# Strange stuff on your truck



## NomadicMedic (Mar 18, 2017)

We actually carry these in the jump bags. 

Anyone know why?

What do you carry that is 100% pointless?


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## TransportJockey (Mar 18, 2017)

Do ya'll regularly place people in traction in your truck?


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## GMCmedic (Mar 18, 2017)

Traction for forearm fractures?

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## EpiEMS (Mar 18, 2017)

For entertaining...uh...kids?

We had MAST on board til last year, which was hilarious. I kinda think carrying contact lens cases is silly, but I could see the use, once in a blue moon. Oh, and paper cups for eye shields - a cheapo method.

(Oh, Hare traction splints - why wouldn't you just get Sager splints?)


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## NomadicMedic (Mar 18, 2017)

Nope. Not for traction. We were told to use these to secure a patient's hands if they were unconscious. Seriously. We also carry a Hand-E for the same reason. 






http://www.epandr.com/products/specialty/hande.php


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## cruiseforever (Mar 18, 2017)

NomadicMedic said:


> Nope. Not for traction. We were told to use these to secure a patient's hands if they were unconscious. Seriously. We also carry a Hand-E for the same reason.
> 
> View attachment 3617
> 
> ...



We have them too.  As far as I know they have never been used.


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## NomadicMedic (Mar 18, 2017)

Same here. I usually use a quick wrap of tape.


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## VentMonkey (Mar 18, 2017)

They do kind of look like Chinese finger traps.

As far as strange stuff on our trucks. I'd have to say tongue depressors. I've never used them, so I'd label them out of place.

Also, how do you guys like that "Hand-E" contraption? Does it work well?


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## Jim37F (Mar 18, 2017)

NomadicMedic said:


> Nope. Not for traction. We were told to use these to secure a patient's hands if they were unconscious. Seriously. We also carry a Hand-E for the same reason.
> 
> View attachment 3617
> 
> ...


We had 'em at my last job, for the same reason. Yet everytime we had an unconscious patient where I'd think about using it  (we carried it in the c-spine bag with the collars and head beds for....reasons?) Fire would just strap their hands in with the gurney seat belts. Sometimes that seemed like it made more sense, but other times I found myself thinking the hand-E would've been better but was out voted so to speak lol. So bottom line it sat in the bag and we never used it...


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## Jim37F (Mar 18, 2017)

Oh, and if I saw those finger traps sitting in a bag at work, I'd assume someone just got a bright idea one day to bring them in to entertain kids a la stuffed animals, and they just got forgot in the bag for however long vs an actual management decision to carry them for some clinical purpose


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## NomadicMedic (Mar 18, 2017)

Jim37F said:


> Oh, and if I saw those finger traps sitting in a bag at work, I'd assume someone just got a bright idea one day to bring them in to entertain kids a la stuffed animals, and they just got forgot in the bag for however long vs an actual management decision to carry them for some clinical purpose



That's exactly what I thought. I said, "why are these Chinese finger traps in the bag?"  The ed director told me to secure hands in unconscious patients and I started laughing. I said, "are you actually serious?"  He was hurt that I didn't think it was a brilliant idea. 

Chinese finger traps. SMDH.


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## NomadicMedic (Mar 18, 2017)

VentMonkey said:


> They do kind of look like Chinese finger traps.
> 
> As far as strange stuff on our trucks. I'd have to say tongue depressors. I've never used them, so I'd label them out of place.
> 
> Also, how do you guys like that "Hand-E" contraption? Does it work well?



Never used the hand-E. Ever.


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## DesertMedic66 (Mar 18, 2017)

Seizure bite sticks. No clue why we carry them. 

I've actually used the tongue depressors before for a finger splint and also to make a clamp for nose bleeds. Also used them to make a cross for a cat my partner ran over.


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## NomadicMedic (Mar 18, 2017)

I've used a bite stick to glurp a bunch of glucose gel into a patient buccally.  

And I've made the epistaxis snout pincher out of tongue depressors. A couple of blasts of Affirn first though.


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## Carlos Danger (Mar 18, 2017)

VentMonkey said:


> I'd have to say tongue depressors. I've never used them, so I'd label them out of place.


I use a tongue blades frequently when I place LMA's or even OPA's.


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## VentMonkey (Mar 18, 2017)

Remi said:


> I use a tongue blades frequently when I place LMA's or even OPA's.


Never even thought of that, TBCH. Was this routine in your field paramedic days as well?


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## Carlos Danger (Mar 18, 2017)

VentMonkey said:


> Never even thought of that, TBCH. Was this routine in your field paramedic days as well?


No, I don't remember ever being shown how to do it in the field. But I always have one handy now; they are great for pushing the tongue forward if they have a large tongue or a small mouth opening.


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## VentMonkey (Mar 18, 2017)

Remi said:


> *No, I don't remember ever being shown how to do it in the field*. But I always have one handy now; they are great for pushing the tongue forward if they have a large tongue or a small mouth opening.


Cool, thanks. Are there any specific, or special techniques that go along with it, and is there a certain finesse to it?


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## Carlos Danger (Mar 18, 2017)

VentMonkey said:


> Cool, thanks. Are there any specific, or special techniques that go along with it, and is there a certain finesse to it?


Nope, just put the blade in the mouth to push the tongue and jaw forward while you slide the LMA in.


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## VentMonkey (Mar 18, 2017)

Remi said:


> Nope, just put the blade in the mouth to push the tongue and jaw forward while you slide the LMA in.


Thanks, I'm sure I'm not the only one who will walk away a bit wiser having read this.


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## GMCmedic (Mar 18, 2017)

Im curious now if the chinese finger traps would work for traction

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## VentMonkey (Mar 18, 2017)

GMCmedic said:


> Im curious now if the chinese finger traps would work for traction


Let us know how it works.

Waiver: we're not responsible if this happens:


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## EpiEMS (Mar 18, 2017)

Tongue blades for finger splints, guys, that's the way to roll!

the hand E - now that's a funny one. I have mostly used gently tied cravats for securing hands. 


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## NomadicMedic (Mar 18, 2017)

Am I the only one that uses a laryngoscope when putting in a King or a combitube? I was taught it's a great way to displace the tongue and avoid the teeth tearing the baloon.


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## DesertMedic66 (Mar 18, 2017)

NomadicMedic said:


> Am I the only one that uses a laryngoscope when putting in a King or a combitube? I was taught it's a great way to displace the tongue and avoid the teeth tearing the baloon.


We learned that during medic school. In the field I haven't needed to use it yet. The King has always been able to slide in with no issues.


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## OnceAnEMT (Mar 18, 2017)

GMCmedic said:


> Im curious now if the chinese finger traps would work for traction
> 
> Sent from my SAMSUNG-SM-G920A using Tapatalk



Quite well. Usually.

In the ED we have a device that may or may not have been custom-made, I can never tell. Think of an IV pole (wheels included, yay!) with a spring scale hanging off one of the hooks. Attached to the spring is a horizontal bar, attached to the bar are 5 "finger traps" that are longer laterally for the 1st and 5th fingers. Either pre-reduction or as the reduction, the device is used as a 5-finger trap for traction of a wrist fracture. I've never seen it used on a forearm fracture, those tend to just be manually reduced as needed. For a wrist fracture though, we have the patient seated with their shoulder flexed to 90, abducted, and externally rotated. The height of the device is adjusted to allow for gentle upward motion of the whole arm until all 5 fingers are fully in, then the arm is slowly lowered (and the patient coached) until the wrist is fully supported by the traction device. If greater force is required, we wrap weights around the arm proximal of the elbow, usually 1-4lbs. Done for around 20 minutes or until the desired reduction is palpable. Also helps to maintain traction while splinting.

It has failed once, and I was horrified. The patient was more scared of me having a medical emergency than of her wrist being shock loaded.

Control of hands is an interesting use though, I may propose that. I'm curious how that would place in the spectrum of restraints.

Edit:

This! Though not this same device, again making me wonder how home-made ours is.


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## MonkeyArrow (Mar 18, 2017)

Yeah, @Grimes we have one too just like you described/the picture. Similarly, used for wrist fractures to aid in resetting in. It failed once in the poorest of ways possible. One of our ortho surgeon's kids broke his wrist playing football. Brought him into the ED and he wanted to do the reduction and splinting himself. I brought the thing into the room and dad was showing kid how it works well, stuck his finger into one of them one, and pulled down, and his hand fell. Kid had a priceless look on his face.

Also, I would be concerned with how well a chinese finger trap would hold up for traction. The ones on the contraption are made from some sort of thick, plastic, polyester, carbon fiber looking material that is much sturdier than a chinese finger trap.


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## OnceAnEMT (Mar 18, 2017)

MonkeyArrow said:


> Also, I would be concerned with how well a chinese finger trap would hold up for traction. The ones on the contraption are made from some sort of thick, plastic, polyester, carbon fiber looking material that is much sturdier than a chinese finger trap.



I saw a video that said you can get them in nylon or a metal material, which I assume is just a mesh. We already get funny looks from everyone as we drag the clanging device over to the room, I'm sure it would only be worsened by multi-colored Chinese finger traps


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## NomadicMedic (Mar 18, 2017)

Or maybe multicolored Chinese finger traps would provide just the right amount of levity and frivolity?


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## Tigger (Mar 19, 2017)

We carry these enourmous space blankets in the bags and in the trauma compartment. They look like they'd work pretty well but I can't really figure out when I'd ever be using them outside of a backcountry call...


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## NPO (Mar 20, 2017)

VentMonkey said:


> They do kind of look like Chinese finger traps.
> 
> As far as strange stuff on our trucks. I'd have to say tongue depressors. I've never used them, so I'd label them out of place.
> 
> Also, how do you guys like that "Hand-E" contraption? Does it work well?


Used my first tongue depressor yesterday.
Last week another medic taught me to apply gauze to the end of two, then tape them together in the middle. Use to apply pressure to epistaxis. 

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## NPO (Mar 20, 2017)

We carry KEDs. I can't come up with a scenerio where we would need them, since we don't do spinal immobilization. 

I'm told they're required by CHP.

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## VentMonkey (Mar 20, 2017)

NPO said:


> We carry KEDs. I can't come up with a scenerio where we would need them, since we don't do spinal immobilization.


Work great for de bey-bez. Situationally dependent. There are some concerns for spinal injury (presentation) that may still warrant full c-spine, even in adults.



NPO said:


> Used my first tongue depressor yesterday. Last week another medic taught me to apply gauze to the end of two, then tape them together in the middle. Use to apply pressure to epistaxis.


I just used a pillow case around their neck, give them a barf bucket, and have them hold a cold compress all the way to the ED if it's still actively bleeding.


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## NomadicMedic (Mar 20, 2017)

NPO said:


> We carry KEDs. I can't come up with a scenerio where we would need them, since we don't do spinal immobilization.
> 
> I'm told they're required by CHP.
> 
> Sent from my Pixel XL using Tapatalk



We're required to carry a KED and several other oddities.


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## NomadicMedic (Mar 20, 2017)

VentMonkey said:


> Work great for de bey-bez. Situationally dependent. There are some concerns for spinal injury (presentation) that may still warrant full c-spine, even in adults.



We have a pedi immobilzer, like a papoose board, for kids. Works great. The upside down KED is good in theory for hip fx, but a pain to apply.


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## EpiEMS (Mar 20, 2017)

VentMonkey said:


> There are some concerns for spinal injury (presentation) that may still warrant full c-spine, even in adults.



What kind of circumstances are you referencing?


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## VentMonkey (Mar 20, 2017)

EpiEMS said:


> What kind of circumstances are you referencing?


I don't know that I would be all that jazzed about moving a patient I suspect of, say, anterior cord syndrome freely with just SMR.

Clearly, you'd be able to distinguish this more often than not over a whiplash-type injury. Nonetheless, I'm ok with an extra-cautious approach in these types of SCI's.

It doesn't hurt that the backboards are so much more convenient in the helicopter. When you have a chance look up spinal shock as well. While there's probably no way to discern the two in the field, I can't imagine that being any fun, and not worrisome to the patient themselves.

Edit: if I had one of those nifty inflatable doo-hickies that's designed to "splint" the body I'd use that. Does anyone have one, and if so, how do you like it?


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## DesertMedic66 (Mar 20, 2017)

I am still fine with the KED being on my unit. They work great for hip/pelvis injuries. We carry a pedi backboard so I've never used it for that before. 

Since I cover one of our race tracks the KED and a "speed board" make getting drivers out of their specially designed seats much easier.


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## Tigger (Mar 20, 2017)

NomadicMedic said:


> _Any use of a_ KED is good in theory, but a pain to apply.



Might at least be easier than sheets...


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## Jim37F (Mar 20, 2017)

I have thought in the past if you wanted to immobilize someone, putting a KED seems like it'd make more sense than sticking a long board under their rear and pulling them out and spinning the other while laying them down on it, like there's no way if there's a spinal injury your not manipulating the back by doing that (but we all know now that last statement is true pretty much regardless....)


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## TransportJockey (Mar 20, 2017)

DesertMedic66 said:


> I am still fine with the KED being on my unit. They work great for hip/pelvis injuries. We carry a pedi backboard so I've never used it for that before.
> 
> Since I cover one of our race tracks the KED and a "speed board" make getting drivers out of their specially designed seats much easier.


That last paragraph is literally why the KED exists 

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## NomadicMedic (Mar 20, 2017)

TransportJockey said:


> That last paragraph is literally why the KED exists
> 
> Sent from my SM-N920P using Tapatalk



Yep. The KED was designed to hoist the immobilized driver out of the car, using the wrecker. Be careful if you want to rig and lift one now. The knockoffs are not load rated like the originals Kendrick devices.


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## EpiEMS (Mar 20, 2017)

VentMonkey said:


> I don't know that I would be all that jazzed about moving a patient I suspect of, say, anterior cord syndrome freely with just SMR.
> 
> Clearly, you'd be able to distinguish this more often than not over a whiplash-type injury. Nonetheless, I'm ok with an extra-cautious approach in these types of SCI's.
> 
> ...



Understood, I'm just not entirely sure that a board is necessarily going to see *less* movement than gentle placement on a flat stretcher.

Oh, those vacuum mattresses - I have to wonder how effective they are, but boy, they look comfy!



TransportJockey said:


> That last paragraph is literally why the KED exists
> 
> Sent from my SM-N920P using Tapatalk



Never actually used it in an MVA...first time I asked about it for a patient where it was indicated (back when we were still boarding and collaring), I was shouted down, so that was fun.


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## VentMonkey (Mar 20, 2017)

EpiEMS said:


> Understood, I'm just not entirely sure that a board is necessarily going to see *less* movement than gentle placement on a flat stretcher.


Sure, but I can't buy into the backboard has zero place on an ambulance quite yet. Most, not all won't need it.

I cringe, and snicker at people who full c-spine GSW's, and even worse, stab wounds nowhere near the spinal column. 

How "uncomfortable" is it to a completely flaccid patient from T-4 down? It serves as a good reminder to mondo the medic, or fireman to gently move them. 

And again, at least in our helicopter, we have a LifeBlanket that has a roll out mover. I would soon rather these SCI patients be on a board (full c-spine, or not) than the flat. The flat takes waaay too much hassle trying to jam it in. We have to lift it up and over, not fun, easy, or proficient with said types of injuries; a KED would be acceptable, too.


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## EpiEMS (Mar 20, 2017)

@VentMonkey, your points are well taken - the abiding concern, of course, is that our precautions may cause more harm than good (as you acknowledged). Absent good data on whether LSB actually adds any benefit, though, we have to be really cautious, and as the NAEMSP statement from 2014 acknowledges:



> {I}_t is unclear whether spinal precautions, including a backboard and cervical collar, adequately protect those unstable injuries at risk to worsen with minimal movement._



I guess as far as a reminder, that makes some sense. Maybe it's silly of me, but I'm not entirely convinced that a LSB is better for that, say, T-4 injury patient than a collar + scoop --> flat stretcher (for ground ambulance purposes).


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## VentMonkey (Mar 20, 2017)

Sometimes I live life away from stats, and cohort studies. I just do what I feel is right (within protocol). Afterall, I'm a primate.


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## DesertMedic66 (Mar 20, 2017)

TransportJockey said:


> That last paragraph is literally why the KED exists
> 
> Sent from my SM-N920P using Tapatalk


Yep. I haven't had to use it yet... *knock on wood*


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## EpiEMS (Mar 20, 2017)

VentMonkey said:


> Sometimes I live life away from stats, and cohort studies. I just do what I feel is right (within protocol). Afterall, I'm a primate.








Haha, don't we all? That said, I am subject to confirmation bias (as you know, I don't like boarding people, so I seek studies that show it to be harmful).


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## VentMonkey (Mar 20, 2017)

EpiEMS said:


> Haha, don't we all? That said, I am subject to confirmation bias (as you know, I don't like boarding people, so I seek studies that show it to be harmful).


I hear ya, that said, medicine is so fickle I like to think an excellent practitioner can still employ a bit of common sense to each case specifically, and be willing to both defend, and explain their rationale for what they did.

This can work for either side of the "de we put people on backboards at all anymore" debate, as well as many others, as is displayed by this forums growth.


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## Tigger (Mar 21, 2017)

EpiEMS said:


> Understood, I'm just not entirely sure that a board is necessarily going to see *less* movement than gentle placement on a flat stretcher.
> 
> Oh, those vacuum mattresses - I have to wonder how effective they are, but boy, they look comfy!
> 
> ...


I am yet to find any evidence that shows vacuum mattress are actually capable of immobilizing the spine. Also, our county bought hundreds of the semi disposable kind form Hartwell. Do _not_ do that.


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## EpiEMS (Mar 21, 2017)

Tigger said:


> I am yet to find any evidence that shows vacuum mattress are actually capable of immobilizing the spine.



I think that's probably true - though I would imagine they avoid some of the adverse effects of boards (e.g. decubitus ulcers, general discomfort)


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## Tigger (Mar 21, 2017)

EpiEMS said:


> I think that's probably true - though I would imagine they avoid some of the adverse effects of boards (e.g. decubitus ulcers, general discomfort)


There is evidence of that. But nothing that they actually do anything.


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## Grozler (Mar 21, 2017)

Seriously, what is this thing?


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## EpiEMS (Mar 21, 2017)

Tigger said:


> There is evidence of that. But nothing that they actually do anything.



That's my sense of the available evidence, as well, for spinal "immobilization" generally.


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## Tigger (Mar 21, 2017)

Grozler said:


> Seriously, what is this thing?


We'd be screwed without all of our paper national forest/ATV maps. Love me some google maps, but sometimes some map reading skills are the ticket.


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## NomadicMedic (Mar 21, 2017)

Gotta have those USFS and topo maps on your iPad.


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## Tigger (Mar 22, 2017)

NomadicMedic said:


> Gotta have those USFS and topo maps on your iPad.


That is actually a good idea, once we move on past the motion tablets.


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## CALEMT (Mar 22, 2017)

Tigger said:


> That is actually a good idea, once we move on past the motion tablets.



PDF maps or Avenza maps is now what's it's call I believe. It has all the 7.5 minute topo maps for free and it doesnt require and sort of wifi or cell service because it's GPS. Comes in real handy for me when I'm out in the woods.


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## Old Tracker (May 25, 2017)

Paper maps aren't useless if much of your area does not have cell phone service. Just sayin'.


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## NysEms2117 (May 25, 2017)

Old Tracker said:


> Paper maps aren't useless if much of your area does not have cell phone service. Just sayin'.





LisaLee said:


> Ok. from my useless stuff:  1. a paper map too, 2. a tape 3. green plastic bucket and shovel for kids (I don't have any)


a little land navigation never hurt nobody . *hey lets drop into a random forest and find your way out! GO!*


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## CALEMT (May 25, 2017)

NysEms2117 said:


> a little land navigation never hurt nobody . *hey lets drop into a random forest and find your way out! GO!*



Give me a topo map and a compass and I'll make it happen.


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## StCEMT (May 25, 2017)

Pretty sure I am gonna have to navigate with a map tomorrow.


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## NPO (Jun 11, 2017)

CALEMT said:


> PDF maps or Avenza maps is now what's it's call I believe. It has all the 7.5 minute topo maps for free and it doesnt require and sort of wifi or cell service because it's GPS. Comes in real handy for me when I'm out in the woods.


This. Avenza is probably the best mapping software out there. There's no navigation, because it's designed for back woods maps. 

Download road, satellite, topo, etc maps of your area. You can usually find these maps with Geo Fencing so your location pops up on the map. This works with, or without cell service. It's the best of both GPS and paper maps. 

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## bakertaylor28 (Aug 16, 2017)

NomadicMedic said:


> View attachment 3616
> 
> 
> We actually carry these in the jump bags.
> ...


My truck is bubble gum pink. I'm not trying to hear it, lol.


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## NysEms2117 (Aug 16, 2017)

bakertaylor28 said:


> My truck is bubble gum pink. I'm not trying to hear it, lol.


awww thats such a cute truck!


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## bakertaylor28 (Aug 16, 2017)

NysEms2117 said:


> awww thats such a cute truck!


lol. Yeah. The sad thing about it is that I get "looks" from people in the public, as if to ask "why on God's green earth would the paint it pink?" Mind you its a breast cancer campaign, but STILL. can we not assign a FEMALE paramedic? REALLY? I have been TRYING to get one of the standard blue-and-whites from the fleet for the longest. They've decided it's not happening. Oh well. I've grown accustomed to her face.


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## NysEms2117 (Aug 16, 2017)

bakertaylor28 said:


> lol. Yeah. The sad thing about it is that I get "looks" from people in the public, as if to ask "why on God's green earth would the paint it pink?" Mind you its a breast cancer campaign, but STILL. can we not assign a FEMALE paramedic? REALLY? I have been TRYING to get one of the standard blue-and-whites from the fleet for the longest. They've decided it's not happening. Oh well. I've grown accustomed to her face.


maybe PICU too? kids like pink?


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## Jon (Sep 1, 2017)

NomadicMedic said:


> Yep. The KED was designed to hoist the immobilized driver out of the car, using the wrecker. Be careful if you want to rig and lift one now. The knockoffs are not load rated like the originals Kendrick devices.



FYI, while designed for such, it's NOT recommended by the designer. Something about an entrapped ankle in the pedals on an attempt at this, and a near-miss.

Also, Rick is a fun dude to hang out with.

PS, Yeah, I know. Necro reply.




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