# Why do YOU carry a personal jump/trauma bag?



## Fox (May 16, 2010)

I've heard some people mention carrying their own jump/trauma bags and always for different reasons. Then I've heard some say they would never, ever carry one. I've not really understood the appeal and I've been quite curious. (I'm fresh out of school, so I still have a lot to learn and this is one thing that makes me curious.) I just want to know for fun, not to call anyone a whacker or debate about the pros/cons of carrying a personal bag. I'm just intrigued. ^_^

So why do you carry a jump/trauma bag? What's inside? Do you use it often? 

If you don't carry one, why not? Do you ever wish you did?


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## Veneficus (May 16, 2010)

Never carried one, never plan to.

Can't think of anything I would need it for. If I am doing CPR as a bystander, it is compression only. 

If somebody is conscious and bleeding i'll give them instructions. 

If somebody is not, if i see the opportunity to safely apply pressure i'll just use some of their cloths. 

I am not taking anyones vitals,heart tones, etc.  and determining from that if they should or shouldn't seek medical attention. I am always going to encourage them to no matter what I find on assessment. 

If somebody is choking, I require no gear.

I am not altering diabetics without a glucometer unless i am related or a close friend and know that they are likely hypoglycemic from history.

I am certainly not giving medications to people I don't know or performing invasive procedures when not working.

I am not hauling around an AED and all the headache that comes with it "just incase."

I am not playing mad scientist and mixing chemicals outside the medical environment if I suspect an ingestion injury.

If I suspect an inhalation or contact injury I am running away, try to keep up.

Nothing I can do for massive burns. Everything i need to care for a minor burn is readily available. 

If I suspect a spinal injury and i am inclined to help, I am just going to hold manual stabilization.

babies come out on their own, and if they don't then calling for help and giving instructions is what I am doing unless i am very good friends with the lady.

What else could I possibly need?


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## ScoopandSwoop (May 16, 2010)

I carry golf clubs, hockey skates, and a gym bag (along with the occasional dirty sportswear). Not one band aid, no pocket mask, etc.

My job ends at the end of my shift, and begins at the beginnig of my shift. Anything in between (other than family) is someone elses job. I will call 9-1-1 for someone.

Call it cold and insensiitive, but I've had a great, long career in this industry, and whatched a whole lot of 24 hour a day life-savers burn out. Call me odd, no text messages either.

And no scanner at home, nor lights, emblems or decals on my car.


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## JPINFV (May 16, 2010)

BP cuff, stethoscope, ophthalmoscope, otoscope, tunning forks, reflex hammer, and snellen chart. Of course that's just because I can't be half assed to take it out of my trunk outside when I need it for clinic or standardized patients...


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## LucidResq (May 16, 2010)

Yes I have a bag in my trunk and yes I've used it.... on myself. 

+1 on Vene's post. It hits the nail right on the head. 

I carry some stuff in my trunk for *me* and potentially friends/family as needed. I'm talking pepto bismol in case the burrito doesn't go down well, band-aids for trail-side boo-boo fixin-up, and ibuprofen because I have bad knees and hike a lot. I had a whacker-acquaintance give me a bunch of stuff like a BVM and IV supplies that I have never used and almost certainly never will. It sits in my trunk because I didn't know what else to do with it. I will probably end up donating it to Project C.U.R.E. (sends medical supplies to impoverished areas).


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## viccitylifeguard (May 16, 2010)

http://www.meretusa.com/product.php?product_id=45
i carry  this bag   stocked with level  OFA  kit including o2. i only carry this for my personal/ family use and only have it because i won it in a work contest.  and yes i know its the identical bag  they use on the tv show "trauma"
(OFA kit is a  kit based from wcb in bc canada )


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## Shishkabob (May 16, 2010)

I have a box latex gloves in my trunk... but they've been there for nearly 2 years, in Texas summer heat, so I wouldn't count on them holding up.


I'm not opposed to helping people off duty, to the BLS level, as long as it doesn't impede on me.  I'm not going to stop at an accident in the middle of a road to render assistance, as sorry, but if I'm not being paid I'm not risking it.


But I have been known to render first aid to people at my paintball field (3 times last summer actually).  The owner, manager, and refs all know I'm a Medic so they often volunteer me as assistance.  I don't mind, it gets me free stuff at the field, and it's typically something like a scraped up leg from rocks.

I'm not opposed to buying some stuff strictly for my family and having it in my trunk, but seeing as how I'm broke as it is, it's not on my list of priorities. 





If I can't fix it with my gloved hands alone, an ambulance better be on the way.


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## mycrofft (May 16, 2010)

*I carried mine so my coworkers wouldn't steal or strip it at work.*

Also used it at scout events, football, cheerleading, three accident scenes, and on myself and family quite a bit over the years.

Use SEARCH and read what folks have in their kits. I've listed stuff thrice and am tired. And old.

Do not get into the "single combat with Death" deal.


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## adamjh3 (May 16, 2010)

I have a bag in my car with a pretty basic first aid kit for myself, friends, and family.


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## bstone (May 16, 2010)

I have a CPR pocket mast with gloves on my keychain. That's all I carry.


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## ffemt8978 (May 16, 2010)

I carry a bag in my work truck, but it is primarily because we do a lot of tower work at very remote locations where it could take a ground ambulance 45-60 minutes to arrive, and a helicopter (if available) has a 35-45 minute flight time.


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## usafmedic45 (May 16, 2010)

I have a first aid kit in my trunk as well.  I do carry a more comprehensive kit while hiking and camping, but that is mostly so I can save my own ***.


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## Fox (May 17, 2010)

Veneficus said:


> If I suspect an inhalation or contact injury I am running away, try to keep up.



Hahaha, best line, ever!


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## Fox (May 17, 2010)

ScoopandSwoop said:


> I carry golf clubs, hockey skates, and a gym bag (along with the occasional dirty sportswear). Not one band aid, no pocket mask, etc.
> 
> My job ends at the end of my shift, and begins at the beginnig of my shift. Anything in between (other than family) is someone elses job. I will call 9-1-1 for someone.
> 
> ...



I think lights on the car are extensive and unnecessary, really. I was kinda weirded out by the fact that you could even apply them as an EMT. 

I could understand why VFD would have them, though.


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## JPINFV (May 17, 2010)

Just curious, why would it be acceptable for VFD but not VEMS?


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## Fox (May 17, 2010)

Aside from some large bandaides for knees, and a few random princess bandaides from my daughter, you guys have me beat on even the first aide kits!

I know of someone around here that has a large truck with decals all over it, vanity plates, lights, only wears shirts related to the profession, and carries a bag. Unfortunately he is not neccessarily the kind of person you'd want to work on you, seeing as he is in it for glory and does not retain the knowledge. 

But I've seen normal calm people carry a bag in their vehicles, too. I've heard everything from "for family and friends" or "I volunteer..."

My biggest at home effort was to try to teach my family CPR, just in case, but they informed me that I had CPR and that was fine. Yes, but what if I'm not around? Well, that's alright, my dad use to know how 30 years ago...


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## Fox (May 17, 2010)

JPINFV said:


> Just curious, why would it be acceptable for VFD but not VEMS?



Well, I guess I should change that, not really acceptable, understandable I guess.

In my area there are some places that are pretty spread out, and if some of the VFD don't spend the night in their station. I could understand the chief driving on scene with lights and sirens on his car, but it's still a road hazard, I think. So I guess that's not really a great idea either, but if you have to wait for all your VFD to show up on scene... haha, it's a catch, maybe you should move closer.


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## Hal9000 (May 17, 2010)

I carry some vitamin I in my backpack.  I hike miles, sometimes by myself, in some remote areas in NW Montana, so I'll bring minor things with me when I'm doing that.  

I once met a whacker at an educational seminar; he had the whole kaboodle: lights, stars of life, oxygen cylinder, and the back seat folded down to accommodate a spineboard should the vehicle "be required to become an emergency vehicle in the case of an MCI."  The person also had a King airway and other items.  

Since meeting him, I've realized that I should at least mount a mini-mod on the back of my Buick Park Avenue, should I ever need to serve as a temporary emergency vehicle in times of crisis.


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## Fox (May 17, 2010)

Hal9000 said:


> I carry some vitamin I in my backpack.  I hike miles, sometimes by myself, in some remote areas in NW Montana, so I'll bring minor things with me when I'm doing that.
> 
> I once met a whacker at an educational seminar; he had the whole kaboodle: lights, stars of life, oxygen cylinder, and the back seat folded down to accommodate a spineboard should the vehicle "be required to become an emergency vehicle in the case of an MCI."  The person also had a King airway and other items.
> 
> Since meeting him, I've realized that I should at least mount a mini-mod on the back of my Buick Park Avenue, should I ever need to serve as a temporary emergency vehicle in times of crisis.


 :blink::huh:

LOL! The spineboard comment broke my brain.


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## Hal9000 (May 17, 2010)

Don't worry, it'll self-repair.  I'm from the land of whackers.  Terrible blight upon the face of EMS.  No need for me to pontificate voluminously upon such mentally indelible horrors.


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## Fox (May 17, 2010)

Haha, I hope so!

He sounds a lot like our whacker, but this guy drives a truck. I'm sure he'd make a spineboard fit, though, if he had to!


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## JPINFV (May 17, 2010)

[youtube]http://www.youtube.com/watch?v=m-okyKivilg&feature=related[/youtube]


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## viccitylifeguard (May 17, 2010)

Fox said:


> Haha, I hope so!
> 
> He sounds a lot like our whacker, but this guy drives a truck. I'm sure he'd make a spineboard fit, though, if he had to!



i so wish i had a pic of the vw beetle i used to drive  we at one point had  2 spine boards and  4 trauma bags attched to the roof.   we used to drive it  to lifeguard comps in it  B)


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## Aprz (May 17, 2010)

A stethoscope, a box of nitrile gloves, safety glasses, a pen light, and a sphygmomanometer only because I go to school Tuesday through Saturday in the mornings and they require me to bring it to class always. I think if there was an emergency that I would call 911, at most throw on some gloves (equipment wise), maintain ABCs/hold manual c-spine, maybe interview the patient or bystanders (get OPQRST, PASTE, and SAMPLE maybe). I live in the city so I would expect fire or an ambulance to arrive quickly with the appropriate equipment and take over.


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## Seaglass (May 17, 2010)

I carry a pair of gloves. Really handy for all kinds of nasty situations. Never actually used them for anything medical, though.


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## Dominion (May 17, 2010)

I carry a personal bag and a box of gloves in my trunk.  I use the gloves for all kinds of things from checking oil to cleaning dishes.  

I USED To carry my bag because my company required us to carry our own kits.  Then they got in trouble with the state for not giving us one so they gave us a bag which was literally a duffel and all of our crap shoved in it.  When enough people complained they got rid of those and went to regular "ems" bags.  I'd say that 50-70% of us still carry our own kits.  

Personally I carry my bag because I HATE the way the issued bags are laid out, I hate that if I use even the BP cuff I have to retag/inventory the entire bag, and most of all I hate the equipment we use, IE the cheapest stuff you can get.  

I keep an ALS sized bag (was a gift from my wife for passing paramedic class final) with BLS supplies.  Right now it's mostly empty   I keep airway supplies for adults, a neb kit with 2 albuterol, aspirin, supplies for 1 SQ epi injection, BVM, a trauma pad, some 4x4's, a couple things of roller gauze, an adjustable collar, some glucose, and BP cuffs/scope.

I do take my bag home with me (although we are provided with storage space) and when it's in my car I use it for myself, family, and friends.  If I ever stopped at an accident (which I've done maybe twice in 2 years) I grab some gloves in case of blood and that's about it.  In the city an ambulance/engine response is just a few minutes away and typically they are there before I've even finished giving information to dispatch.  

The biggest reason I can give though for carrying a bag is that I'm OCD about organization and my supplies.


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## Simusid (May 17, 2010)

I'm a recovering whacker.  I bought myself a Meret bag as a gift to myself after I passed EMT-B.  Now almost a year later I KNOW it is over the top and I never should have bothered.


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## mycrofft (May 17, 2010)

*Everyone goes a little whacker at first.*

In a similar vein, you should have seen and hefted my first iteration C.E.R.T. backpack. I yanked it up by the shoulder straps one day and they ripped out. That was without water or food.


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## TransportJockey (May 17, 2010)

my POV has a decently stocked kit. For me. I go offroad for 1-2 weeks at a time, and with a group. So what's in there is mine to use. I will not use it on anyone other than the offroad group I'm with either.


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## firecoins (May 17, 2010)

I carry my work supplies in a bag. That is my scope, my bp cuss, gloves, a flashlight and shears.  I have stopped at several serious accidents.  All I ever used were gloves.

I do carry my own flourscent vest and aspirin for personal use.


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## mycrofft (May 17, 2010)

*Here's a fresh perspective*

http://www.sandiego.org/article_set/Visitors/12/88
Dr Donner allegedly has worked on spacve shuttle medical kits.


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## foxfire (May 17, 2010)

I have two bags floating around. One has has the basic first aid stuff for family, friends and myself. This gets used quite abit.
The other bag have vet wrap, gloves, 2x2's, roll of paper towel, small bottle iodine,  peroxide, flyoff cream, rope, small surgical kit, gauze, and who knows what else.  

 I really don't see the point in carrying a bunch of junk for the "just in case" scenario. By The time it comes most of the stuff is worthless by then.


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## Dominion (May 17, 2010)

Simusid said:


> I'm a recovering whacker.  I bought myself a Meret bag as a gift to myself after I passed EMT-B.  Now almost a year later I KNOW it is over the top and I never should have bothered.



This is the same bag my wife bought me for passing my paramedic final.  As a BLS bag it's WAY over the top unless you're using them on the trucks as the 'state minimum' bags.  As an ALS kit though I like it much better than anything else I've seen other medics using at our service (except for maybe the Pacific bag but it's about 350$ or something ridiculous).

I've seen medics use the issued bag, I've seen them use a small first in with just one IV setup, a round of acls drugs, and BP/scope, and I've seen them carry a personal bag AND a small first in bag.  Just personal preference I guess.


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## mcdonl (May 17, 2010)

*Does it change when you are on duty with POV?*

Well, I am counting my chickens that have not yet hatched as my IPE's are Saturday, but I feel safe and confident with my skills and knowledge 

So, back to the topic. Picture a town of 5,000 people. I live on the very corner of the town, the rescue units are in the center of the town (About 8 minutes from me.....) and there is as much town on the "other" side of central station as well. So, when I respond as driver I typically go straight to the scene as I am the furthest person from the station on the department.

This will change when I am the licensed EMT responding. Right? We can't have an unlicensed driver showing up first. They are not even first responders. 

So, if the call is on the other side of town, and I have to drive past central, then the driver can get the rig ready to go and I will just hop in... but if the call is on my side of town, I would likely go direct to the patient. In this case, should I have a jump bag in my car? I do have a remote station with an engine that I am engineer of at the end of my driveway so I could grab that, and it would only take a minute. 

What would you do?


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## medicRob (May 17, 2010)

Veneficus said:


> Never carried one, never plan to.
> 
> Can't think of anything I would need it for. If I am doing CPR as a bystander, it is compression only.
> 
> ...



Quoted for the truth


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## Pneumothorax (May 17, 2010)

Veneficus said:


> Never carried one, never plan to.
> 
> Can't think of anything I would need it for. If I am doing CPR as a bystander, it is compression only.
> 
> ...


quoted for truth! ..but seriously..youre right haha.




bstone said:


> I have a CPR pocket mast with gloves on my keychain. That's all I carry.



mine stays in my glove box LOL!

i do have a first aid kit, a box of gloves (comes in handy when u have to touch nasty stuff like gas pumps ) and some asa/ibuprofen. all for myself/family in my car.


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## Melclin (May 17, 2010)

*What would you know Vene*

Seriously...I can't believe how uncaring you guys are. You're so burnt out. Since reading CPR for dummies and filling out the coupon on in the back for a free pocket mask, I wanna be prepared to use my medical skills for the betterment of human kind, so I carry:

- 26 hard collars.
- two identical packets of band aids...just in case one of them is faulty, I know I can rely on the back up in an emergency.
- my scanner, just in case someone needs me.
- my equipment belt complete with deluxe BVM holster (that cost extra off galls) and dual lumen glove pouch technology.
- aviator sun glasses. 
- a selection of pens: to the untrained eye...handy for writing but, but too those of us trained to act quickly in an emergency..BAM!.. pen cric.


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## firecoins (May 17, 2010)

I recently spent $30 on the NASA space pen just in case I have to write upside down, underwater, in space or upside down underwater while in space. 

My partner spent $0.88 and got a pencil.


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## MonkeySquasher (May 17, 2010)

Dominion said:


> I carry a personal bag and a box of gloves in my trunk.  I use the gloves for all kinds of things from checking oil to cleaning dishes.
> 
> Personally I carry my bag because I HATE the way the issued bags are laid out, I hate that if I use even the BP cuff I have to retag/inventory the entire bag, and most of all I hate the equipment we use, IE the cheapest stuff you can get.
> 
> The biggest reason I can give though for carrying a bag is that I'm OCD about organization and my supplies.



^ This.  First, the bags at work are crap.  Half are falling apart, and they're small bags with a large amount of crap shoved into them.  Also, they lack a couple things I feel they should have.

At my volly company, we don't have a BLS house bag.  Yes, that's right, no bag.  Yes, we had a crew recently walk in with only a stretcher and a bag with a BP cuff/steth/a few 4x4s in it, and it was a cardiac arrest, and it was a mad scramble to go back and get everything.  I try to avoid that embarrassment.

So, my bag does carry things like Adult/Ped BVMs, airways, etc..  Things for bleeding control, and yes, Adult/Ped collars.  I also carry a couple things that no one else seems important enough to carry, like a thermometer and a ring cutter.  Personally, I feel the most important part of my kit is the emesis bag, because I hate having to clean up puke.  Ironically, they always seem to miss the bag.  <_<

However, I can say that I can probably count on both hands the number of times I've actually used it in my personal life, and never more than a puke bag or a 4x4 and some tape.

I'm actually allowed, per my volly company, to carry ILS equipment.  IV supplies and King tubes, but no ETT, due to not having capnography handy.  I just see no need for any of that.  Outside of work/volly, I follow Veneficus' policy.


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## mcdonl (May 17, 2010)

MonkeySquasher;225051Outside of work/volly said:
			
		

> Ok, so it is reasonble then to have a jump bag if you are on duty for a volly service and may be first on scene, before the ambulance?


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## MonkeySquasher (May 17, 2010)

mcdonl said:


> Ok, so it is reasonble then to have a jump bag if you are on duty for a volly service and may be first on scene, before the ambulance?




Exactly.  I live 1000ft from the University we cover, where typical response time from our station (approx 5 miles away) to the University is around 5-15 minutes, depending on time of day, staffing, etc.  If the dispatch info sounds iffy-to-serious or the ambulance is already en route, I'll go right to the scene.

In just the last two years, just at the University, I've been first on scene (with equipment) for a cardiac arrest, 3 unresponsive ETOHs, a diabetic, a seizure, and an uncontrolled hemorrhage, among others.  I don't carry O2 or drugs, so I don't really count SOB/asthma calls, as there's not much I can do past diagnostics and positioning prior to ambulance arrival.

I'm also just down the road from the nursing/rehab facility where we only get called for 911s (but they call the paid service, with better response times, for non-emergent.  Go figure!)  So when we get a cardiac arrest there, I tend to go to the scene as well.  This is probably where my disdain for NH staff comes in, as I'm usually the one showing up and either correcting their actions, or pushing them out of the way to do something right.**

Sometimes it feels like they get paid more to end lives than I get paid to save them.  :unsure:  lol


**Disclaimer - I realize that not all nursing and NH/Rehab staff are horrible, and many are compassionate intelligent people who are very well trained and good at their jobs.


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## thatJeffguy (May 17, 2010)

Veneficus said:


> Never carried one, never plan to.
> 
> Can't think of anything I would need it for. If I am doing CPR as a bystander, it is compression only.
> 
> ...



Vene,

Usually your posts blow me away with their content and, I'm sad to say, this disappoints me a little bit.

I can tell that you're very intelligent and have a mind for this field.  Did you pick this field out of a hat?  Why not be an engineer, or an attorney, or a plumber?  Those all require mental aptitude, critical thinking and the ability to wrap your mind around a problem that might not have "textbook" answers.  Surely it's not the fantastic pay of EMS that attracted you, right?

I recently read an article about tourniquet use, pre-hospital, and it featured a gentleman who was at a rifle range when he caught a .30 caliber bullet through both thighs, severing the popliteal artery in one leg and the femoral in the other.  A tactical medic present said that it was the most blood loss he's ever seen.  Two responders that happened to be at the range applied tourniquets, improvised, and most likely saved this man's life.

  Surely you're not suggesting that you'd just ignore the dying person simply because you're not "on the clock"?  I find that to be ignoble and not keeping faith with the profession.  We HELP people, we're trained to HELP people.  I'm not saying you've got to stop at every car accident and spend four hours on scene, I'm not saying you've got to carry your trauma bag, AED and O2 bottle everywhere you go "just in case", but to think that you'd sit there and watch someone bleed to death, especially knowing that you could easily remedy the situation....  perhaps that mentality would work at McDonalds but I don't see it being applicable in the EMS field.

I'm just a basic EMT myself, but I try to be the most educated basic I can be.  I pay for classes out of my own pocket, I miss good shifts at my paying job to travel hours out of my way to take these classes, I purchase quality aid implements to carry in my "go-bag" and I feel that if I were present when "something bad happened", I'd be a bit more concerned than "Well I'm not making my thirteen dollars an hour, :censored::censored::censored::censored: that guy!".

Everyone else that supported Vene's mentality; why are you in this career?  The ability to earn a few bucks while ****ing around on the internet and not working?  Cool lights and sirens? Doesn't "helping people" come into play at some point?  

I'm thinking now of the airline jump kit thread and wondering what you folks would do in that situation; simply sit back and let someone die?  Are you really that much of an arrogant :censored::censored::censored::censored::censored: that you'd do that simply because you weren't "on the clock"?  

Not all of this is directed at Vene, just at that mentality in general.  The mindset of "Screw the family in the van that I just saw run off the road, I'm not earning the gargantuan sum that I do when I'm on duty so MF's can just die!" isn't one that I'm able to understand.

That said, I carry a decent trauma kit with me, including a blow-out kit and two tourniquets.  If I'm ever shot, hopefully some paramedic will be around, notice what I've got and not have rectal/cranial insertion disorder and actually be able to save my life.  I suppose if I were with friends and one of them were bleeding to death and unconscious, I just might throw a band-aid their direction as wll 

If you're looking for jobs that provide minimal training to minimally functional individuals and never require you to do anything;

http://www.mcdonalds.com/us/en/careers.html

Best of luck!


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## BLSBoy (May 17, 2010)

I have a legal plan that covers me on/off duty. 
I am a $hit magnet. Bad wrecks on fast highways that leave me alone for quite a while until FD/EMS gets there. 
The only thing that I have bought was my EMS bunker gear that I use at work, wrote off on my taxes, and have kept me VERY warm and dry during snow season. 

My bag, its contents, the ANSI Class II vest have all been paid for by agencies I work for. 
I don't stop at every since accident I see, nor do I do anything out of the scope of practice of a First Responder.


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## JPINFV (May 17, 2010)

thatJeffguy said:


> I recently read an article about tourniquet use, pre-hospital, and it featured a gentleman who was at a rifle range when he caught a .30 caliber bullet through both thighs, severing the popliteal artery in one leg and the femoral in the other.  A tactical medic present said that it was the most blood loss he's ever seen.  Two responders that happened to be at the range applied tourniquets, improvised, and most likely saved this man's life.



Here's a problem with that story and your argument. You don't need any sort of specialized equipment to make a tourniquet. Give me a shirt or rope and a cleaning rod (or really, anything similar, like a stick) and I can make one for you. 


> Everyone else that supported Vene's mentality; why are you in this career?  The ability to earn a few bucks while ****ing around on the internet and not working?  Cool lights and sirens? Doesn't "helping people" come into play at some point?



[YOUTUBE]http://www.youtube.com/watch?v=Aa9mNistHSs[/YOUTUBE]




> I'm thinking now of the airline jump kit thread and wondering what you folks would do in that situation; simply sit back and let someone die?  Are you really that much of an arrogant :censored::censored::censored::censored::censored: that you'd do that simply because you weren't "on the clock"?


Different situations makes this a non-sequitur. There's a big difference between rendering aid, especially care beyond first aid, when EMS is 5-10 minutes away (at most), and 30 minutes to an hour because you have to land the plane first. 




> Not all of this is directed at Vene, just at that mentality in general.  The mindset of "Screw the family in the van that I just saw run off the road, I'm not earning the gargantuan sum that I do when I'm on duty so MF's can just die!" isn't one that I'm able to understand.


Let's think about this one for a minute. How much gear do you really need to help a van off the road? Gloves and gauze at most since you shouldn't be extracting people from the van anyways. Hmm... supplies that most basic commercially available first aid kits have. Nothing special is really needed.


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## adamjh3 (May 17, 2010)

thatJeffguy said:


> Vene,
> (berevity)



Source: Dozens ignore man dying on NY street.



> It's a myth that we have to do this or do that. We have time off like everyone else. Unfortunately there is this misguided belief- the one outgrowth of volunteer EMS and fire services that I have a problem with- that if you don't live for the job, your heart is not in it. I give everything I have when I am on duty to anyone who crosses my path. The moment I am off duty, we play by the law and by my right to self-determination. One does not give that up the day you pass an EMT exam (at least in all but three or four states).
> 
> ...You don't live there anymore. Also correct me if I am wrong, but I do believe most countries with such regulations stipulate that simply seeking assistance for a person in need (read as: calling for help as you keep on trucking) is sufficient under the law. I don't believe any of them require someone to expose themselves to bloodborne pathogens or actually render direct patient care. My understanding of this was based on an incident I was involved with in rural France while visiting the country for a conference...


  (snippets taken from seperate posts.)

This sums up what I would say in response. This gentleman says it way better than I ever could.


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## emtstudent04 (May 17, 2010)

Now i feel bad. I don't carry anything in my truck and it has come to my attention and something i have thought about a lot lately, that maybe i should carry the basic necessities just in case an emergency does come before me. I think i would carry some gloves, safety glasses, a mask, pocket mask that i received from school and band aids and a bandage. Anything beyond that they better be going to the hospital in an ambulance or having a freind or family member taking them to the emergency room to sit for 3 hours for a broken arm (personal experiance).


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## thatJeffguy (May 17, 2010)

JPINFV said:


> Here's a problem with that story and your argument. You don't need any sort of specialized equipment to make a tourniquet. Give me a shirt or rope and a cleaning rod (or really, anything similar, like a stick) and I can make one for you.



Not that this detracts from your point, that being that it's not necessary to carry things which can be improvised, but the article in question was talking about how ineffective improvised tourniquets can be and the increased risk of localized tissue damage from said improvised tourniquets.  If the Spanish Windlass was so effective, combat medics wouldn't have invented SOFTT/CAT's etc.

http://www.tacmedsolutions.com/blog/?p=125  <-- the article in question








The belt tourniquet didn't work, the SOFTT did.  "Improvising", in this situation, would have caused this man to die (in the opinion of the on-scene medic, not me!).



> [YOUTUBE]http://www.youtube.com/watch?v=Aa9mNistHSs[/YOUTUBE]



How will ya impress chicks by driving past an accident? 



> Different situations makes this a non-sequitur. There's a big difference between rendering aid, especially care beyond first aid, when EMS is 5-10 minutes away (at most), and 30 minutes to an hour because you have to land the plane first.



True.  I'd say that my interventions would be, essentially, manage the ABC's until the ambulance arrived.  I'd also try for a PMH in case the patient lost consciousness before the ambulance arrived.  Obviously I don't necessarily need tools to do this, but they'd sure help.  If I drove past a MVC and later heard that the driver died of positional asphyxiation, or airway compromise due to the head being tilted forward and the tongue occluding the oropharynx, I'd know that I could have simply tilted his head and saved his life and I'd have to deal with that for the rest of my life.




> Let's think about this one for a minute. How much gear do you really need to help a van off the road? Gloves and gauze at most since you shouldn't be extracting people from the van anyways. Hmm... supplies that most basic commercially available first aid kits have. Nothing special is really needed.



I believe in preparedness.  I'd say that any bystander would get the basic "ABC's" dealt with, family and friends get a bit more and I carry gear in my kit (my blowout kit) that would allow a medic to decompress my chest, stop severe bleeding or obtain an airway.


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## thatJeffguy (May 17, 2010)

adamjh3 said:


> Source: Dozens ignore man dying on NY street.
> 
> (snippets taken from seperate posts.)
> 
> This sums up what I would say in response. This gentleman says it way better than I ever could.



I don't help people because I'm compelled by the law, I do it because it's the right thing to do.  Our job isn't like other jobs.  I'm a bartender but I don't  feel compelled to help a guy getting bad service when I'm out by pouring him a beer.  A IT specialist might not want to bounce around Starbucks on his personal time fixing people's Wi-Fi.  However, when you're trained to save a life, you should feel a *ethical compulsion* to do so if you can.  I'm not saying that people should be prosecuted for walking by an injured person, I'm very libertarian in my beliefs and don't like much government or legal intervention at all, I'm simply wondering how someone can be drawn to a field in which we help people, then not want to do that when presented the chance.


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## TransportJockey (May 17, 2010)

thatJeffguy said:


> I don't help people because I'm compelled by the law, I do it because it's the right thing to do.  Our job isn't like other jobs.  I'm a bartender but I don't  feel compelled to help a guy getting bad service when I'm out by pouring him a beer.  A IT specialist might not want to bounce around Starbucks on his personal time fixing people's Wi-Fi.  However, when you're trained to save a life, you should feel a *ethical compulsion* to do so if you can.  I'm not saying that people should be prosecuted for walking by an injured person, I'm very libertarian in my beliefs and don't like much government or legal intervention at all, I'm simply wondering how someone can be drawn to a field in which we help people, then not want to do that when presented the chance.


I do not and will not feel any compulsion to help if it places me in danger. If someone is bleeding out, and I have PPE and am the only sucker there I will help. But I'm not gonna touch some guys blood without gloves. Screw that. I'm more important than any patient. And if that's not taught since day one in your EMT class, your instructor is an idiot. Scene safety first. That means your safety


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## thatJeffguy (May 17, 2010)

jtpaintball70 said:


> I do not and will not feel any compulsion to help if it places me in danger. If someone is bleeding out, and I have PPE and am the only sucker there I will help. But I'm not gonna touch some guys blood without gloves. Screw that. I'm more important than any patient. And if that's not taught since day one in your EMT class, your instructor is an idiot. Scene safety first. That means your safety





Scene safety?  I agree completely, but we're not talking about that. I wouldn't rush into a firefight to apply a band-aid, but we're talking about people that feel that it's not their "job" to help a wounded or medically critical person and think it's absurd to carry materials necessary to do that.   I mean, we're talking here about *WHAT DO YOU CARRY* and the first thing you said is that "without gloves..." you wouldn't do anything.

Well, if you're open to suggestions, how about you *carry* a few pairs of Nitrile gloves with you?  I ALWAYS have two pair in my pocket, even when I'm at my fancy cushy bartending job.  

Again though, I see your point here.  If my father gets shot in the  chest and I don't have gloves, he's getting a bare hand to cover his sucking chest wound.  If a stranger gets shot in the chest, I'll advise his friends or family on what to do.  I'd never advocate putting yourself in danger *for a stranger*, as for family... that's up to you 

I suppose living in a rural area and being an active outdoorsman has given me a different perspective.  I've done all sorts of things from bandaging a minor boo-boo on canoe trips (which probably helped more with the childs mental state than anything else) to putting quick pressure on a deep distal forearm laceration in the backcountry.  I like to be prepared for those situations and while I feel that KNOWLEDGE is the number one means of preparedness I don't mind carrying a pound of kit with me for that purpose.


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## adamjh3 (May 17, 2010)

jtpaintball70 said:


> I do not and will not feel any compulsion to help if it places me in danger. If someone is bleeding out, and I have PPE and am the only sucker there I will help. But I'm not gonna touch some guys blood without gloves. Screw that. I'm more important than any patient. And if that's not taught since day one in your EMT class, your instructor is an idiot. Scene safety first. That means your safety



^+1. What about all the people that I _won't_ help after I get Hep C or get struck by a semi on the side of the freeway? Off the clock it's my family, my friends, myself, and then the patient(s).

By the way, I do carry a pair of gloves in my pocket. Never used them, hope I never have to.


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## Veneficus (May 17, 2010)

thatJeffguy said:


> Surely it's not the fantastic pay of EMS that attracted you, right?



My journey through public safety and later medicine has been ever evolving. At no point has it been the money.



thatJeffguy said:


> I recently read an article about tourniquet use, pre-hospital, and it featured a gentleman who was at a rifle range when he caught a .30 caliber bullet through both thighs, severing the popliteal artery in one leg and the femoral in the other.  A tactical medic present said that it was the most blood loss he's ever seen.  Two responders that happened to be at the range applied tourniquets, improvised, and most likely saved this man's life.?



I think you may be superimposing what I said onto a very abnormal situation, which would call for measures beyond the commonplace situations I was thinking when I replied. I am quite clever, and I really don't need a bunch of commerical equipment to render aid. I would be willing to bet I could stop esophageal hemorrhage with a party baloon. But it doesn't mean I keep a stash of them for just such an event.



thatJeffguy said:


> Surely you're not suggesting that you'd just ignore the dying person simply because you're not "on the clock"?  I find that to be ignoble and not keeping faith with the profession.



I never suggested I would not help a person in a particularly unforseen event where I thought it could be done safely. Because of the innumerable events possible or even imaginable, I could not hope to detail all of my potential responses. What I consider "safe" is both situation dependent and probably not what most would. 




thatJeffguy said:


> We HELP people, we're trained to HELP people.  I'm not saying you've got to stop at every car accident and spend four hours on scene, I'm not saying you've got to carry your trauma bag, AED and O2 bottle everywhere you go "just in case", but to think that you'd sit there and watch someone bleed to death, especially knowing that you could easily remedy the situation.....



I don't usually find myself in the position where my aid is needed. I have rendered aid in the past and have no problem with offering assistance in the future. But I reserve the right to decide what is "safe" intervention based on the circumstances.



thatJeffguy said:


> perhaps that mentality would work at McDonalds but I don't see it being applicable in the EMS field.



I think you may be superimposing my thoughts of not needing to carry equipment with me to not providing aid. I mentioned about direct pressure because it does stop most bleeding. If I were to make that attempt and it did not, I would review the situation and act accordingly. 

I also don't consider a tq, an invasive measure. It was a basic skill when I went to EMT class. (it is also just focal pressure) But if somebody had a simple laceration, I would probably instruct them on how to clean and dress it so they could go to get it properly taken care of if it required suturing. No I am not going to suture it when not acting in some official capacity either paid or volunteer.



thatJeffguy said:


> I'm just a basic EMT myself, but I try to be the most educated basic I can be.  I pay for classes out of my own pocket, I miss good shifts at my paying job to travel hours out of my way to take these classes,



I am no longer a basic EMT, my education will go on as long as I live, I have also paid dearly for it both is dollars (in the sum of hundreds of thousands) and in time.(a little over 2 decades)  I have traveled to 4 countries outside of North America to provide care, 3 at my own expense and volunteering months of time. If you read the aircraft thread, I do offer to help when the need arises. I also do not accept reward for it. I do not see the need to purchase or carry personal gear.



thatJeffguy said:


> I purchase quality aid implements to carry in my "go-bag" and I feel that if I were present when "something bad happened", I'd be a bit more concerned than "Well I'm not making my thirteen dollars an hour, :censored::censored::censored::censored: that guy!".



You would work for $13 an hour? just kidding  needed to lighten things up a little. Really though, I love what I do, it is a privilege and I cannot always believe I get paid for it.  



thatJeffguy said:


> Everyone else that supported Vene's mentality; why are you in this career?  The ability to earn a few bucks while ****ing around on the internet and not working?  Cool lights and sirens? Doesn't "helping people" come into play at some point?



I just thought being a fireman was cool.  Again, the ability to render aid is completely seperate from carrying gear. I stand by the position, I am not rendering invasive aid outside of my work environment. (with exception of a major catostrophic event) I am using the airport, the school's or the mall's AED. The aircraft medical kit, or the materials available on hand. There is more than enough compelling evience of the effectiveness of compression only CPR for me not to find benefit putting my lips on somebody or carrying a pocket mask.




thatJeffguy said:


> I'm thinking now of the airline jump kit thread and wondering what you folks would do in that situation; simply sit back and let someone die?  Are you really that much of an arrogant :censored::censored::censored::censored::censored: that you'd do that simply because you weren't "on the clock"?



Read my post there. Aid was asked for and aid was rendered. Even after it was apparent it was not a life or death emergency. I will be on a transatlantic flight again ths month if somebody asks for help, they will be helped in an appropriate way. But I can tell you, in all of my considerable travels, I have only ever been in the situation once where aid was even asked for on a plane. (I fly across the pond an average of 4 times a year)  



thatJeffguy said:


> Not all of this is directed at Vene, just at that mentality in general.  The mindset of "Screw the family in the van that I just saw run off the road, I'm not earning the gargantuan sum that I do when I'm on duty so MF's can just die!" isn't one that I'm able to understand.



Actually I stopped at an accident once as well. Which also turned out to be nothing, but it did look impressive. It is not about work or pay, but honestly I can recall every instance where I was not working and somebody required or even requested aid. In all of those instances I offered. Most of them were not serious and the only one that was, after I performed the heimlich, I sat down and finished my dinner after. (and paid the cheque in full) 



thatJeffguy said:


> That said, I carry a decent trauma kit with me, including a blow-out kit and two tourniquets.  If I'm ever shot, hopefully some paramedic will be around, notice what I've got and not have rectal/cranial insertion disorder and actually be able to save my life.  I suppose if I were with friends and one of them were bleeding to death and unconscious, I just might throw a band-aid their direction as wll .



I was never a boy scout. I guess I wouldn't have been very good at it. I don't leave the house expecting to get shot, hit by a car or any other ill form of fate. I also have only 3 or 4 friends who are not physicians, (or very close to becomming one)  or emergency workers of some sort. (LE, medics,firefighters, ER nurses, etc) generally they don't need a lot of input or care when we hang out. For my friends (who are equal to my family), you cannot imagine the lengths I would go. I just never need to.



thatJeffguy said:


> If you're looking for jobs that provide minimal training to minimally functional individuals and never require you to do anything;
> 
> http://www.mcdonalds.com/us/en/careers.html
> 
> Best of luck!



It is a running joke in my circle to find the job with the least responsibility. I got Mcds beat soundly. I saw on TV a guy in Australia who makes a living sitting on the beach with a wagner powerpainter charging $10 a person to "paint" them with sunscreen. 

My rendering aid (both at work and as a volunteer) has also taken the form of some rather unpleasant tasks that most US EMS workers will never experience. 

There is no way to feel like a hero when you tell a teenage sex worker at the free clinic you volunteer (as in miss time with friends and family and don't get paid) she tested HIV positive and then procede to form a care plan knowing it is not the best because the economic resources are not there and educating her on her disease. There is no way to magically "save her life." 

It is not as glorious as say pulling a BVM out of your pack and ventilating somebody.


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## Veneficus (May 17, 2010)

thatJeffguy said:


> Not that this detracts from your point, that being that it's not necessary to carry things which can be improvised, but the article in question was talking about how ineffective improvised tourniquets can be and the increased risk of localized tissue damage from said improvised tourniquets.  If the Spanish Windlass was so effective, combat medics wouldn't have invented SOFTT/CAT's etc..



Whoever put that belt on should have known it was not going to work. That was not good improvising.

The very tennant of damage control surgery is to save life prior to worrying about recovery. 

Both the online trauma forums and several surgical publications have detailed preventable fatalities trying to "preserve function and quality of life" in professional sports figures and other highly active or public persons instead of standard procedures that would have resulted in incomplete recovery.


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## Sasha (May 17, 2010)

I carry a trauma bag so i have an excuse to cut off hot guy's clothes


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## mycrofft (May 17, 2010)

*Thanks for getting us back on subject, finally.*

And five is four, we always slide back into the "I'm not gonna treat people on my own time" quagmire. Sheesh.

Sasha, Sasha, Sasha...just go buy those xray glasses they advertise in Popular Science!


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## firecoins (May 17, 2010)

Sasha said:


> I carry a trauma bag so i have an excuse to cut off hot guy's clothes



I am sure you can get him out faster w/o.


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## JPINFV (May 17, 2010)

thatJeffguy said:


> Not that this detracts from your point, that being that it's not necessary to carry things which can be improvised, but the article in question was talking about how ineffective improvised tourniquets can be and the increased risk of localized tissue damage from said improvised tourniquets.  If the Spanish Windlass was so effective, combat medics wouldn't have invented SOFTT/CAT's etc.


If I'm applying a tourniquet as a bystander, it's because I think the patient is going to die otherwise. Similarly, I hardly see that article saying that everyone should have a tourniquet in their vehicle just in case. There's a very big difference between having the proper equipment because it's either your job (i.e. medical providers when on duty) or because there's a general expectancy of exposure (i.e. law enforcement officers, who are the targeted population in your link).


The belt tourniquet didn't work, the SOFTT did.  "Improvising", in this situation, would have caused this man to die (in the opinion of the on-scene medic, not me!).

Similarly, that's not how you improvise a tourniquet. 
A belt would not hold a candle to:










> How will ya impress chicks by driving past an accident?


First off, "chicks dig it" is my canned response to the "no true Scotsman" fallacy that get's thrown around all too often in EMS. 

Second, phone, 911, not dieing from getting struck by passing vehicles. Now, depending on where the accident is, I may stop. There's a big difference between, say, the 5 in the middle of Camp Pendalton and the 5 at, say, the 5-405 interchange. 

To give you an idea: Camp Pendalton is the big area at the bottom of the map of nothingness. The 5/405 is in a highly populated area. 
http://maps.google.com/?ie=UTF8&ll=33.500179,-117.614136&spn=0.538227,1.234589&z=10

In one area, by the time I call 911, pull over, walk up, and form even a basic scene safety assessment, the fire department will already be pulling up. The other, should be fairly obvious... 




> True.  I'd say that my interventions would be, essentially, manage the ABC's until the ambulance arrived.  I'd also try for a PMH in case the patient lost consciousness before the ambulance arrived. * Obviously I don't necessarily need tools to do this, but they'd sure help. * If I drove past a MVC and later heard that the driver died of positional asphyxiation, or airway compromise due to the head being tilted forward and the tongue occluding the oropharynx, I'd know that I could have simply tilted his head and saved his life and I'd have to deal with that for the rest of my life.



1. Bolded for emphasis.
2. You don't need tools for a PMH. You don't need tools outside of gloves to provide inline stabilization.
3. PMH is going to be asked again by... well... everyone involved in the chain of care including just about everyone at the hospital anyways... 



> I believe in preparedness.  I'd say that any bystander would get the basic "ABC's" dealt with, family and friends get a bit more and I carry gear in my kit (my blowout kit) that would allow a medic to decompress my chest, stop severe bleeding or obtain an airway.



Why don't you go big or go home?

http://www.zombiehunters.org/forum/viewtopic.php?f=43&t=33826


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## Sasha (May 17, 2010)

mycrofft said:


> And five is four, we always slide back into the "I'm not gonna treat people on my own time" quagmire. Sheesh.
> 
> Sasha, Sasha, Sasha...just go buy those xray glasses they advertise in Popular Science!



Silly mycrofft, you can't palpate with xray glasses. Excuse me sir, I must check your abs for abnormal masses.


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## emt_irl (May 17, 2010)

i thought you meant on the ambulance.. i prefair my own bag and have it stocked up to use when on the ambulance or staged somewhere then take it home with me and leave it locked in the boot(trunk) of the car i wouldnt call myself a whacker but i do have a small ems star of life sticker on the front window(mainly for parking reasons) next to the 3 other discs we have to display in ireland(insurance, road tax and road worthy test) i have driven past many a mvc without a second though, and id only consider breaking it out for a family member or friend if needed. Although i wouldnt go looking for trouble/ accidents etc but if i came upon something serious and i was going to be stuck there anyways in traffic or had to walk right by/over them etc id probally stop to help.

ive a stat packs load n go bag to give you the idea of size and is filled with trauma and bls equipment


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## usafmedic45 (May 17, 2010)

> I was kinda weirded out by the fact that you could even apply them as an EMT.
> 
> I could understand why VFD would have them, though.



In some jurisdictions, including one I used to run in, we were issued jump kits and AEDs (thanks to a grant from one of the local residents who had more money than she knew what to do with).  Those of us who were ALS qualified were also issued drug boxes we could exchange out with the county ambulance crews when they showed up (the ambulances carried an EMT-I level drug box and an EMT-P level drug box so that staffing could vary depending upon whether the unit in question was a first out truck (EMT-P) or backup (EMT-I)).  We were expected to respond POV because in a lot of cases we were able to get to the scene before someone could get to station and get the truck.  




> The belt tourniquet didn't work, the SOFTT did. "Improvising", in this situation, would have caused this man to die (in the opinion of the on-scene medic, not me!).



You're right.  Most people can not produce enough pressure to stop bleeding in the case of an improvised tourniquet, mostly because of a lack of familiarity with the windlass technique.  The article I mention below relates a case of why improvisation, especially by the untrained bystander is a bad idea:


> However, the safest approach in the case of the marginally trained and inexperienced person with basic first aid training is probably to rely upon simple direct pressure or basic forms of pressure dressing. This is due to a lack of evidence that such persons can effectively recognize the need for a tourniquet and properly apply such a device- especially given the likely need to improvise under such circumstances. [9,62] This last point is illustrated by a case of femoral artery transection by broadhead arrow as the result of a deer hunting accident to which the author responded as an emergency medical technician. The victim's nephew had attempted to place a tourniquet made from the victim's belt prior to going for help. The patient was deceased due to blood loss at the time of the arrival of the author and his coworkers. It was determined that the bystander had improperly placed tourniquet distal to the injury and with insufficient force to be of any utility even if it were in a proper position.



The two referenced articles by the way (9, 62) are, respectively: 
Rocko JM, Tischler C, Swan K:  Exsanguination in public – a preventable death. Journal of Trauma 1982, 22:635.
National First Aid Science Advisory Board:  First aid. Circulation 2005, 112:196-203.

BTW, if the guy was so critical, does anyone else think it odd that he sitting up, or at least in something approaching a low Fowler's?



> If I'm applying a tourniquet as a bystander, it's because I think the patient is going to die otherwise.



...or if you have something more pressing to do (airway, etc)?

May I suggest a review of tourniquet use that is up to date?  http://wjes.org/content/2/1/28 


> Based upon the best evidence available from the literature, the following conclusions are drawn:
> 
> - Emergency medical personnel, both civilian and military, should be trained in and equipped for the proper use of tourniquets; the focus of first aid training for civilian populations should continue to deemphasize their use and focus instead on early medical assistance and the use of direct pressure to control hemorrhage.
> 
> ...





> If the Spanish Windlass was so effective, combat medics wouldn't have invented SOFTT/CAT's etc.



Please get your facts straight.  The CAT was actually designed to be applied by wounded persons under fire, which might require placing it on one of their arms.  The windlass technique is effective but it, unfortunately is not something that can be done one handed.  There was a comparison between the CAT and SOFFT a few years back and several other tourniquet models in utility in self-application and while the CAT and SOFFT both achieved 100% (as opposed to 77-88% occlusion), keep in mind that we are not talking about the scenario depicted in that study.  (Walters TJ, Wenke JC, Kauvar DS, McManus JG, Holcomb JB, Baer DG: Effectiveness of self-applied tourniquets in human volunteers. Prehosp Emerg Care. 2005 Oct-Dec;9(4):416-22).  I do agree that they are a wonderful tool and encourage anyone who is going to be packing a first aid kit to have at least two of them in it.  They have a place on every ambulance. My preference is towards the CAT but that is mostly due to my familiarity with and prior use of it.


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## usafmedic45 (May 17, 2010)

The dreaded double post!


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## Pneumothorax (May 17, 2010)

Melclin said:


> Seriously...I can't believe how uncaring you guys are. You're so burnt out. Since reading CPR for dummies and filling out the coupon on in the back for a free pocket mask, I wanna be prepared to use my medical skills for the betterment of human kind, so I carry:
> 
> - 26 hard collars.
> - two identical packets of band aids...just in case one of them is faulty, I know I can rely on the back up in an emergency.
> ...



only 26? why not 30? might have a full church bus accident u have to triage 



jtpaintball70 said:


> I do not and will not feel any compulsion to help if it places me in danger. If someone is bleeding out, and I have PPE and am the only sucker there I will help. But I'm not gonna touch some guys blood without gloves. Screw that. I'm more important than any patient. And if that's not taught since day one in your EMT class, your instructor is an idiot. Scene safety first. That means your safety


exactly. if u get an infectious disease or hit by a semi truck what good are u to that patient? LOL.



Sasha said:


> I carry a trauma bag so i have an excuse to cut off hot guy's clothes



too much work, just cut them off and say... trust me im a trained medical professional


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## JPINFV (May 17, 2010)

Pneumothorax said:


> too much work, just cut them off and say... trust me im a trained medical professional









Yes... I have a similar shirt actually.


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## medichopeful (May 17, 2010)

JPINFV said:


> Why don't you go big or go home?
> 
> http://www.zombiehunters.org/forum/viewtopic.php?f=43&t=33826



Do you know where I can buy that?  I feel I could do a lot of good and save a lot of lives at every scene I come across :wacko:


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## firecoins (May 17, 2010)

usafmedic45 said:


> The dreaded double post!


The Dreaded Pirate Roberts!
http://joeindie.com/blog/images/tj200703181935-1.jpg


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## Melclin (May 17, 2010)

mycrofft said:


> http://www.sandiego.org/article_set/Visitors/12/88
> Dr Donner allegedly has worked on spacve shuttle medical kits.



With the exception of the "full size SAM splint" I like her suggestions. quite practical, and something you could easily tuck into your glove box. 

I used to have a first aid kit in my car, that was mostly for hangover curing (disolvable aspirin, berocca and a liberal helping of sodium bic, co-administered with a large plate of lasagne - best cure ever). I found though that everyone else kept nicking stuff out of it, so I stopped restocking it. 

I do have alcohol swabs in my wallet, mostly for when I've touched something disgusting, but they come in handy for everything. Cleaning glasses, cuts, got some permanent marker of a whiteboard at uni, fixed my cousin's blackberry with some swaps once.


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## usafmedic45 (May 17, 2010)

adamjh3 said:


> Source: Dozens ignore man dying on NY street.
> 
> (snippets taken from seperate posts.)
> 
> This sums up what I would say in response. This gentleman says it way better than I ever could.


You're welcome.   I can see you don't agree with my stance, but do you think it makes me a bad person simply because I don't believe we are beholden to endanger ourselves? Key phrase here: "endanger ourselves"...if I can do it safely, in keeping with the accepted practices of our profession, then I will help.  If not, then I am simply another passerby with a cell phone.  It is not a matter of "I don't help when off duty", it's a matter of "I don't endanger myself as a standard practice, on or off duty"  Any problem with that?


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## usafmedic45 (May 17, 2010)

> I don't help people because I'm compelled by the law, I do it because it's the right thing to do.


Same here.  Well, the paycheck doesn't hurt my desire to show up to work either. LOL



> Our job isn't like other jobs.



No, it isn't.  It's like a LOT of other jobs, but not all of them.  But then again, being an electrician and waitress don't have a whole hell of a lot in common with each other either....



> However, when you're trained to save a life, you should feel a ethical compulsion to do so if you can.


We are trained from the first day of class to not endanger ourselves in the name of "saving a life".  Ethical compulsions or not, our first responsibility is always to ourselves.  BTW, once people start telling me how I should _feel_ about something, I begin to question what agenda they are trying to advance and generally start tuning them out, especially when it involves risking my life or decreasing the balance in my bank account.



> A IT specialist might not want to bounce around Starbucks on his personal time fixing people's Wi-Fi.



He's also not risking his life by helping those people out.  Learn to pick better examples. 



> I'm simply wondering how someone can be drawn to a field in which we help people, then not want to do that when presented the chance.



Amazingly, some of us are actually *pauses to allow shocked gasping* in it for a paycheck.  Well, maybe not EMS, but health care in general.  It's a job just like anything else.  

The difference you are missing, that is leading to this idea that we do not want to help whenever the opportunity presents itself, is that some of us- most of us, it seems- are not willing to die simply because a minority of us (mostly the newbies and the emotionally and academically vacuous amongst us) think we are some how more beholden to offer ourselves as sacrificial lambs at some imagined altar.  Calling 911 and staying safe while doing so is helping.  It's better than the alternative which is walking away and not doing a damn thing about something that does not concern or even involve me.


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## usafmedic45 (May 17, 2010)

> Well, if you're open to suggestions, how about you carry a few pairs of Nitrile gloves with you? I ALWAYS have two pair in my pocket, even when I'm at my fancy cushy bartending job.



Do that for a few shifts then take them and fill them with water.  Chances are you'll find leaks in them.  Gloves, especially nitrile, don't hold up well to friction, heat and other abuses that they encounter in pockets.  The patient is going to benefit far more from that space being taken up by a cell phone than by a couple pair of gloves.


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## LucidResq (May 17, 2010)

firecoins said:


> I do carry my own flourscent vest and aspirin for personal use.



I know this is digging back, but it's a good point. Several of us have mentioned a willingness to, in a serious accident, call 911 and then perhaps hold c-spine or jaw-thrust... I have a traffic vest that was issued to me and I do keep it in my trunk. I have never used it, but if I were to decide to assist at an accident as described, I would definitely be wearing it. 

Hopefully I would actually have gloves... I tend to steal gloves from my car to dye my hair or pick up dog poop in the yard. 

Random whacker story... did I ever tell you about the time I argued with one because he was adamant that the service he vollied for carried *50%* lidocaine.... for parenteral use (not that the idea of such an amount of lidocaine for topical use isn't equally insane...).

It's one thing to tell a stupid person that they're wrong (even offering, do you mean 0.5%.... maybe?!), it's an entirely different thing when you explain to them all the reasons they're wrong and they won't stop freaking arguing with you that they're right....

Had to get that off my chest. Sorry.


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## EMTNJA (May 18, 2010)

*First and only aid*

I have a larger first aid kit that stays at home for use on the family...for those times that it's past band-aid stage, but I don't need to call for an Engine, Rescue, and a trip to the ER...like today my kid brother getting a fairly good laceration on his hand. It's handy to have the stuff around.

When I'm not on duty I usually just have some gloves, trauma pads, and cpr mask in the car...for the rest of the world.


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## Hal9000 (May 18, 2010)

LucidResq said:


> the service he vollied for carried *50%* lidocaine....


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## mycrofft (May 18, 2010)

*Belt as tourniquet*

1. You need a belt that will clinch at the right length and not stretch or snap.
2. You need to leave a generous fist's space of slack, not cinch it down, then secure it to length (close the buckle). A 1.5 inch web belt is better because you won't have to cut a new hole for the wimpy buckle tongue.
3. The handle for the windlass has to be substantial, not a popsicle stick, and long enough to exert enough torsion, then get secured in place.
4. You need to apply enough torsion to stop arterial flow or it can make it bleed somewhat worse. This will cause the patient excruciating pain. Many folks will not do it.
5. The handle may not be parallel with the limb when it has enough torsion. You will need to find a practical way to secure it, or _crank it *up*_ enough so it is parallel with the limb.
6. Then you need something to tie it in place.

All this while the pt is bleeding out, and usually in the dark, the rain, under fire, running from the toxic cloud, whatever.

How did we slip back onto tourniquets from why we carry kits?? _Mea culpa, cinco es quatro._


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## mycrofft (May 18, 2010)

*A better question:*

"Does you first aid kit that stays at home compare to your jump kit?".


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## usafmedic45 (May 18, 2010)

> It's one thing to tell a stupid person that they're wrong (even offering, do you mean 0.5%.... maybe?!), it's an entirely different thing when you explain to them all the reasons they're wrong and they won't stop freaking arguing with you that they're right....


:deadhorse:
Welcome to my entire existence on this forum.   :beerchug:


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## firecoins (May 18, 2010)

LucidResq said:


> I know this is digging back, but it's a good point. Several of us have mentioned a willingness to, in a serious accident, call 911 and then perhaps hold c-spine or jaw-thrust... I have a traffic vest that was issued to me and I do keep it in my trunk. I have never used it, but if I were to decide to assist at an accident as described, I would definitely be wearing it.
> .



I have the vest in case I need to be on the a highway or road for any reason like my car breaking down.  I have stopped at major car accidents but not any in 3 years.


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## usafmedic45 (May 18, 2010)

mycrofft said:


> 1. You need a belt that will clinch at the right length and not stretch or snap.
> 2. You need to leave a generous fist's space of slack, not cinch it down, then secure it to length (close the buckle). A 1.5 inch web belt is better because you won't have to cut a new hole for the wimpy buckle tongue.
> 3. The handle for the windlass has to be substantial, not a popsicle stick, and long enough to exert enough torsion, then get secured in place.
> 4. You need to apply enough torsion to stop arterial flow or it can make it bleed somewhat worse. This will cause the patient excruciating pain. Many folks will not do it.
> ...


Actually the last thing you want in a tourniquet is something as rigid as leather.  Not to mention the tendency of smooth surfaces to slip when you are dealing with a blood-covered extremity.



> I have the vest in case I need to be on the a highway or road for any reason like my car breaking down.


+1.  Same here.  I keep the raincoat I was issued by the VFD in the back of my POV for just such an occurrence.


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## mycrofft (May 18, 2010)

*Rich Corinthian leather.*

B)

Most buckles and snaps tend to fail also, they need to be on the side, not around the handle.
Maybe a strap-type oil filter wrench with a ratchet...


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## usafmedic45 (May 18, 2010)

> Rich Corinthian leather.



What a waste of good craftsmanship....

As a side note, most people don't realize the amount of pressure it takes to compress a femoral artery.  I have a very distinct and clear memory of kneeling on a Marine's thigh wound because it took almost my full body weight (185 lbs at the time) to compress enough to staunch the bleeding.  The guy had legs like tree trunks and even someone in peak physical condition like I was (275 lb bench press, held the base pushup record at the time, etc) I couldn't push hard enough with my hands.  

While it's an extreme example, it still makes a point that we need to be prepared for more than what we expect.


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## mycrofft (May 18, 2010)

*We need realistic training.*

We're way off kits, but they are part of the Wonderland mindframe. Bring in a bone-in ham and a pressure transducer and have trainees try to get enough torsion on it.
We have trained four generations of EMS workers to dress, TK and splint forearms.

How'd that thigh compression work for you? Was the pt helpful??

Oh, and about using dental floss....


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## adamjh3 (May 18, 2010)

usafmedic45 said:


> You're welcome.   I can see you don't agree with my stance, but do you think it makes me a bad person simply because I don't believe we are beholden to endanger ourselves? Key phrase here: "endanger ourselves"...if I can do it safely, in keeping with the accepted practices of our profession, then I will help.  If not, then I am simply another passerby with a cell phone.  It is not a matter of "I don't help when off duty", it's a matter of "I don't endanger myself as a standard practice, on or off duty"  Any problem with that?



I'm not sure if that was directed at me, but I DO agree with your stance 100%. That's why I quoted you. My safety comes before everyone else, unless for some weird reason putting myself in danger will significantly benefit (i.e. result in them not dying vs. dying) my family and a select few friends. But I really can't see any situation where that would happen.


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## usafmedic45 (May 18, 2010)

adamjh3 said:


> I'm not sure if that was directed at me, but I DO agree with your stance 100%. That's why I quoted you. My safety comes before everyone else...


Ah...just making sure.  I've gotten quite a few nasty PMs from (mostly) newbies on this site about my posts in the thread you quoted from, so I figured I would ask.



> unless for some weird reason putting myself in danger will significantly benefit (i.e. result in them not dying vs. dying) my family and a select few friends. But I really can't see any situation where that would happen.



Never say never.  I never thought I would be staring down the throat of my best friend as he coded, but it happened.  I have worked on more family members and friends than I am comfortable admitting to.  That is the price one pays working in EMS, soon or later, it always gets personal and it hurts when it does.


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## adamjh3 (May 18, 2010)

It's unfortunate that people see your level-headedness (is that a word?) as a negative trait. Not to be a brown-noser but you're one of a few people I definitely look up to on this board. 

As far as friends and family, all I can say is I'm not looking forward to when that day comes.


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## TransportJockey (May 18, 2010)

usafmedic45 said:


> Ah...just making sure.  I've gotten quite a few nasty PMs from (mostly) newbies on this site about my posts in the thread you quoted from, so I figured I would ask.



I'm glad that they leave me alone and put all their anger towards you


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## usafmedic45 (May 18, 2010)

> Not to be a brown-noser but you're one of a few people I definitely look up to on this board.



Thank you.  It's nice to know that I'm beating my head against a wall for the benefit of a few.



> It's unfortunate that people see your level-headedness (is that a word?) as a negative trait.



It's viewed as being:
-cold
-unfeeling
-a son of a *****
-brutal
-callous
-nasty
-despicable

...and those were just the words used by one person to describe me!  I liked the other person who accused me of having ice water coursing through my veins.  They got really upset when I replied with "Well now, I guess that explains why my hands are also so cold! Thanks Chief!"   

Granted, I may be a little callous and not prone to letting my emotions (other than anger and frustration) get the better of me, but it doesn't mean I don't have concern for my fellow man.  I just happen to believe in a hierachy of social "value" (for lack of a better or, at least, more polite way to describe it) based on how much one gives to society as balanced by what they take from it.  That seems to rub a lot of people the wrong way.



> As far as friends and family, all I can say is I'm not looking forward to when that day comes.



When it does, you know I'm more than happy to provide a (believe it or not) empathetic ear.


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## usafmedic45 (May 18, 2010)

> I'm glad that they leave me alone and put all their anger towards you



Squeakiest wheel gets the grease first, I guess.  LOL


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## Melclin (May 18, 2010)

*We have a word for people like you *

woops sposed to be in PM


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## Trayos (May 18, 2010)

I feel as long as somebody has a rational decision making process on whether to render care outside of work, they are fully entitled to do as much or as little as they please. 
$0.02


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## thatJeffguy (May 19, 2010)

I'll address some of the things I've read here and attempt to clarify some things I've said;

First off, I never said and *advocate against* placing yourself in danger.  Any opinions I offer, advice I give or suggestions I toss out all are predicated by the understanding that "THE SCENE IS SAFE.", or at least as safe as one can make it.

I think that some of us might be speaking of different terms here as well.  The medical gear that I carry is mainly to be used on myself or my friends or family members.  I'm not carrying a special aide bag specifically for the purpose of responding to a scene as an EMT-b.  A number of activities that I undertake involve a combination of items with potential danger (firearms, specifically) and being far away from the EMS system (backcountry hiking, canoeing, etc).  I believe that either of those two things individually should be enough to provoke an individual into carrying at least a basic first aid kit, it not a trauma kit geared towards self-aid.  

The majority of the contents of my kit aren't geared specifically towards serious trauma.  My "blow out" kit and tourniquets are about the only trauma-specific things in the bag.  Kerlix, tape, gauze, occlusives, blister-pads, band-aids, OTC medications, syringes (for irrigation)... all can be used for minor injuries or complications.

If you feel OK with yourself driving past an accident, or if you'd witness an individual being injured and not intervene, that's on you.  I think we can all agree that we're not going into a dangerous scene.


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## Fox (May 20, 2010)

melclin said:


> - aviator sun glasses.
> - a selection of pens: To the untrained eye...handy for writing but, but too those of us trained to act quickly in an emergency..bam!.. Pen cric.



:3


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## Fox (May 20, 2010)

firecoins said:


> I recently spent $30 on the NASA space pen just in case I have to write upside down, underwater, in space or upside down underwater while in space.
> 
> My partner spent $0.88 and got a pencil.



Got mine for $12 in bootcamp!


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## Fox (May 20, 2010)

Sasha said:


> I carry a trauma bag so i have an excuse to cut off hot guy's clothes



Hahaha! 

don't forget to do a priapism sweep, they could have a head/spinal injury.


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