Personal EMT bags

[mjm224]

So this is probably a stupid question, but I am curious if anyone has any suggestions or comments...

I have been certified as an EMT for a while but I have not worked for a company in a while. Recently I was asked to be medical personal on the fields for a sports event, with that note I was looking through my bag.

What would you put in a personal bag. I know the basics and some of the general stuff needed, but does anyone know of any guidelines? I am from Massachusetts if that makes a difference, and I did not know if there was a recommended list or required equipment list anywhere out there?

Any suggestions would be great, Thanks

 

[feldy]

first of all...would you be working under someone like a team or just as a CFR?

 

[mjm224]

I would not be working under anyone. So yeah basically I would be responded as a CFR. When looking at my bag though I am looking into what would last me. I am currently interviewing to get back into a company, so at that point it will be my personal bag while I am working with the company.

 

[feldy]

I Work as a CFR for the ARC at large events sometimes and although its not my personal bag, in our bags we have what most bls bags carry: Lots of 4x4s, roller gauze, alcohol preps, a few ace bangages, ice packs, hot packs, bp cuff, stethescope, pen light different scissors, triangular bandages for splints and stuff like that, sam splints (or something like that).

Since you are working sports, Athletic tape is very useful if you know how to tape a wrist or an ankle properly otherwise dont do it. Due to liability, let the team provide the more emergency equipment i.e AED, glucometer possibly 02 (i think you need an order for this by prescription but im not sure).

If you dont mind me asking where in MA/ who are you interviewing with? You can always PM me if you dont want to say publicly.

 

[TccEMT]

possibly 02 (i think you need an order for this by prescription but im not sure)

Correct, medical O2 is an Rx item. There are ways around this for emergency use. However going that route as an EMT and using it when working is walking a thin line (and the fact that'll be really hard to get it refilled without the Rx).

 

[reidnez]

Correct, medical O2 is an Rx item. There are ways around this for emergency use. However going that route as an EMT and using it when working is walking a thin line (and the fact that'll be really hard to get it refilled without the Rx).

My dad was able to get O2 for my grandmother when she was sick, using his pilot's license--she was refusing to go to the hospital. So yeah, there are ways. But obviously that is a different situation than an EMT giving oxygen to a member of the public. There aren't any contraindications for oxygen that I know of in the prehospital setting, so it *seems* like it would be hard for someone to make a malpractice case on the basis that you gave them O2 and it somehow hurt them...however, in this litigious society, nothing is outside the realm of possibility. It is still a drug, so I would be nervous about administering it to someone when working totally on my own (no agency, no medical director.)

 

[Buzz]

It is still a drug, so I would be nervous about administering it to someone when working totally on my own (no agency, no medical director.)

Only situation I'd ever administer O2, assuming I had it available, while on my own (I.E. no medical direction) would be with a diver that is experiencing symptoms of decompression illness.

 

[reidnez]

Only situation I'd ever administer O2, assuming I had it available, while on my own (I.E. no medical direction) would be with a diver that is experiencing symptoms of decompression illness.

Ahh, now you've piqued my interest! (I'm a DMT student). Absolutely, oxygen is first aid for DCS until they can get to a chamber. DAN (an awesome organization) has an oxygen first aid course for divers, and have convinced a lot of fill stations to fill oxygen cylinders for (non-medic) divers who have taken the course. The FDA has relaxed its rules on this, but some states still consider it a prescription drug. Recompression chambers are not on every street corner and it can take hours to get to one; oxygen is the best thing you can do for them in the meantime. The risk/reward calculation for putting someone on O2, especially a suspected DCS, is so slanted towards reward that you shouldn't even have to think about it. AED's should be in every public area, and O2 should be on every dive site.

Even in that case, there is a lot of liability concern. Most people (unless they are doctors) will only "recommend" O2, and have the patient place the mask on their own face if they are able. supposedly this would offer you some protection in court if that person turns around and tries to sue you for practicing medicine on them, or some such nonsense. Obviously that would be ludicrous, but again, we live in a litigious society.

 

[Buzz]

Ahh, now you've piqued my interest! (I'm a DMT student). Absolutely, oxygen is first aid for DCS until they can get to a chamber. DAN (an awesome organization) has an oxygen first aid course for divers, and have convinced a lot of fill stations to fill oxygen cylinders for (non-medic) divers who have taken the course. The FDA has relaxed its rules on this, but some states still consider it a prescription drug. Recompression chambers are not on every street corner and it can take hours to get to one; oxygen is the best thing you can do for them in the meantime. The risk/reward calculation for putting someone on O2, especially a suspected DCS, is so slanted towards reward that you shouldn't even have to think about it. AED's should be in every public area, and O2 should be on every dive site.

Even in that case, there is a lot of liability concern. Most people (unless they are doctors) will only "recommend" O2, and have the patient place the mask on their own face if they are able. supposedly this would offer you some protection in court if that person turns around and tries to sue you for practicing medicine on them, or some such nonsense. Obviously that would be ludicrous, but again, we live in a litigious society.

Agree 100% with everything you have written there. Could not have said it better myself.

 

[mycrofft]

Let's see....

Bolt cutters, windshield punch, three thousand lumen flashlight, handmade German serrated combat shears, Johnson and Johnson "J"-tube airway, magnetic light to slap on roof of car, chemical hot packs, titanium sheath bayonet, chrome steel ring cutter, triage tag and tarp kit, copy of the Last Rites, satellite phone with EKG attached, automatic vital sign monitor, Honda 500 watt generator, 3/4 inch bandaids, 2X2 gauze pads, eye ointment, Johnson and Johnson first aid cream, suction cup snakebite kit, oxygen concentrator, Elder valve, VVac suction pistols, and a CD mix of hot pursuit themes from various TV shows and movies.

B)

USe SEARCH. Welcome!!

 

[mycrofft]

PS: O2 limit

I'm told O2 at or under six LPM is essentially OTC in California, just use it and store it like a thinking adult.

 

[emt_irl]

There aren't any contraindications for oxygen that I know of in the prehospital setting, so it *seems* like it would be hard for someone to make a malpractice case on the basis that you gave them O2 and it somehow hurt them...

paraquat poisoning, bleomycin lung injury, and in ways exacerbated copd if you ad min to high flow o2 and titrate spo2 above 92%

 

[reidnez]

I'm told O2 at or under six LPM is essentially OTC in California, just use it and store it like a thinking adult.

The biggest reason I can see to justify restricting the distribution of oxygen to individuals, is that they definitely need to have basic training on how to safely store and handle cylinders, and the danger of fire or explosion with flammable materials. Smear some oil on an oxygen fitting, put pressure to it and you have a bomb.

But it's easy to minimize these dangers with a modicum of training and common-sense.

 

[VentMedic]

I'm told O2 at or under six LPM is essentially OTC in California, just use it and store it like a thinking adult.

Not exactly. This is also a Federal (FDA) standard.

OTC "emergency" O2 is meant to be used by establishments which can have their employees trained to use it in that facility. This is similar to AEDs. It is not meant for every one with an EMT patch not associated with any organization or someone with a 3 hour emergency O2 class to be running around with an O2 tank.

http://www.lifecorporation.com/fda-gif.html

http://www.specialtygasreport.com/features/396

 

[mycrofft]

You mean, no one running a mask at two lpm? (I used lots of wiggle words above)

The six liter units I saw all had one flow rate and a mask affixed. They came in a lightweight disposable aluminum cylinder like little welding kits.

A firefighter once showed me pure oxygen intentionally blown across an oily surface. No fire, no explosion, because the heat was dissipated.
Theoretically your oil would eventually either get rancid or turn to wax. The myth about a LA squad blowing up becuase they were sealing their cylinders with medical tape was BS. If a flow of medical O2 will IGNITE it, it would ignite at room gas conditions without the additional oxygen.

 

[FLEMTP]

Hmm in my bag... i like to usually just keep a small ambulance.. that makes it easier to find what you need... not one of the big ones mind you.. just a small type II...

The only EMT bag i keep around is the one issued by my dept.. but that has our traffic safety vests...turnout coat, helmet, rain gear and hazmat suit and gas mask..and I keep my own shoulder mike in there too. I put a couple of pair of gloves in it, and an adult BVM. Unless something looks really crazy bad or its someone I care about.. im just joe schmo off duty

 

[FLEMTP]

oh.. btw.. i've never understood getting a prescription for something (meaning oxygen) that is already in 21% of the air we breathe...?

Thats like telling me i need a prescription for a bottle of water!

 

[phildo]

Where I live, I remember reading that unauthorized possession of medical supplies is grounds for decertification. I'm sure that was meant to discourage the self-appointed free-lance rescue types from stocking their bags from their agency's supply room. If I felt the irresistible urge to have my own trauma bag, it would be stocked with brands that my service does not buy, and I would keep all the receipts in a safe place. Come to think of it, I don't buy ANY of the same brand of product my employer buys. On another note, I would have to give serious consideration to carrying my own malpractice insurance if I intended to provide any kind of care off-duty.

 

[reidnez]

The six liter units I saw all had one flow rate and a mask affixed. They came in a lightweight disposable aluminum cylinder like little welding kits.

A firefighter once showed me pure oxygen intentionally blown across an oily surface. No fire, no explosion, because the heat was dissipated.
Theoretically your oil would eventually either get rancid or turn to wax. The myth about a LA squad blowing up becuase they were sealing their cylinders with medical tape was BS. If a flow of medical O2 will IGNITE it, it would ignite at room gas conditions without the additional oxygen.

Where the real danger lies is in the lines and fittings themselves, as high-pressure O2 behaves very differently from an atmospheric-pressure stream. The reason you don't normally see quarter-turn valves in an O2 system is that when you pressurize those systems too quickly, there is a spike in temperature--there's your ignition source. If there is even a trace of hydrocarbons in the system, there's your fuel (oxygen on its own is not flammable, despite popular notion). And obviously we have plenty of oxygen, thus the fire triangle is complete. This is also the reason that cylinders and valves have to be "oxygen-clean" before they can be filled with O2.

 

[mycrofft]

But seriously OP,

One cubic foot kit (about the size of a milk crate):
500 ml SNS irrig., OP airways, three rolls of 3" Medirip, two rolls 1" Medirip, about twenty-five packets of paired sterile 4X4, one or two 5X9 combine dressings, three rolls of 1" TRANSPORE tape, a few fabric bandaids inclouding large and 3/4 ", a few sterile 2X2, four triangular bandages, a couple large chemical ice packs (or, better, bring a lunchpail-size cooler packed with ice in baggies), lotsa gloves on your belt and in your pockets, small flashlight, 7" Tetrasnip-style cheap shears, 4 oz squeeze bottle of hand sanitizer, about ten each alcohol wipes and betadine wipes, CPR mask fastened to exterior strap, BP cuff, stethoscope, spare glasses if you wear them, 1 or 2 mylar space blankets, a couple rolls of Lifesavers and maybe four or five restaurant honey packets (or go buy Glucose tabs and Glucogel), pen and paper, and a few ammonia inhalers in a crushproof plastic tube or bottle.

Hey, that's almost what I've carried for ten years.