Where is your gear?

[Melclin]

I got a bit of a surprise in another thread when usal said the drugs have to be taken out of the safe on every call. It got me to thinking in general about the distribution of gear because I don't like how ours is spread out.

How is your gear, specifically your drugs, spread out?

I'll give a run down of how ours is as an example:

We have three main bags:
- Our closed circuit ventilation/suction with oxygen and a few other masks and bits and pieces.
- Monitor.
- (I think you guys would call it a drop bag): This one pisses me off - First aid bits, bp cuff, steth, bsl, thermometer, drugs, cannulation gear, fluid, LMAs, bvm.

There is another oxygen bag without all the closed circuit and suction for less sick pts. Collars and spinal gear are in two different bags in two different compartments.

Everything in the bags (drugs, first aid, cannulation, airway, bp etc) is duplicated in the truck with the exception of the monitor and closed circuit/suction.

I find this all to be a fairly frustrating and illogical lay out. Airway spread across two bags, assessment gear in lots of different spots. If we have a not particularly sick pt, we still have to carry all the advanced airway and drug stuff with along with the first aid stuff. It s*** me and my back. Although not having your drugs on you sounds worse, usal.

How's it done in your parts?

 

[STXmedic]

I'm pretty sure what usal was saying was that he has to pull his Narcs out of the lock box, as per law. All of our other drugs are typically carried with us in a med or jump bag. What I bring in:

Jump bag with:
-Bandaging supplies and trauma management
-IV equipment
-Drug kit

Airway bag w/o2 and assorted delivery devices

Monitor

 

[TransportJockey]

At work we have the following on the truck separated:
Portable Vent
Portable Suction
First in Bag (IV kit, ETI kit, MLA, BP cuff, pulse ox, CBG kit, airway supplies, bandaging materials)
Trauma bag (head blocks and c-collars)
Drug bag (IV kit, non controlled drugs eg Zofran, Benedryl, D50, etc)
Narcotics (in safe, has MS, Fent, and Valium)
Zoll M-series (the usual electrodes and paper, also has ASA and NTG in the side pocket)

 

[mycrofft]

Due to theft, we couldn't shelf stock any PO or IM/IV meds.

Not only none in the kits, but none in the exam rooms. Had to go to the IMED computerized drug box (size of a Neptune clothes washer on a stand) for anything (including advil or syringes), there was only one, and it was at one end of a 100 ft long building behind three levels of locked doors.
No Fooling.

 

[Shishkabob]

At usal's and mine agency, we have Versed and Fentanyl inside of a safe that ONLY the Paramedic has the code to, and our Ativan and Roc are in a cooler witha lock that only the Paramedic has a key to.





As for gear, we have a giant red bag which holds pretty much all of the gear needed to stabilize any critical patient we may come across on a call. Every bag in every station is set up the same way. It's a duffle-bag type of style, pretty big and hefty;

One compartment on the front holds all of our ACLS meds.
A second compartment on the same side holds all the IV stuff, such as start kits, needles, syringes, catheters, and combat TQs and trauma dressings.
A side compartment holds our sharps container.
The other side holds our BP cuff, steth, and glucometer.
The back holds our intubation roll (with all the required intubation equipment), LMAs and King tubes. We also have an adult and pedi C-collar in that pouch.
The main compartment holds our medication box, our cric kit, our suction unit, our EZ-IO, adult and pedi BVMs, our respiratory stuff such as NRB, nebs and the like, IV fluid bag, and other misc. stuff.
The drugs are in a box in the main compartment, and it holds a small supplement of main medications that could be used on a call when not in the truck, such as NTG, ASA, etomidate, Roc, pepcid, Epi, etc etc



We also have our EKG on the cot with the red bag, and the O2 is on the cot as well. We have a trauma bag which can be used on MCIs or remote trauma things. It's a backpack with trauma bandages and IV supplies.

 

[usalsfyre]

Yep, only narcotics are in the safe.

Otherwise we have

Gigantic heavy as all get out first in bag with drugs, IV/IO supplies, airway kit with ETT, backup airways, cric kit, portable suction, basic trauma supplies, tourniquets, BVMs, oxygen administration...I'll put it this way, on critical calls I often never even open a cabinet.

Cardiac monitor with typical supplies.

We also have a "trauma" bag that tends to take up space and gather dust, it has a few more bandaging supplies than the first in bag.

Other than the fact that the first in bag is far to heavy for the single shoulder strap provided, it's really a good setup.

P.S. Linuss beat me to it with a far more complete description...dang parapup

 

[Melclin]

Is all your gear duplicated inside the truck or do you use the stuff out of your bags?

Do you just carry an O2 bottle with a reg on top? Does it go into every job?

Seems like you guys have a similar problem although I think our problem sprung from adding more and more gear into a set-up that was designed around not carrying that much stuff. I wish someone would spring for some roller bags or backpacks or something.

 

[Shishkabob]

Yes, everything that's in the bag is in the truck, with the exception of a single EZ-IO gun, which is in the bag.

Some medics refuse to touch the bag if they're in the truck. I don't care. I grab whatever is closest.


We have an O2 tank, with reg, on the cot. I tend to leave the cot at the front door until we know if we're transporting or not, but it's company policy that the red bag and monitor goes next to every patient.

 

[Chief Complaint]

Bue airway bag
Green trauma bag
Red drug bag

The LifePak comes in on every call, and a decision is made when we arrive on scene as to which bags need to be loaded on the cot to go into the patient's house.

 

[NomadicMedic]

We carry all of our meds, an iv set up, bp cuff and what not in a Pelican 1550 box. Narcs and benzos are locked in the safe. We also have an airway bag with o2, intubation gear and other airway flotsam and jetsam. Monitor is standard. We have a portable suction, ez-io and pediatric bag all separate. We also have a c spine bag with collars, headbeds, straps, duct tape. I love the pelican box. It makes a handy seat.

 

[DesertMedic66]

One bag with everything in it including drugs. Narcs are in the medics pocket. And then the monitor has the pulse ox in a pouch.

 

[shfd739]

We have 4 pieces that comprises our take in scene stuff.

LP12 with a custom pouch that holds all the monitor stuff
E size portable O2 bottle
Small BLS/Trauma bag that has various bandages,BP Cuff,cold packs,sam splints,oral airways etc.

Main ALS bag-2 front pouches have glucometer kit and shears/BP cuff/crappy stethoscope.

Side pouch 1 has hand held suction,O2 masks,cannula,nebulizer,manual IO needle,30cc syringes.

Side pouch 2 has ET tubes and associated supplies,laryngoscope,combitube,chest decompression needles.
Main compartment has Stat Pack with all our meds, EZIO pouch with 4 needles and drugs to run an arrest,adult/pedi bvms, 1000cc and 500cc bag NS,250cc bag D5, inside lid has IV caths, Saline locks, prefill NS syringes, 4x4s, vaseline gauze, veniguards, 1cc/3cc/10cc syringes and straight needles, MAD devices.

Medic carries morphine and versed on a belt pouch and either hands it off to relief or locks it back station safe if not a continuous unit.

 

[Melclin]

Wow you guys have some crazy strict rules about the narcs.

So typically the stretcher is carrying your stuff in a lot of the time? We don't tend to get the stretcher until we know we're taking the pt.

What would you change about the lay out if you could choose?

 

[DesertMedic66]

Wow you guys have some crazy strict rules about the narcs.

So typically the stretcher is carrying your stuff in a lot of the time? We don't tend to get the stretcher until we know we're taking the pt.

What would you change about the lay out if you could choose?

Yeah we take the gurney in on every call. The O2 bottle is connected to the gurney and the rest of the stuff is seatbelted to the gurney.

The only thing I would change is to make our bag a little bigger so that everything isn't crammed in so tightly.

 

[Shishkabob]

Wow you guys have some crazy strict rules about the narcs.

DEA rules, apparently. "Double locked", which is funny since when I was at AMR I carried morphine and valium in my pockts since we had no lock box.

So typically the stretcher is carrying your stuff in a lot of the time? We don't tend to get the stretcher until we know we're taking the pt.

What would you change about the lay out if you could choose?

That's why I leave the stretcher at the front door. Close enough that if needed we can get it, but far enough that it's out of the patients mind and they don't instantly think they're going to the hospital. But officially, I leave it there because I'd rather go in and assess the patient then spend 10 minutes trying to find the best way to get the damn thing through the door.


Only thing I'd do different is make it a backpack... easier to carry when there's only two of you. MedStar in Ft Worth uses (used?) backpacks when I rode with them. One was airway with drugs, other was trauma.

 

[MrBrown]

We have it amazingly simple and Brown loves it ....

Inside the ambulance in the top lockers on the left are drawer sheets, blankets and pillow cases. On the right (above the stretcher) are oxygen supplies, an IV kit, first aid bits and pieces, glad wrap and one or two other things minor.

In the side locker is the scoop stretcher, traction splints, KED and stair chair

All of our supplies for going into a job are in a big green backpack and Brown means everything - IV kit, drug roll, intubation gear, bag masks, LMAs, everything.

Oxygen is in the portable cylinder and so is entonox on vehicles that still carry it

Morphine, ketamine, suxamethonium and vecuronium are carried in a hip pouch, we do not have a safe.

 

[fast65]

We have ours broken down into 3 bags:
-first in bag with bandaging supplies, IV supplies, BP cuffs, CBG kit, drug box (excluding narcs and benzos), etc.
-airway kit (oxygen bottle, ETI supplies, Kings, etc.)
-C-spine bag (c-collars, spider straps)

Then of course we have our portable vent., suction unit, and Zoll. We keep our morphine, stadol and versed in the safe, and we have our succinylcholine and rocuronium in the first-in bag and we have some more on the wall.

 

[MrBrown]

Brown should add it is rare to take the stretcher into a job (Brown has done it ONCE) on every job Brown takes the cardiac monitor, oxygen and backpack.

A lot of places our stretcher just won't fit or it's easier to carry the patient out on the scoop if they are acutely unwell or stair chair if not.

 

[i5adam8]

-EMS Jump bag- contains adult BVM,Intubation kit,2 IV bags with stick kits,pulse ox,BGL,assortment of b/p cuff sizes with stethoscope, NRB masks and nasal cannulas, trauma side with assortment of trauma dressing,cravats,ect. tube of oral glucose,pen light,trauma shears,and window punch. Plus the jump bag has a large circular hole in the center. Someone decided we should put our portable o2 tank in this hole so we would have less to carry. So basically this bag weighs a ton and is a real pain to carry.

-Drug box- which contains all medications that we carry including all narcotics. The drug box is stored in a double locked cabinet on the truck.

-Monitor(LP-12) with spo2 sensor,NIBP cuff,12 lead cables and patches with defib pads in side pouch.

-Portable suction unit.

Our longboards are stored on a side compartment on the truck along with c-collars,headblocks and straps. We have a pediatric jump bag that contains peds intubation equipment along with some IV suppliies and child/pediatric b/p cuff. Along with trauma dressings.

Cric kit and EZ-IO are not in scene bags(although I think they should be). And just about all of the equipment listed above in bags are duplicated on the Ambulance.

This is not everything of course,just a quick run down.

 

[katgrl2003]

Our first in stuff is in 2 bags plus a Zoll monitor.

Airway/first in bag: O2 bottle, CPAP, cric kit, nebs, BVM, combitube, intubation equipment, bp cuff, steth, plus wound care including tourniquets, 4x4s, kerlix, etc. Heaviest bag I've ever carried... thank god for firefighters!

Drug box: EZIO, glucometer, bp cuff, steth, and most drugs we carry on the ambo, except for narcs.

Narcs are kept in a lock box, which is then locked in a cabinet in the truck, only the paramedic has the keys to both.

We also have a c-collar bag and portable suction, but those rarely go on scene with us.

And the world is coming to an end, because I agree with Linuss. I would LOVE if our Airway/first in bag would be a backpack.