Forming an equipment wishlist for my agency... suggestions!

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Talonrazor

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Hey all,

I am the training officer and one of the lead supervisor EMTs for my agency. I write our current training program and a lot of our policies and procedures. One thing managment has asked me to do is review our current medical supplies and come up with equipment additions and a wishlist. We are a BLS agency that is tasked with enforcing public intoxication statues. Essentially, we place public inebriates in medical custody and transport them to our detention facility. I oversee a lot of EMT-Bs and we treat a large population of chronic alcoholics and homeless streetfolk.

Right now we have very basic medical stocking. Most of our supplies come from ZEE Medical and BoundTree. I am currently working on getting equipment additions like pulse oximeters, temporal artieral scanners and SALT airway devices. I have been looking at the new i-gel airway devices but it looks like an ALS skills to run those. I am also trying to get us some good hemorrhage control like pressure dressings and hemostatic agents like CELOX or QuikClot. Anyone have any good suggestions? We do a lot of limited primary care for chronic patients who refuse hospital care and get a lot of their basic wound care from us.
 
I'd follow your state equipment guidelines and not buy a lot of extra stuff, as it'll just get thrown away when it expires. (Appendix I of the Alaska EMS agency application has the list.) http://www.hss.state.ak.us/dph/emergency/ems/Assets/Downloads/Ground_Ambulance_Application_8-05.pdf

And SALT airways?Why? Do you intubate? If not, just buy a simple OPA/NPA assortment and a BVM.

The rest of what you need (and are trained for) can be accomplished with 4x4s, kling, coban and tape.
 
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The reason for SALT airways is we do EMS handoffs. For example, we work codes pretty regular and if we can drop a SALT to help the incoming ALS ambulances from fire department I'd like to adopt it.

And I finally got us stocked with coban and ACE bandages. Now to teach all my EMTs how to do Army Combat Medic style wound wraps... ;)
 
power stretchers are always nice, and some febreze to get rid of that drunk smell
 
suggestion

try http://www.buyemp.com/ also Amazon has alot of useful tips and books on the matter. I used to live in Kodiak. If the coast Guard base is still there I would ask them or even the air force base there in anchorage, I bet they could help you a bunch, I'm assuming all that is still there, its been over 20 years since I was there.
 
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Stick to what your EMSA allows.

Never "drop an airway" for someone else's convenience, only if it is immediately necessary; "JIC" (just in case) treatment can be construed as unlawful battery even when it does not cause harm (which any procedure can).

Talk to your receiving ED or providers about things like chemical clotting agents, they are not the Godsend they were initially thought to be; pressure and dressings almost always do the job.

Spend money on staff training and setting up protocols within the regs and suitable to all parties involved, including law enforcement.

First aid companies as a rule supply "better than nothing" materials at "pay me anything, you need it" prices. Look to others like Dynamed, LifeAssist and others for at least some pricing ideas, and for more durable and better quality equipment and supplies. If you are municipal, you might legally be required to take or research multiple bids/prices.

If you are having to decontaminate your units frequently, get with disposable blankets, pillows etc. And know that Febreeze and related products do not do anything but blind your nose to the smell of something you need to be cleaning out of the unit instead of covering up. Also tend to leave a sticky residue, as the disinfectant wipes often do.

Biomedical equipment requires certified and user maintenance, batteries, and replacement. When in doubt, ask someone who owns one, and if you buy, get one then try it out (see if the dealer has a loaner).

And start keeping stats, see if you can get them from the receiving ED, about how many of what sorts or cases are being seen, and mold your supplies/equipment to those.

I know this will make you or your boss impatient, but there is no replacement for a well-trained practitioner with good quality basic equipment. We tend to get caught up in gadgets and techniques, but like any other tools, they have to be chosen and used with care.

PS: powered litters, with training, are becoming the standard and a big conservator of employee back health and patient safety.
 
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a reference library
 
Forget SALT airways. See if your medical director will allow Kings for arrest patients. Pulseox is good with basic training, and as others have said, you don't need quikclot. Tourniquets and dressings will do fine.
 
^ I'll second that. Celox gauze is great for massive penetrating wounds, but it doesn't sound like you'll be getting a lot of that. And I think hemostatics and wound packing is out of scope for EMT-Bs anyway.

WRT pulse ox, that's out of scope in a lot of places, as is Blood Glucose, so I'm not sure if you'd be allowed to use them. And even if you could, there aren't really any BLS treatments that require those diagnostics. Plus the equipment needs to be calibrated x times a year, which if it isn't needed that much could end up as an added financial burden.
 
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