Where is your gear?
- Thread starter Melclin
- Start date
Yep. We tend to take the stretcher with our main bag,O2 and monitor into every call. If we find the patient looking bad we can put them on it and get out. It also keeps me from leaving the patient and my partner from fighting a heavy power cot on their own.
And ours is a backpack as well. Ill take a pic tonight if I can remember. I think our bags are custom made by a company in Canada.
TxParamedic
Forum Crew Member
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One big bag with backpack straps, o2 mounted on the cot, narcs in a locked box on the rig, LP12. pretty much everything on the bag duplicated on the shelf except EZ IO, first line drugs are in the bag more of everything in a large drug box on the truck.
dixie_flatline
Forum Captain
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I think I've stated our breakdown before, but I'll do it again since I am also fascinated by the organizational thought process (or lack thereof) that goes into distributing all this stuff.
BLS Bag (The Red Bag, big old red duffel)
ALS Bag (The Blue Bag, slightly smaller than the BLS kit)
Trauma Bags[x3] (Much smaller, about the size of a small cooler. one for each of the 3 LSBs we have on board)
"Loose" on the unit
As to the original crux of the question, the controlled meds are in a locked drawer that only paramedics have access to and which inventory is closely monitored at all times.
BLS Bag (The Red Bag, big old red duffel)
- O2 Cylinder
- Airway Adjuncts (NPA/OPA)
- BVMS, NCs, NRBs
- Glucose, A Charcoal, Epi-Pens
- Pulse Ox, steth+sphygmomanometer
- Trauma gear (shears, tape, 4x4, 2x2, a trauma dressing or 2)
ALS Bag (The Blue Bag, slightly smaller than the BLS kit)
- Basic(?) ALS drugs - not entirely sure whats in there - D50, Narcan, Zofran?
- Intubation kit
- Glucometer (hopefully this will soon be a true BLS skill)
- IV kit
- portable sharps container
- possibly missing some stuff here
Trauma Bags[x3] (Much smaller, about the size of a small cooler. one for each of the 3 LSBs we have on board)
- Adult, Peds, Infant Collars+Headblocks
- Straps
- Tape, some bandages and assorted other basic trauma/bleeding control supplies
"Loose" on the unit
- EZ-IO
- Glidescope
- CPAP
- Nebs
- Portable Suction
- Lifepak-12
- Splints
- Thermometer
- Electric razor
- Peds kit
- "loose" surplus of almost everything in the bags - some extra collars, a spare O2 cylinder, plenty of NC/NRBs...
As to the original crux of the question, the controlled meds are in a locked drawer that only paramedics have access to and which inventory is closely monitored at all times.
jjesusfreak01
Forum Deputy Chief
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Wake County EMS
Blue Bag (Jump Bag)
Trauma Supplies
Tympanic Thermometer
Penlight
IO Supplies (Including Drill)
Steth and Adult BP Cuff
Triage Tags
PPE (N95s, facemasks) and Biohazard Bags
Small Drug Box (Versed, Haldol, Asthma meds, Tylenol, Toradol, Benadryl, etc)
Large Drug Box (rest of the drugs excluding narcs)
Code Bottle (epinephrine, atropine, vasopressin, don't quote me on that)
IV Kit (all necessary IV supplies)
IV Set (a start pack, 3-way, and liter of saline taped together for quick access; the only saline in the bag besides the 250ml in the IV kit)
Red Bag (Airway Bag)
D tank
OPAs
NPAs
ET Trigger tube and BAM whistle
Laryngoscopes
King Airways
ITD
BVMs
NRBs
NCs
Neb Mask
We have separate intubation kits that are kept on the truck and brought with us only if necessary, as intubation is only attempted if simple ventilation with a BVM fails and then a King airway cannot be placed successfully. We have a pediatric jump bag that contains pediatric sizes of all the airway and assessment equipment. Narcs are double locked, but our one benzo isn't unless the truck is out of service, in which case its locked in a safe at the station with the narcs.
Blue Bag (Jump Bag)
Trauma Supplies
Tympanic Thermometer
Penlight
IO Supplies (Including Drill)
Steth and Adult BP Cuff
Triage Tags
PPE (N95s, facemasks) and Biohazard Bags
Small Drug Box (Versed, Haldol, Asthma meds, Tylenol, Toradol, Benadryl, etc)
Large Drug Box (rest of the drugs excluding narcs)
Code Bottle (epinephrine, atropine, vasopressin, don't quote me on that)
IV Kit (all necessary IV supplies)
IV Set (a start pack, 3-way, and liter of saline taped together for quick access; the only saline in the bag besides the 250ml in the IV kit)
Red Bag (Airway Bag)
D tank
OPAs
NPAs
ET Trigger tube and BAM whistle
Laryngoscopes
King Airways
ITD
BVMs
NRBs
NCs
Neb Mask
We have separate intubation kits that are kept on the truck and brought with us only if necessary, as intubation is only attempted if simple ventilation with a BVM fails and then a King airway cannot be placed successfully. We have a pediatric jump bag that contains pediatric sizes of all the airway and assessment equipment. Narcs are double locked, but our one benzo isn't unless the truck is out of service, in which case its locked in a safe at the station with the narcs.
CANMAN
Forum Asst. Chief
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I understand Wake County to be a top notch EMS system but I am surprised that you guys aren't even attempting intubation anymore unless a King airway fails? IMO thats kinda backwards. It's already a skill that studies show a decrease in the amount of tubes you place obviously decreases the success rate, and now you guys are only using it if a King can't be placed? IMO the King Airway is the backup to ETT, and if I can't intubate or place a King and ventilate then I am looking at surgical airway as a possibility.....
With the above airway algorithm you are only decreasing the amount of attempts your providers have at ETT and with that being said I wouldn't be using that as your backup to the King Airway.
With the above airway algorithm you are only decreasing the amount of attempts your providers have at ETT and with that being said I wouldn't be using that as your backup to the King Airway.
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But there are very few scenarios that a King, if used appropriately, isn't suitable for. Kings are not "failed airway devices." They're a very effective and quick tool for managing an airway. I understand the thought of losing the skill, but there are other ways to stay proficient. Mannequins to keep technique, a procedure lab every now and then if available, etc.
CANMAN
Forum Asst. Chief
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I agree that you can sink a King in most situations and I am also aware that the King is not just a backup airway but with that being said ETT is STILL the gold standard in airway management and if I can drop a tube without issue vs. putting a King in I am going to intubate. It shouldn't take much more time to tube then to sink a King, seconds at best.
I am sorry but I disagree with "staying proficient" with intubating harry the head a few times and dropping some tubes in a cadaver once every two years. Those should also be included in the training regiment but to say those two things along will keep you proficient is a false statement. I will continue to practice DL and intubation unless I cannot get the tube in an acceptable timeframe.
12 Tubes a year maintains a roughly 90% success rate. If I needed to be intubated I would much rather prefer the gentleman who is intubating on a regular basis vs. the medic who drops a King instead of intubating every chance he gets but he has tubed hairy the head successfully in the last year.....
I am sorry but I disagree with "staying proficient" with intubating harry the head a few times and dropping some tubes in a cadaver once every two years. Those should also be included in the training regiment but to say those two things along will keep you proficient is a false statement. I will continue to practice DL and intubation unless I cannot get the tube in an acceptable timeframe.
12 Tubes a year maintains a roughly 90% success rate. If I needed to be intubated I would much rather prefer the gentleman who is intubating on a regular basis vs. the medic who drops a King instead of intubating every chance he gets but he has tubed hairy the head successfully in the last year.....
We beat this subject to death on another board recently. "Intubating every chance he gets" is a crappy way of looking at it (system should serve the patient and not the other way around) but I get the sentiment. Simple answer? Restrict the number of people doing DL.
TransportJockey
Forum Chief
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With the new guidelines on CPR, ETI is going away here on codes. Most of the time, especially if my ILS unit is first on scene for the code, I'll have a combi in place before my medic gets on scene. Minimizing gap in compressions is the name of the game now for codes.
Shishkabob
Forum Chief
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Any agency who completely gets rid of ETI, be it on codes or any call, is stupid.
There are times it's called for, even on codes, and to completely disregard it due to some idiot providers does not fix the problem.
I disagree. Any agency who keeps it without putting the commitment needed behind it is stupid. It's needed and important, but has the potential to do a lot mor harm than good.
Shishkabob
Forum Chief
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The issues with ETI, the vast majority of the time, are due to providers not doing their job /being lazy, and not an issue with the actual act or device itself.
This rests on both the providers AND agency for allowing it to happen.
Yep...but there are agencies within spitting distance of both of our areas who may or may not have the commitment to do ETI right.
Based on your experiences there, did Evil Empire, Big D division have the equipment, training and average level of "give a crap" among their medics on every unit to be doing ETI?
Shishkabob
Forum Chief
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Not at all. When I was first hired I told them my concerns about ETI due to my lack of tubes, and while they offered to send me to a local hospital with their medic school students to do the tubes, that was it. There was no incentive to drive out there for a few hours on my day off, no threat of job loss, or being demoted to a BLS level only until competence was proven.
They had colorimetric detectors, but no waveform capnography. They don't allow medics to transport intubated patients just so they can bill Crit Care level, which lessens even more the amount of exposure to airway control the medics get.
They don't do any actual testing of intubation skills when hired. They didn't do any follow up to see if people were competent with it. The only 'rescue' device was a combi-tube, and no actual protocols on crics.
And I know of atleast 2 instances in my time there where patients died from lack of airway control.
ah2388
Forum Lieutenant
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Our layout
In our first in bag, we have:
Main compartment: Adult BVM, Glucometer, Sharps container, EZIO, IV start kit, Airway Kit.
Airway Kit includes:
everything for ETI, bougie, King tubes, NPA/OPA
Side compartment:
Trauma supplies, splints, kerlex, triangular bandage
Other side:
Nasal Cannula, NRB:-(, and a neb mask with meds
Top compartment:
Surgical cric kit, quick trach, chest decompression kit, port access kit
(Vacuum sealed)
In the lid of the bag, we carry 3x Epi, 1 Atropine, 1 D50, 3x Naloxone, 1 Glucagon, and in a small container we have 1 benadry, 1 epi 1:1, syringes for both.
Then we have a locked compartment, and a locked refridgerator.
We carry MS, Fent, Valium, Versed, Etomidate, Toradol, Haldol in the locked compartment
Ativan, and RSI meds in the fridge.
We have duplicates for all of the above supplies, excluding the narcotics/locked stuff, and we have 1 quick trach.
In other bags we have:
CPAP, Vent, Ped/Broselow bag, Suction equipment.
In our first in bag, we have:
Main compartment: Adult BVM, Glucometer, Sharps container, EZIO, IV start kit, Airway Kit.
Airway Kit includes:
everything for ETI, bougie, King tubes, NPA/OPA
Side compartment:
Trauma supplies, splints, kerlex, triangular bandage
Other side:
Nasal Cannula, NRB:-(, and a neb mask with meds
Top compartment:
Surgical cric kit, quick trach, chest decompression kit, port access kit
(Vacuum sealed)
In the lid of the bag, we carry 3x Epi, 1 Atropine, 1 D50, 3x Naloxone, 1 Glucagon, and in a small container we have 1 benadry, 1 epi 1:1, syringes for both.
Then we have a locked compartment, and a locked refridgerator.
We carry MS, Fent, Valium, Versed, Etomidate, Toradol, Haldol in the locked compartment
Ativan, and RSI meds in the fridge.
We have duplicates for all of the above supplies, excluding the narcotics/locked stuff, and we have 1 quick trach.
In other bags we have:
CPAP, Vent, Ped/Broselow bag, Suction equipment.
NREMTroe
Forum Crew Member
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In our narc box, we have our Narcs, and IO.
Our bag has airway/suction, intubation, iv supplies, drugs etc.. Everything is duplicated in the truck.
Our bag has airway/suction, intubation, iv supplies, drugs etc.. Everything is duplicated in the truck.
the_negro_puppy
Forum Asst. Chief
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We have 3 large bags and 1 small-
Drug/primary kit- has 2 comaprtments, hold all bandages, temp, BSL, cuffs, cold packs, IV gear, syringes, and the drugs
Oxygen kit- Cylinder, regulator, masks, OPAs, suction
Monitor - Lifepak 12
AIrway kit- a small bag containing laryngoscope, LMAS, NPA, OPA, Magill forceps
Most jobs we take primary kit and monitor into. If suspected resp problems/requiring 02 then it comes in. A
Drug/primary kit- has 2 comaprtments, hold all bandages, temp, BSL, cuffs, cold packs, IV gear, syringes, and the drugs
Oxygen kit- Cylinder, regulator, masks, OPAs, suction
Monitor - Lifepak 12
AIrway kit- a small bag containing laryngoscope, LMAS, NPA, OPA, Magill forceps
Most jobs we take primary kit and monitor into. If suspected resp problems/requiring 02 then it comes in. A
Anjel
Forum Angel
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We have for basics
Blue jump bag. Little duffel looking thing. Has dressings, bandaids, oral glucose, combitube, airway stuff. No o2 tank thats on the stretcher.
Our medics have their jump bag which has the same thing as ours plus their airway intubation kit, etc.
Then they have a small little red bag with iv supplies. Needles tubing saline etc.
Then they have.an A-pack which has some meds like d50, commonly used stuff I think. Not to sure. Its a county pack so they dont have to bust the seal on the drug box.
Then we have the big orange and white tackle box drug box. That has every medication in it that we have.
Blue jump bag. Little duffel looking thing. Has dressings, bandaids, oral glucose, combitube, airway stuff. No o2 tank thats on the stretcher.
Our medics have their jump bag which has the same thing as ours plus their airway intubation kit, etc.
Then they have a small little red bag with iv supplies. Needles tubing saline etc.
Then they have.an A-pack which has some meds like d50, commonly used stuff I think. Not to sure. Its a county pack so they dont have to bust the seal on the drug box.
Then we have the big orange and white tackle box drug box. That has every medication in it that we have.