A collar is incredibly helpful when you need to extricate someone from something while maintaining an advanced airway. That is about it. I also have a BP cuff in my home, but it's to help out a roommate with some early onset HTN concerns. I do not need one to determine when I need ALS or a helicopter. If the patient is 60/P odds are that they will look like absolute crap, and there's nothing I can do about that substantively. I also have a real CAT in my "kit" because that's not something I want to improvise and as it turns out BP cuffs are not really made for tourniqueting wounds in patients that are relatively hemodynmaically stable.
As someone that has been in need of EMS afer some substantial injures, I want EMS to take me to the hospital and that is about it. I and most people are more than capable of waiting on their own. And when I arrive at scenes with "knowledgeable" bystanders I am happy to listen, but I am not replacing a thing that they say with thorough assessment.
Why does everyone keep assuming that when I say that bystanders are great assets, that I am implying that they're doing your job and you should not listen to them at all because you should be doing the job that you better damn well be doing anyways? What kind of idiot doesn't assess patients themselves? But asking someone when stroke symptoms started being noticed in someone else is a damn good use for a bystander, and I'd certainly use that information to help me determine a timeline for the patient's symptoms and help guide the beginnings of my assessment beyond the initial rapid exam. If a bystander was a physician, walked up to me and said that someone is exhibiting symptoms of an atypical MI, I'm probably going to use that information in getting ALS on scene a little more quickly. I'm not going to suddenly not examine the patient as normal, but I'm certainly going to keep that information at hand and use it as a resource.
How is a collar not helpful in maintaining position of the cervical spine? Why then, does a hospital usually collar anyone they suspect of having a possible MOI that could cause spinal injury, even when symptoms are not present? King county has relaxed our protocols quite a bit now so we don't C collar very often anymore unless the pt is complaining of neck/back pain or CMS related symptoms, and even still, once we get these otherwise stable patients to the hospital, a collar gets slapped right on them. I'd trust Harborview's stance on C collars anytime, considering they're one of the hospitals that writes the book on burns and trauma. Done more than enough airlifts to know the benefits there.
If you don't have a tourniquet and you need a tourniquet, a BP cuff will do the job for a few minutes at the very least. Never had to do it, but know people who have (here in seattle they don't issue us tourniquets for some ridiculous reason. Fire gets israeli bandages. We also don't have glucometers on our rigs which is pants-on-head retarded) and have heard that they actually do the job well enough to prevent quite a bit of blood loss when you crank them up to 300-400mmhg
If you've got a proper CAT in your kit, you've got a bona-fide jump bag, mate. you were making yourself out as having a couple large ABD pads and some kerlex, which will handle the vast majority of bleeding emergencies. There's nothing wrong with keeping a BP cuff in your "all in one" bag. And I'm sure you've seen people with BP's in the tank that were still compensating reasonably well. Kids in particular can look pretty good while being pretty trashed internally, and I've taken a few "drunks" who fire didn't examine properly only to find that they'd taken too much lisinopril and his BP was in the tank. Pressures can be important tools. Not necessarily on the scene of an MVA, but why does that discredit ladening your vehicle down with a whopping half pound and 4x4 square inches of BC cuff?
My point on keeping a BP cuff in a "jump kit" is that it's more a matter of just keeping a bag with most of your atypical medical **** in it. Mine's got cold and hot packs and there's absolutely no reason I'd be using those on an MVA that I rolled up on. But I know there's always one or two in there, so when I sprain my own ankle I can hobble out to my truck and grab it, and it's also there for when I'm out in the woods with buddies and one starts having chest pain.
Do you keep a pocket mask or BVM in your "kit"?
