# Pediatric Bag Recommendations - R&B Pediatric Pack?



## scmedic85 (Feb 26, 2013)

I am looking for alternative pediatric EMS bags to replace our current system. We are using the Broselow system: https://www.armstrongmedical.com/index.cfm/go/product.detail/sec/3/ssec/14/fam/150.

My number one choice is the R&B Pediatric Pack:
http://www.savelives.com/product/rb-purple-pediatric-pack-6132.cfm

*If you have used this bag I would like your input; good or bad. Also, if you have used another bag that you like let me know what you think of it.*

My reasons for recommending against replacing our worn out Broselow system with the same:

1) *Size*: Since we have to carry in the monitor, oxygen and combo bag (for drugs) as well cutting down on size is important. Space is also limited in our truck for larger bags.

2) *Ease of Use*: Current system put most needed supplies at back of bag (BVM) and secondary airways. Even if you grab the correct color the laryngoscope handle, CO2 detector and tube holder must still be found elsewhere in the bag.

3) *Cost*: The Broselow system results in the duplication of supplies that are rarely used so we won't be replacing as many unused supplies.

Any thoughts on the topic are greatly appreciated.


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## Household6 (Feb 26, 2013)

I'm not a fan of zippers, I like all the velcro and the way you have an option of using the quick release straps instead of the zippers.


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## Veneficus (Feb 26, 2013)

I hae seen places put their own bags together using the same color system as the Broselow.

One of the more compact I saw eliminated the smaller sizes due to the lack of calls in those ranges.

I have seen seperate jump kits and airway bags for peds/neonates.

I like the broselow tape as a very useful reference tool. But don't really see the practical benefit of having pre-drawn meds. It is not wise to give a med without checking for the proper dose and verifying the proper dose before pushing it. 

I have seen many medics in my time think the dose of things like lidocaine, bicarb, etc was "one prefilled syringe full." I have seen many adult patients underdosed doing this and many peds overdosed.

Whether that is in a prefil or a generic syringe is really of no consequence.

I also think that many people are not comfortable with peds so there is benefit in slowing down the actions and thought processes.

It is not unheard of for services to move away from peds intubation, so eliminating that may cut down on the equipment carried as a benefit. 

Rather than buying a premade kit. Perhaps it is time to sit down, look at your calls, decide what is needed, what is rarely used but still necessary, and wha can be eliminated in terms of each indivdual item?

Personally, rather than carrying around 3-4 sizes of BVM, an anesthesia bag might be more beneficial? (just make sure to have a spare in case somebody makes a hole in it.)


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## scmedic85 (Feb 26, 2013)

Veneficus, thanks for the detailed response but it didn't really touch on the specifics of my request. Do you have any experience with a particular bag that you have found to be of high quality and easy to use?

We are already looking to put our own bag together which is why I am looking at the R&B bag; Adjusting quantities and adding/removing items to fit current practice and system needs. I already have an example bag done up and have had an overwhelmingly positive response from our street crews. My boss has asked for input from a service that is already using it in the field before we implement. He is nervous about going away from the Broselow system even though he acknowledges that it is cumbersome and costly.

The Broselow bag does not include any medications, nor do we carry any pediatric specific doses. They expire out before they are used and like you said it is best to only carry one concentration of each medication.

I don't think you can elimate peds intubation. It is true that most patient airways can be controlled with just a BVM/mask or secondary airway (LMA/King) but there are a select few where nothing else will do. Our state requires that we carry the equipment, so it will stay even if my medical director thought it wasn't needed.

While I am all about reducing the bulk and excess I don't think the pediatric and infant BVMs can be replaced with an anethesia bag. This requires large amounts of oxygen and a 'D' tank could be depleted rather quickly leaving you without the ability to ventilate that patient.


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## NomadicMedic (Feb 26, 2013)

We use the r&b pedi bags at my service. Its a bag. I have to say I don't understand what your question is. It's a bag. It carries all the stuff you would need on a pedi call. You could carry it all in a wal-mart duffle bag if you wanted. Use your Broslow tape for tube sizes and drugs.


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## scmedic85 (Feb 26, 2013)

n7lxi said:


> We use the r&b pedi bags at my service. Its a bag. I have to say I don't understand what your question is. It's a bag. It carries all the stuff you would need on a pedi call. You could carry it all in a wal-mart duffle bag if you wanted. Use your Broslow tape for tube sizes and drugs.



Not all bags are created equal in terms of durability and ease of use. How have the bags held up? Have you used the bag during a serious pediatric call where you had to intubate? If so, was it easy to find everything you needed quickly? If you have ever used a modular bag on a pediatric arrest which did you find was easier to use?

I think this has more to do with how the system sets the bag up, but this is the information my boss wants to know before we purchase.


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## NomadicMedic (Feb 26, 2013)

We don't carry drugs in our pedi bag, so that's a non issue. We also have two broslow tapes, one in our regular ALS bag and one in the pedi bag.  My last pedi intubation was a code and I used the pedi handle and tube from the pedi intubation wrap. No issues. The bag has held up great as it rarely ventures from the truck. I'll be at work on Thursday and I can pull our inventory and take some pictures if you'd like.


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## WTEngel (Mar 1, 2013)

If you just want bag recommendations, I like StatPaks. Very versatile and well designed. They are on the pricey side for initial investment, but they hold up well and have good customer service.

As for peds specific... I never saw a reason to keep peds stuff sequestered from materials used for other patients. It always seemed like a great marketing scheme to me, not a practical application.

When I get on a crap airway call, I want my airway bag, with all supplies plain and simple. I don't want to pull out a bag with supplies that no one ever pays attention to unless its monthly check time. 

My advice, have everything you need, peds, adult, or otherwise arranged in airway and medical bags. Trauma equipment can be kept as you like it.


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## NomadicMedic (Mar 2, 2013)

I agree, I don't see the reason for a dedicated pedi bag, but we have them, and changing our equipment configuration is a nightmare. 

I also second the StatPack recommendation. We use them as our primary bags and they hold up very well.


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