# Rural Bike Ride Support



## frdude1000 (May 4, 2013)

Hey all.  In June, I will be the SAG (support and gear) vehicle driver for a team of 5 bikers on a 200 mile ride through rural Vermont.  The team consists of my father as well as some of his close friends.  While I have not done all my research, I know for sure we will be very far from advanced medical care most of the route, and have limited cell phone reception.  I am in the process of making a list of EMS supplies to carry.  I have recently become an AEMT, and am now able to start IVs.  What would the legality be of me carrying an IV start kit and normal saline?  I am fully taking responsibility for my actions, and know that my team would be behind me.  One of the team members is an Vermont licensed interventional cardiologist.  Could he write a prescription for this stuff?


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## DesertMedic66 (May 4, 2013)

You need to have a Medical Director inorder to function as an EMT, AEMT, Medic. I'm fairly sure in order for a Dr. to be a Medical Director there is some kind of license that they need to have but I have no other information on that.


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## MedicBender (May 4, 2013)

DesertEMT66 said:


> You need to have a Medical Director inorder to function as an EMT, AEMT, Medic. I'm fairly sure in order for a Dr. to be a Medical Director there is some kind of license that they need to have but I have no other information on that.



Agreed. You're going to be restricted to basic first aid. Which isn't a bad thing, in all honesty it's all you'll really need. Carry some bandaids for cuts and scrapes. 

Has this group done a long distance ride like this before? How many miles a day are they trying to do? I've done multiple 60 mile + rides and a few 100 milers. I don't see a need for IVs unless they aren't hydrating properly. Just remind them to drink before they're thirsty, eat before they're hungry, and don't be afraid to stop every 30 miles or so. Carry extra water with some sort of electrolyte replacement, and a decent assortment of food. I like Gu packs and Stinger Honey Waffles. 

I would also consider carrying something for saddle sores like Chamois Butter or Bag Balm. Do some reading on saddle sores and know what to expect. If they're experienced then it shouldn't be a huge issue.


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## frdude1000 (May 4, 2013)

*Vermont EMS people comment!*

The group has done lots of training and preparation.  Multiple 60+ rides and some 100 milers.  

Here is the route for the ride:http://100-200.org/Route.html
Any vermont ems guys/gals out there?  Know of the hospitals along this route?  What response capabilities are available along the route (ie. BLS, ALS, aeromedical)?  This will be my first time in Vermont, don't know the area.


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## rwik123 (May 4, 2013)

frdude1000 said:


> The group has done lots of training and preparation.  Multiple 60+ rides and some 100 milers.
> 
> Here is the route for the ride:http://100-200.org/Route.html
> Any vermont ems guys/gals out there?  Know of the hospitals along this route?  What response capabilities are available along the route (ie. BLS, ALS, aeromedical)?  This will be my first time in Vermont, don't know the area.



I'm involved in Vermont ems. On my phone right now but once I get to my computer later I can give you a detailed response.


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## frdude1000 (May 4, 2013)

rwik123 said:


> I'm involved in Vermont ems. On my phone right now but once I get to my computer later I can give you a detailed response.



That would be great, rwik!  thx


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## rwik123 (May 4, 2013)

So Vermont is its own animal EMS wise, basically the definition of rural ems. Everywhere basically except the urban Burlington, South Burlington area is handled by volly squads. Intermediates (like myself...but now transitioning to Aemt) are the main level of care with a handful of squads utilizing paramedics and doing intercepts and such. Cell phone service can be spotty, so thats something to keep in mind. First repsonders in POV are fairly common for initial response. 

There are smaller hospitals such as Rutland Hospital (Level III) and Central Vermont medical center but all major trauma gets pushed to Dartmouth Hitchcock in NH or Fletcher Allen (Level 1 trauma center) in Burlington VT. There is no HEMS in Vermont. All air transports are handled by DHART out of Dartmouth Hitchcock. Major trauma is often transported by DHART from Rutland up to Fletcher Allen.


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## medicdan (May 4, 2013)

rwik123 said:


> So Vermont is its own animal EMS wise, basically the definition of rural ems. Everywhere basically except the urban Burlington, South Burlington area is handled by volly squads. Intermediates (like myself...but now transitioning to Aemt) are the main level of care with a handful of squads utilizing paramedics and doing intercepts and such. Cell phone service can be spotty, so thats something to keep in mind. First repsonders in POV are fairly common for initial response.
> 
> There are smaller hospitals such as Rutland Hospital (Level III) and Central Vermont medical center but all major trauma gets pushed to Dartmouth Hitchcock in NH or Fletcher Allen (Level 1 trauma center) in Burlington VT. There is no HEMS in Vermont. All air transports are handled by DHART out of Dartmouth Hitchcock. Major trauma is often transported by DHART from Rutland up to Fletcher Allen.



Aren't there like 30 paramedics in the state?


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## fortsmithman (May 4, 2013)

DesertEMT66 said:


> You need to have a Medical Director inorder to function as an EMT, AEMT, Medic. I'm fairly sure in order for a Dr. to be a Medical Director there is some kind of license that they need to have but I have no other information on that.



Here in Canada all a you need to be a EMS medical director is just be a licensed physician.


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## CFal (May 4, 2013)

emt.dan said:


> Aren't there like 30 paramedics in the state?



I don't think that's right, we had 3 or 4 working on our ski patrol and I know town had a few, there was some overlap but town definably had a couple unaffiliated with us.


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## epipusher (May 5, 2013)

Basic bls supplies sounds about right. They appear to be used to the requirements of long rides, therefore they will understand the need for proper replenishment of what the body needs.


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## rwik123 (May 5, 2013)

emt.dan said:


> Aren't there like 30 paramedics in the state?



That's a little low but you've got the idea. Definitely not over 100 in the state. The district I'm in (Burlington area) has gotten medics in the last 2 years.


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## medic741 (Jun 1, 2013)

You NEED a medical director to carry/use ALS gear. Otherwise you will be practicing medicine without a license. In NY the issuer of protocol must be a practicing EM physician, don't know about VT. Cervical collars req medical direction btw.

Perhaps consider a suction unit (a bit excessive but hey), combat gauze, tourniquets, SAM splint?

Race/ride a good bit in remote areas without cell service and ALWAYS carry a SPOT messenger - it's been out to Patagonia and back. I use it whenever rock/ice climbing our biking in the countryside... and is incredibly accurate. I'm in no way associated with this company but a firm believer in the product. Do some of your own research but it has a few functions that are really nice to have.

Track - family/followers can follow progress in real time
Custom message - Set a custom message sent via text or email to phones or emails
Help button - send a custom help message text/email to emails/phones. I have this set to basically "I need the nearest ambulance sent emergently." This would be sent to my mom/girlfriend/brother and would include the GPS coordinates of where I was when the message was sent and they would contact the nearest agency to wherever I was
Emergency - red covered button on the unit that sends emergency message to clearing house (somewhere) that directly dispatches the nearest resources.

Here's a link if you're interested
http://www.findmespot.com/en/

The SPOT Connect looks interesting but have no experience with it


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## Tigger (Jun 2, 2013)

Why would a c-collar require medic direction? Do you have medical control for splinting?


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## medic741 (Jun 7, 2013)

Tigger said:


> Why would a c-collar require medic direction? Do you have medical control for splinting?



Packaging on collars req physician direction. To order them you need a doc to sign off. At least that's how our ordering works


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