Shoulder straps

RocketMedic

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How important are shoulder straps on the cot to you?

For me, they’re important both as *the* critical piece of the cot’s restraint system and as a tell of the company’s overall safety culture. If they’re absent, they’re probably not too concerned about safety.


And yes, my current employer doesn’t enforce rules that cost have them and doesn’t put them on the trucks, so I’m the one oddball who hunts the things down.
 

Peak

ED/Prehospital Registered Nurse
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What drives me more crazy is the number of companies that require the use of those ferno peds strap thing instead of the childs actual car seat. Why would anyone have a policy not to use a car seat in that is in good condition and actually designed for that specific child's size?
 

Jim37F

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My previous private company, added the shoulder straps, and had policies that they would be used at all times unless interfered in patient care.
Supervisors would periodically show up to the hospitals and crews could and would get written up for not using them.

The current state funded, county ran municipal third service here, only has a grand total of one seatbelt on the gurney which always kind of weirds me out...
 

VentMonkey

Ajaw
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I do remember a time when putting baby on mom's lap pre-Pedi-Mate was a thing...
What drives me more crazy is the number of companies that require the use of those ferno peds strap thing instead of the childs actual car seat. Why would anyone have a policy not to use a car seat in that is in good condition and actually designed for that specific child's size?
I don't know of any company that I've worked for that discouraged the use of the child's car seat and preferred, or mandated a Pedi-Mate; it's more or less always been optional between the two. That said, a potentially critically-ill child whose call can turn dynamic in a flash, I'd prefer they'd be on a Pedi-Mate for the accessibility.

We recently added a shoulder restraint system to the sled of our helicopter. I can understand the safety advantages that they carry, but from a practicality standpoint--especially with bloodied patients--they're more of a nuisance; I'm sure it'll just take a bit of getting used to. The last few scene calls I've just sorta "danced" them around the patients bloodied heads/ airways.

We're required to hand our straps to our mechanic when they're soiled so that they can properly disinfect them and give us a spare set. I believe that there's also a three-cleanse max on the straps before they're discarded as well.

I will also admit that when I was a paramedic supervisor and I'd see the patient on a crews gurney without the shoulder straps I'd either go over and begin to re-buckle them, or ask them to do so themselves. Seeing this always made me nervous. Most of the ED techs weren't kind enough to help the crews re-buckle or at least put the straps back over the patient post-12 lead ECG as a friendly reminder. It was a peeve of mine when said tech was an employee of ours to boot.

And FWIW, I'm pretty big on making sure those straps are on the patients especially in the back of the ambulance.
 

Peak

ED/Prehospital Registered Nurse
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I don't know of any company that I've worked for that discouraged the use of the child's car seat and preferred, or mandated a Pedi-Mate; it's more or less always been optional between the two. That said, a potentially critically-ill child whose call can turn dynamic in a flash, I'd prefer they'd be on a Pedi-Mate for the accessibility.
There are quite a few agencies here that have, or had, that exact policy. Fortunately we have had some success in changing that, but some agencies are resistant to change.

I don't disagree that in emergent transports that the patient presentation may necessitate some compromise in our ideal safety goals, however the reality is the the vast majority of transports including pediatrics are for non-critical patients.
 

Jim37F

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I do remember a time when putting baby on mom's lap pre-Pedi-Mate was a thing...
You say that like it's only a back-in-the-day thing... I've def seen more kids transported via mom holding them vs the Pedi mate strap thingy
 

VentMonkey

Ajaw
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You say that like it's only a back-in-the-day thing... I've def seen more kids transported via mom holding them vs the Pedi mate strap thingy
Because where I've worked it is, and should be. Any company worth their salt that cares about liability, let alone the patient(s) safety has long removed themselves from this asinine practice.
 

Tigger

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I would wager that shoulder straps could be used on 95% of our calls. And they should be. Why would not try and best protect our patients?? Not to mention that the cot manufacturer (or Ferno at least) includes them and specifically mandates their use in training materials.

Most calls are not particularly urgent. If it takes an extra five minutes in the back to start an IV and get a 12 lead to ensure that both patient and provider are restrained during transport, what is the real loss?
 

RocketMedic

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So it turns out the straps are actually Texas mandates. Cots have to be equipped to manufacturer recommendations, which explicitly include shoulder straps, per TAC title 25 part 1 chapter 157 sub chapter b. Turns out we’re in violation of Texas regulation without them.
 

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RocketMedic

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Interestingly, the regulation also explicitly states that patients need to be restrained to manufacturer specifications to be legal.
 

cruiseforever

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I use them every time now that we are using the X strap system with our Strikers. Before that I was not very good at using them. It was almost impossible to get a good fit on the pt.
 

DrParasite

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the manufacturer provides them, and their directions mandate their use. if your agency's written policies say you shall follow the manufacturer's recommendations regarding all equipment, and you fail to, and the patient has a negative patient outcome, it's highly likely that you will be hung out to dry and have the blame squarely placed on you for any incident that occurs with a hint of a correlation to their use.
 

Tigger

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I like the X-straps a lot...my agency went back to the old kind because...I have no idea.
 

StCEMT

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I used to not be very good about it, but now 99% of the time I use them. My exception is things like an arrest or a situation that may necessitate moving **** out of the way.
 

cruiseforever

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I like the X-straps a lot...my agency went back to the old kind because...I have no idea.
My guess would be someone did not want to not use the shoulder straps. The X straps more or less force you to use them to secure the upper body.
 
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