Interesting interview question popped up today... Remove one piece of equipment

[Mishka]

wow you guys have all that stuff on your buses...hehehe... I guess short-boards on our side...most useless thing

 

[WuLabsWuTecH]

I love this post! I have always fought the whole "Treat the patient, not the machine" because the phrase is overused and misunderstood. It is imperative that any medical provider have a mastery of physical assessment and a good PE can bring hidden truths to light. However, there is a reason why EKGs, ABGs, Pulse oximeters, glucometer, CT scanners, X ray, etc were developed. To augment and enhance the PE. Of course you are going to treat findings from diagnostic studies, as long as you are educated enough to know when they are precise and accurate and you are not being fooled by them. (Kudos to those who know the difference between precise, and accurate. If not, read up on it, and while you are at it, read up on specificity and sensitivity)

Precision and accuracy is easy. Precision is how close to the value that your sensor wants to read can get. So if your sensor wants to read 97% when given finger A, willl it be able to read 97% 10/10 times? Also, if your sensor wants to read that same finger A, can it read 97.23% (more precise) or just 97% (less precise)?

Accuracy is how close to the actual value it is. If finger A is actually 85%, then a reading of 97% is less accurate than one of 90%.

Specificity and sensitivity has been awhile for me, but lemme take a stab at it.

Sensitivity recognizes the pathology. So if a test is very sensitive, you recognize all people with the pathology as having the pathology. Therefore, false negatives are rare and you use the test results looking to identify patients with a negative result as NOT having the pathology.

Specificity identifies individuals without the condition of interest. So if a test is very specific, then it minimizes false positives and we use the test results looking to identify patients with a positive result as having the condition.

Theres a way to calculate using formulas too and a 2x2 square but I have long lost that!

@usaf, we need to upgrade then!

@ everyone. Can anyone explain to me why we still carry MAST pants?

 

[usafmedic45]

@usaf, we need to upgrade then!

Well, look at the precision level you guys are aiming for (in terms of decimal places) versus what you are looking at in a pulse ox (2 decimal places at most and often just one). The QC/QA gets a lot harder to establish and maintain with the increased precision of the instrument. I don't work with the same equipment you do in your lab, so I can't say if anyone has bothered to produce an automated model. It's a lot cheaper and easier to simply hire an undergraduate to do it. No offense of course....

Can anyone explain to me why we still carry MAST pants?

I think it is mostly due to the fact that no one has the drive to rewrite the state minimum equipment lists.

 

[Hal9000]

How specific do we get to be?

I'd get rid of 2x2s. We also have 3x3s/4x4s...though they're phasing out one for the other.

I'd keep things that keep me safe, such as gloves, glasses, radios. It's me, then you.

 

[akflightmedic]

Can anyone explain to me why we still carry MAST pants?

We don't in Florida. State removed them years ago, somewhere around 2003 I think.

 

[Hockey]

Why did my title get edited?

 

[mycrofft]

Check this thread:

http://www.emtlife.com/showthread.php?t=8649

I love these exercises.
Toss the 2X2 gauze (you can use a bitestick as a door prop or finger splint).
As the unit burns, carry away your radio, definitely.
I would cheat that exercise and put stuff down my shirt. All's fair in fire and EMS.

 

[Seaglass]

I'd get rid of: MAST, bite stick.

If I was allowed to improvise, I'd also get rid of most of the specialized bandages, tourniquets, and some of the splints. I'd only say this if they were asking about an emergency jump bag, though.

I'd keep: radio, gloves, boots (I hate dropping stuff on my toes), sharpie.

I suspect we still have MAST pants because they're so rarely used that nobody even remembers we have them...

 

[mycrofft]

MAST is good for busted pelvis and as a flotation device.

(Don't put them on to float, you will float head DOWN).

 

[apagea99]

(Don't put them on to float, you will float head DOWN).

Haha! I was thinking something similar B)

I'd dump the PTL. When I first had to use it in class I thought it was simple and easy to use. After a few weeks I figured out how much I hate it. It's much too bulky and it's a pain to inflate the cuffs with the BVM (I wasn't about to inflate by mouth after everyone else in class had handled the thing). The combitube is a much better choice IMO.

 

[WuLabsWuTecH]

(Don't put them on to float, you will float head DOWN).

Well, duh! But yuo can hold on to it. At least I hope what the poster was referring to!

Also, what are these bite sticks everyone keeps referring to? The OPAs?

 

[TransportJockey]

Also, what are these bite sticks everyone keeps referring to? The OPAs?

No, not OPAs. I'm not sure exactly what they are, since we don't carry them, but I do know they aren't OPAs

 

[Rob123]

Also, what are these bite sticks everyone keeps referring to?

As far as I know, "bite sticks" are also known as "seizure sticks". They are plastic U shaped tongue depressors that provides an airway for seizure patients. I have never actually seen one as they are not in the current NYS BLS protocols.

 

[MRE]

I'm cheating, but I would drop the 30lb car jack from my rig. We don't carry a spare tire, so its not much good, but according to the director, we are required to carry it.

 

[usafmedic45]

tourniquets,

Care to explain why you would get rid of tourniquets? They are a low use item but are extremely useful in some situations.

 

[PapaBear434]

I'm cheating, but I would drop the 30lb car jack from my rig. We don't carry a spare tire, so its not much good, but according to the director, we are required to carry it.

You know, we have that too. Little stupid scissor jack, that in no way would EVER lift an ambulance. No spare tire, either.

I guess it might be useful if I ever needed to lift a car off someone, but in those cases we almost ALWAYS have an extrication team on hand.

 

[usafmedic45]

we almost ALWAYS have an extrication team on hand.

Key word, "almost". I'd rather have it around when I need it for those cases where we have a car fall on someone in a garage or something similar that doesn't get put through by dispatch. I've walked into exactly that situation without the benefit of an extrication team.

 

[WuLabsWuTecH]

Haha, that's funny. Perhaps you guys ARE required to carry a spare tire? I probably wouldn't feel comfortable changing a tire on the rig anyway...

And yeah i've never seen a bitestick either, but an OPA would do the same job?

 

[WuLabsWuTecH]

Key word, "almost". I'd rather have it around when I need it for those cases where we have a car fall on someone in a garage or something similar that doesn't get put through by dispatch. I've walked into exactly that situation without the benefit of an extrication team.

I don't have extrication training so I don't extricate people except from cars using a KED like we learned. If we need extrication that's what the guys on the engine and rescues do!

 

[usafmedic45]

I don't have extrication training so I don't extricate people except from cars using a KED like we learned. If we need extrication that's what the guys on the engine and rescues do!

Pulling someone from under a car that has fallen off it's jack while they were working on it is not that involved of an extrication. We're not talking cutting someone out of a car or rolling an overturned car off of them.