. Shoved it into the backboard compartment of the ambulance, back at the bay wiped it off with cancer wipes, and then it sat in my front seat over night until I could return it to the park.



Wasn't it already wiped down by the hospital?  By the time backboards make it to the bays in our local hospitals they have been deconned already.  They have signs posted everywhere that things do not get put in the bays until they have been properly cleaned.  Who does it, I don't know, but I do know I've never gotten a dirty back board back.


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## JPINFV (Jul 27, 2010)

Sassafras said:


> Wasn't it already wiped down by the hospital?  By the time backboards make it to the bays in our local hospitals they have been deconned already.  They have signs posted everywhere that things do not get put in the bays until they have been properly cleaned.  Who does it, I don't know, but I do know I've never gotten a dirty back board back.



I don't know and don't remember if it had been wiped down by the hospital. I've seen some hospitals just put them out there and others clean them. However I know 100% it's been cleaned if I clean it.


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## medic417 (Jul 27, 2010)

Sassafras said:


> Wasn't it already wiped down by the hospital?  By the time backboards make it to the bays in our local hospitals they have been deconned already.  They have signs posted everywhere that things do not get put in the bays until they have been properly cleaned.  Who does it, I don't know, but I do know I've never gotten a dirty back board back.



The hospitals in my area do not clean anything.  They stick boards etc with blood, grey matter, etc still on them in the ambulance entrance.  You wear gloves while gathering your services equipment.


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## exodus (Jul 27, 2010)

LondonMedic said:


> Stopping irrigation on a PU bleed is not normally the done thing, not until it's running rosé at least. Unless you fancy doing a few hours of bladder washout (or digging it out with a rigid cystoscope).
> 
> If they didn't have spigots for the cath did they not have catheter bags? :unsure:



Guess not unless our nurse was an idiot. It was easily above my level, so I did what the nurse wanted.


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## Veneficus (Jul 27, 2010)

Sassafras said:


> Wasn't it already wiped down by the hospital?  By the time backboards make it to the bays in our local hospitals they have been deconned already. They have signs posted everywhere that things do not get put in the bays until they have been properly cleaned.  Who does it, I don't know, but I do know I've never gotten a dirty back board back.



Then that hospital is obviously not busy enough.

I spent most of my life in high volume services and hospitals. No hospital I ever went to used their staff to clean EMS gear. 

Most of the EMS services had people dedicated to retrieving their own equipment from various places and cleaning it themselves. 

I have also seen hospitals dump contaminated EMS equipment into the biohazard trash when it wasn't removed by the service in a timely manner. (2 weeks)

Some of the flight services I have visited would clean and ship EMS gear back to the original agency as a courtesy, but they were certainly not as busy as the ED staff.

I cannot imagine why a facility would pick up the cost of cleaning EMS supplies (materials, man hours, etc) unless EMS was part of that facility or EMS gave the facility money for it.


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## reaper (Jul 27, 2010)

Actually, Our Level 1 does clean all equipment. Why do they do this? Because it is an OSHA regulation. They cannot placed contaminated equipment anywhere it could come in contact with people.

Had a small rural hospital that used to dump it outside, covered in blood. After the major OSHA fine they received, they were fast to clean all equipment before being placed outside.

Only way around it for them, is if they are placed in a locked area, that public has no access to.


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## Sassafras (Jul 28, 2010)

Veneficus said:


> Then that hospital is obviously not busy enough.
> 
> 
> I cannot imagine why a facility would pick up the cost of cleaning EMS supplies (materials, man hours, etc) unless EMS was part of that facility or EMS gave the facility money for it.


I'm pretty sure that the major teaching hospitals we transport to are pretty busy being you can wait hours to be seen if you aren't actually dying on the litter (and even then you may have to wait).

Secondly the hospitals around here DO have their own EMS units.  I say "around here" but really our transport times are about 40-60 minutes from our tiny backsticks town.  The major hospitals all run their own units.  The towns around the hospitals and within treatment range may have smaller paid units (ours is one of the only volley units left), but they are not contracted by the hospital.  They simply deliver to whichever hospital is designated for what needs treated (ie. trauma hospital gets traumas, heart attacks go to the hosp known for cardiac, and only two hospitals have the hyperbaric chamber so we divert those cases there).

Third, I'm pretty sure it's an OSHA thing anyway and illegal to throw nasty gray matter in a public place like an ambulance bay (hence the decon rooms at the ER entrances around here). And the following post confirms my suspicions.


reaper said:


> Actually, Our Level 1 does clean all equipment. Why do they do this? Because it is an OSHA regulation. They cannot placed contaminated equipment anywhere it could come in contact with people.
> 
> Had a small rural hospital that used to dump it outside, covered in blood. After the major OSHA fine they received, they were fast to clean all equipment before being placed outside.
> 
> Only way around it for them, is if they are placed in a locked area, that public has no access to.


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## jjesusfreak01 (Jul 28, 2010)

Sassafras said:


> Third, I'm pretty sure it's an OSHA thing anyway and illegal to throw nasty gray matter in a public place like an ambulance bay (hence the decon rooms at the ER entrances around here). And the following post confirms my suspicions.



I always thought that the decon rooms were primarily for people coming into the hospital rather than equipment going out, hence the showers often found outside the ER entrances. There is probably a protocol at the hospital for cleaning all equipment used in trauma cases.


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## Sassafras (Jul 28, 2010)

Well, the one decon room I've had the displeasure of needing had the shower but also other stations for cleaning equipment...and it was gross...who decons the decon room?  I threw nitril gloves on my feet!


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## cristianb36 (Jul 28, 2010)

emt.dan said:


> Can you please explain to me why some EMTs find it necessary to carry a hemostat? Is there some unnamed purpose I am not realizing in prehospital medicine? Outer whackerdom?
> 
> I carried metal bandage shears for a while when I worked in a clinic for short period-- they provided for smoother cutting of gauze, but otherwise I found no functional difference. Trauma Shears are serrated, and beside being cleaned with cancer wipes, versus sterilization (?) for the metal shears, I don't see any difference...?



Haha, the same like the emtbs with 300 dollar littmanns or welch allyns...


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## Sassafras (Jul 28, 2010)

Hey don't knock my litman. I seriously can't hear Jack out of other steths AND mine was a hand me down from my doctor friend who does NOT wear an orange jumpsuit.


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## cristianb36 (Jul 28, 2010)

I'm not knocking littmanns, they're great. I'm knocking emtbs that have 300 dollar cardiology steths.haven't seen a run sheets asking for heart sounds yet. A basic littmann is all you need unless u have seriously diminished hearing, in which case this doenstvapply to you since u do need a high end steth to hear lung soounds in the back


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## Sassafras (Jul 28, 2010)

I don't even know WHAT litmann I have LOL.  Wait lemme look...

o.k. allmighty google tells me I have the master classic II.  All I know is I can hear pretty darn good with it and I'm the envy of the unit LOL.


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## jjesusfreak01 (Jul 29, 2010)

Ill eventually get a Master Classic, but I will probably hold onto the Classic Lightweight (v1) hand me down until I trade up.


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## EMTSTRONG (Aug 28, 2010)

*In answer to the original question. . .*

As one who has used both trauma shears and bandage shears and has patents for scissors (trauma-shears.com), I can confidently say that there is nothing that a bandage scissor has over even the run-of-the-mill, new trauma shear.  

Over time, the big difference would depend on the quality of the trauma shear since some are made without expectation for long term use and will go dull.  Bandage scissors generally seem to have a longer life.  I would point out that the blades on our trauma shears are one exception.


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## thatJeffguy (Aug 28, 2010)

If you visit your local Central Processing department at the hospital, I'm sure they'd be happy to package and sterilize your shears.

I have no idea why you'd want to to that, but if 270 @ 70 for 15 makes you happy, rock out


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