How do you make up your cot?

[InkaHootz]

We all (mostly) have one. We all work with them. How do you make up your cot post-call? Considering it's used on nearly every run, whether you transport or not...The cot is a workhorse of the industry. How you put yours together, what you leave on it, and how you 'dress' it, may say a lot about you.

In this thread, I'd like to open an exchange where we share our peeve's regarding cot making.

Myself:
After the call at the hospital begins with a thorough decontamination of the entire cot. Messier calls require some disassembly to get in those nooks and crannies below the cushion, and on the bottom wheel-frame. A clean cot is a happy cot!

Making the cot-
Supplies required: 2 sheets, 2 blankets (maybe more in heavy winters), 1 towel (2 in the winter) and one hospital gown.
1: I like to get the sheet squared away. Hospitals never seem to fold them properly in half. So I usually unfold and refold on the line, and tuck the corners hospital-fold style under the cushion.
2: At the head of the stretcher I lay a folded blanket. I place a towel over this, and then tuck it under the cushion. This creates an extra 'pillow' for the patient's head to rest on. I'm the only person I know that does this. (The cushion on top of the oxygen cylinder at the head doesn't provide any degree of comfort. I think it's just a skull-saver, honestly.) I leave the pillow under the bench seat, and prefer it over the vacuum splints for those ankle/wrist traumas.
3: Place the sheet down on the foot of the cot, blanket on top of that, and then the hospital gown on the top. I button all the sleeves together (<10% of which are buttoned to begin with) and lace the seatbelt throught the arm sleeves. This rapidly identifies the arm holes on a folded up gown, and prevents confusion on the call when utilizing the gown on the patient. Don't forget to make sure your IV pole is on the "outside" of this seatbelt. Nothing sucks more than having an unstable multiplesystemstrauma with right lower extremity and having to fiddle-f&#@ with the belt to get the IV pole jiggled up to transfer out of the ambulance and into the ED.
4: The monitor and the portable oxygen cylinder are placed on the center of the cot, and the middle seatbelt laced through their handles.
5: Fold up the head of the stretcher, place my in-bag on the rear platform behind it.
6: Optional in the wintery areas, place a towel on the foot of the stretcher in similar fashion (minus the pillow-blanket). This way, your patient's muddy shoes (or gangrenous toes) can be covered up by SOMETHING if nothing else.


Ok....enough of my ranting.

What are YOUR 'tricks' to cot making?

 

[Anjel]

We use the pole stretcher(without the poles) on the stretcher for every single call.

And we have the stryker cots.

SO it goes like this.

1. Open pole stretcher and lay flat.
2. Take paper sheet pack from the cupboard.
3. Take bottom sheet and lay over the pole stretcher.
4. Fold the pole stretcher so it folds the sheet with it.
5. Take pillow and place in pillow case. Place pillow at the head of the stretcher and secured with top strap.
6. Fold up loose end of strap and tuck.
7. Take top sheet and place at the head of the stretcher.
8. If time for a blanket. Fold Blanket in two. Then fold in 3's. So it looks kinda like a log. Then secure with bottom belt and tuck.

Wah Lah.

 

[NomadicMedic]

Are you all familiar with the two blanket rule?

Every patient gets a blanket. If its chilly enough that I'm wearing a job shirt or long sleeves, every patient gets two blankets.

And everyone gets a pillow.

And now that I'm on a squad and not an ambulance, I never have to make up a stretcher. One of the best parts of the job.

 

[JPINFV]

Supplies: 1 cloth sheet, 2 disposable sheets. Add additional sheets and blankets as needed for weather. Add pillow and pillowcase for comfort.

Base sheet that can double as an emergency draw sheet if need be. Also if you get caught without a made gurney for whatever reason.
1. Take the mattress off. Drape the linen sheet over the frame.
2. Place mattress upside down on the gurney on top of the sheet.
3. Knot the top and bottom corners together using a square knot. to secure the sheet.
4. Flip the mattress/sheet combination over.
5. Tuck in sides.

Now add the disposable base sheet.

6. Drape disposable sheet over mattress and linen sheet.
7. Knot the corners on the top of disposable sheet.
8. Insert head of mattress into the knotted area.
9. Lift the foot of the mattress and knot disposable sheet.
10. Tuck into make it look nice.

Top sheet:

11. Fold disposable sheet width wise until it's small enough to fit under the foot of the gurney for storage until patient is ready to be packaged.

 

[JPINFV]

Are you all familiar with the two blanket rule?

Every patient gets a blanket. If its chilly enough that I'm wearing a job shirt or long sleeves, every patient gets two blankets.

And everyone gets a pillow.

And now that I'm on a squad and not an ambulance, I never have to make up a stretcher. One of the best parts of the job.

Every patient gets covered, but I don't think that everyone needs a blanket when it's 100 degrees outside.

 

[DesertMedic66]

Get a hospital sheet and place in on the gurney so it lays flat with no wrinkles. Tuck the ends of the sheet under the gurney cushion. Monitor gets belted in at the foot of the gurney. Main bag goes anywhere on the gurney and that's all.

No need for extra stuff. We don't keep pillows in my unit. Takes about 5 minutes to clean the gurney and make it back up. We normally get another call as soon as we hand over patient care so our hospital turn around time is 9 minutes on average.

 

[JPINFV]

Why doesn't your company provide any pillows?

 

[Tigger]

The bottom sheet covers the entire mattress. No exceptions, none of the half folded sheet down the middle crap.

On top of that, a towel at both the foot and head ends. The head end towel is a useful emergency vomit catcher, the foot one just looks nice. If available, a chuck (non-pink in color) will be placed in the middle and folded under the mattress. On top of that, a folded blanket and a pillow secured with a seatbelt with the straps folded and tucked. All the other strap ends will be folded and tucked as well. The shoulder harness ends get slipped under the waist belt and tightened.

In the net I try to keep an NRB, NC (there's a D tank on the cot), my sized gloves, an emesis bag, a sheet, and blanket. Some crews keep cravats for improvising restraints, I think that's lame. For a while I kept the transfer sheet under the bottom sheet so it could always be used but was told to stop as it "has to be kept in the truck."

In the winter, company policy dictates the stretcher. Bottom sheet like normal, then the "company blanket" (wool blue plaid blanket with service patch sown on at the top) gets laid unfolded on top of the bottom sheet. Then you put another unfolded blanket on that and then a sheet and then fold into thirds so it looks pretty. Most know it as a burrito wrap apparently. I'm not sure if we will keep doing this, I think there is a serious cross contamination risk with reusing the same top blanket all day and our contracted hospital network also does and was on the way to banning its use.

 

[DesertMedic66]

Why doesn't your company provide any pillows?

They do. Our unit may go a couple of days before we get cleared to our main station to restock so instead of wasting room with pillows we have other supplies. If you were to take everything out of our ambulance you could almost fully stock 2 ambulances.

Honestly the only time I've ever seen pillows used in my area are for long distance IFTs.

 

[Joe]

They dont need pillows. Ill put up a video of my making the gurney style in a while

 

[truetiger]

1) Unfold sheet and place on cot
2) Tuck sheet in
3) Place pillow in middle and buckle seat belts

 

[fast65]

I don't usually make the cot unless I'm on an IFT. We carry disposable "heavy duty" fitted paper sheets for our base sheet. When I make the cot it goes as follows:

1) Decontaminate the cot.
2) Fitted paper sheet.
3) Pillow in the center.
4) Blanket
5) Sheet
6) Lap belt to secure the pillow, sheet, and blanket.
7) Buckle leg and chest/shoulder straps.

 

[Trashtruck]

I'm speechless.
A touch of OCD around here, perhaps?
Just sayin'...

However, I do like the sheets that are longer(only certain hospitals have them) so you can easily cover feet.

 

[usalsfyre]

After cavi decon, disposable sheet goes on. On arrival at the call, monitor, bag, vent, pumps, sheets, blankets, ect get piled on.

The fun really doesn't start till it's time to get the patient, monitor, vent and two pumps secured to the cot...

 

[Tigger]

I'm speechless.
A touch of OCD around here, perhaps?
Just sayin'...

However, I do like the sheets that are longer(only certain hospitals have them) so you can easily cover feet.

Just a touch. There's not a lot I can control at work, but the way the cot is made as well as how the truck and bags are stocked is and that is somehow reassuring to me.

 

[JPINFV]

I'm speechless.
A touch of OCD around here, perhaps?
Just sayin'...

However, I do like the sheets that are longer(only certain hospitals have them) so you can easily cover feet.

It's all about presenting a professional appearance. It doesn't take much energy, or time (especially if the driver is resetting the gurney as the attendant is giving report, finishing up the PCR, and getting signatures) to get the gurney set up in a neat manner.

 

[bahnrokt]

That sounds like a lot of work.

My cot is:
Sheet
PeePee Pad
Sheet

Lay the sheet across cot, add pink pad, lay 2nd sheet across. Grab ends of sheets and flip over cot and fold back neatly, repeat on other side. Strap jump bag to foot of cot.
Takes about 30 seconds.

 

[the_negro_puppy]

Sheet on neatly, tucked in, pillow on top secured by harness, leg straps clipped up. extra folded sheet or blanket resting on top depending on weather.

I see a trend that most EMS in the US take their cot/stretcher in straight away with every call?

Unless we are going up a building or into a nursing home we generally take the gear in, work out whats going on, where the patient is. Many of our houses have stairs and steep driveways, so I like the idea of doing a recon before dragging the stretcher in every call.

We tend to stay and play more than you guys- longer scene times, start treatment on scene like IVs, 12 leads etc

 

[Epi-do]

Sheet on the cot, tucked under the mattress. Then, a towell at the head, also tucked in. If it is cooler outside, a blanket roll in the center, secured by the strap. If not, then the extra sheet/blanket is tossed underneath the head of the cot.

 

[Trashtruck]

Hey,
Don't get me wrong...I'm very particular about many things and am self-diagnosed OCD. I, too, organize the $&^% out of supplies and equipment. My little world is a tightly run ship, despite what's unraveling around me.

Yes, the driver makes up the stretcher after the call. I take a sheet and spread it nicely over the mattress to make it as wrinkle-free as possible. I tuck the edges of the sheet under the mattress on all four sides. A sheet goes on the back to cover people. We don't have disposable sheets or chucks or pillows. No equipment on the stretcher.

Like puppy said, we go in first with gear and decide if we need the stretcher.