EMT Tricks of the trade

[ffemt8978]

We keep a knitting hoop with a red biohazard bag in it on the cots...great for when the patient wants you to see what he ate for his last 3 meals. They're cheap, disposable, and can hold a lot more than the standard basins we carry on the rigs. Plus you can get to them in a real hurry.

 

[HotelCo]

Never set your shears down anywhere, even for a minute. They won't be there when you goto pick them up.

A Tegaderm works better than a bandaid, it won't peel off so easily.

 

[mycrofft]

OK I'm liking this thread.

If you have a pt on a raised ambulance litter (aka "cot"), ALWAYS have positive physical control of it. They can tip them over, believe me. I'm talking at least one hand if the other hand is free, or both hands.

Don't use Combine or other "highly absorbent" dressings (often found sold as abd's) to stop bleeding. Toss a plain old gauze 4X4 on, then if you want pile on other stuff so you can make a pressure dressing and cover the mess. A "Combine" dressing is like a Kotex napkin, the blood is sucked up into it and the clotting takes place in the bandage not the wound.

Search our old threads about what NOT to pack ot carry.

Sometimes you can get a drunk to start to quiet down by talking and lowering the volume of your voice as you do, so they shut up to hear you. Sometimes.

Any pickup off the street, quickly and lightly frisk them once in the unit.

 

[BLSBoy]

Any pickup off the street, quickly and lightly frisk them once in the unit.

I know the safety sallies will fall over with that one.

Make sure you get yourself a pair of "skell gloves" for that. Ask any LEO for a suggestion.

 

[Buzz]

Never set your shears down anywhere, even for a minute. They won't be there when you goto pick them up.

I once had some scissors tucked into my belt after dealing with a trauma patient. We got to the ER and there was another guy about to get flown out. A nurse ran out of the room grabbed my scissors and as she was pulling was like "Mind if I borrow these?" Only problem is the belt is a good way of holding scissors like that. She ended up yanking me along with it. She stopped was like "Those are in there really good, eh?"

 

[mycrofft]

I meant patdown. Don't dip into pockets or socks.

Remember that if you go to court, you paperwork will hang or absolve you. Make it good, keep it to the point, and make sure all copies go where they are supposed to.

 

[NRNCEMT]

You mean you didn't learn that in your EMT-B class? Seems like a pretty basic skill...

And just to tell you, I saw a medic do the heart squeeze on a pt. on a scene and I asked my medical director about it and he said that it was fine. Sorry if you don't like the tips I posted, they are ones that I've witnessed myself.

 

[HotelCo]

A medic doing a heart squeeze... A bit of a stretch, but I'll bite. Considering that this "trick of the trade" was posted in the BLS section, I couldn't help but poke fun at it.

 

[NRNCEMT]

A medic doing a heart squeeze... A bit of a stretch, but I'll bite. Considering that this "trick of the trade" was posted in the BLS section, I couldn't help but poke fun at it.

Well...I am BLS, I don't do much roaming in the ALS section.

 

[nomofica]

place a roll of med (or any other type of) tape around the body of your steth; they can make great tape dispensers.

One for the c-spine: "C-3, 4, 5 keeps the body alive!"


Well known CPR compression timing tip: hum to (should probably do this in your head...) "Stayin' Alive" or "Another One Bites the Dust"

If scene safety is compromised by an individual (say, an "attacker"), throw something at their face/chest, and a jump kit at their feet. Then get the hell out of there.

 

[mycrofft]

"C 1 and two, not much to do"....that's not right!?

OK OK, serious stuff....
If you get the luxury of making your own kit, after looking at the threads here about what not to carry etc., consider these:
1. A good quality padded camera case will probably cost less than an equivalent "EMS" case, have moveable dividers, and a better selection of colors, straps, zippers, etc. Get burly double zippers, heavy nylon, no mesh.
2. Soft kits have less wasted space than a hard kit, and you can use their padding and the arrangement of contents to protect stuff. They don't hurt your legs.
3. Think of what you wil use most, stock the most of it, and make it central. Think of what you might absolutely need to save a life, list them, then stock the smallest and easiest to maintain items..one or two (OP airways being one). Periodically go through it for familiarization, inventory, replacement.
4. The capped plastic aliqout tube used to transport serum or the capped tapering plastic tubes used to spin down urine are great for carrying a few ammonia inhalants, or AA batteries, or flashlight bulbs, large bore hypo needles, etc. Plastic sotrage tubes for Epi-pens are larger but good also.

Keep it legal!

 

[zzyzx]

"If you you have a CABG pt. and his/her staples bust open, you can perform CPR by squeezing the heart with a gloved hand."

Better yet, you should tear out the heart as it will then beat independently of the body.

 

[nomofica]

Not sure if anyone here has done this, but:

To improvise a good eye-washing unit, grab an NC, lay the pt supine and place the NC so that the nose tubules are in the corners of the pt's eyes (one in each eye). Then grab a 60cc syringe, fill 'er up with saline or water and squirt into the eyes via the NC tubing. Alternatively, set up an IV saline and hook the IV tubing to the NC tubing.

 

[HotelCo]

Not sure if anyone here has done this, but:

To improvise a good eye-washing unit, grab an NC, lay the pt supine and place the NC so that the nose tubules are in the corners of the pt's eyes (one in each eye). Then grab a 60cc syringe, fill 'er up with saline or water and squirt into the eyes via the NC tubing. Alternatively, set up an IV saline and hook the IV tubing to the NC tubing.

The second way is much better. You don't want to push the Saline/water through with a ton of force, just let gravity do it.

 

[nomofica]

The second way is much better. You don't want to push the Saline/water through with a ton of force, just let gravity do it.

That's true, but not everyone has IVs available. I don't see many personal jump bags with full IVs.

 

[mycrofft]

I've had mixed news on the NC thing.

Poorly or not tolerated when I tried it, but I've had people tell me it worked wonders.
I douse 'em if I can, works fast, gets the crud off the face which can get back into the eyes, and enough liquid gets rid of your worries about contaminating the pt, it's diluted.

For uncomplicted post-foreign object irritation or a little schmutz like dust, a refrigerated drinking fountain is very soothing, well tolerated if the pt holds their own eye open. Follow with NS flush if possible, can't hurt.

For a small kit like I have, carry a handful of the 3ml sterile NS pillows for inhalation. Good for IMMEDIATE mini-lavage (until you can get a real rinse for chemicals), often will wash out a speck of dirt on the first try, and also good for "dry eyes", or with small wounds. Extremely quick, variable pressure with excellent directivity, but little volume. And a lot cheaper than the "eyewash" they sell you for dry eyes, or first aid kits.

 

[EMTelite]

I learned this in class as I was going through my trauma assessment... A blanket can be used very nicely as a hip splint

 

[HotelCo]

That's true, but not everyone has IVs available. I don't see many personal jump bags with full IVs.

Why would you need a personal jump bag? How often is it used?

 

[nomofica]

Why would you need a personal jump bag? How often is it used?

Volly first responders and even the EMS boys at the oil rigs usually have their own bags.

I, myself, use a personal jump bag because i do a bunch of vollying for events like the Weekend to End Breast Cancer and the Ride to Conquer Cancer.

 

[mycrofft]

Good question Hotelco

It is a luxury and the first step down the steep and slippery slope to Whackerdom.
I use one because the beancounters and pilferers at my work make it dubious that I can quickly and efficiently treat "mandowns".
All the more embarassing because they "put me in charge" of managing the emergency kits and gear, then largely ignore me.:blush:
OK, let's say you stumble onto the dream situation....
Back to the thread!