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Do you carry a bag in your car?

Discussion in 'Pre-Hospital [ EMS ]' started by Febrifuge, Apr 14, 2004.

  1. Febrifuge

    Febrifuge Grizzled Old Newcomer
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    Crash kit/ jump bag/ emergency kit/ bag o' tricks... whatever you call it.

    I'm curious about what, if anything, you carry with you in your own personal vehicle, in terms of medical supplies. What makes for a good "just in case" kit? Do you feel weird driving anything that doesn't have at least an ambu bag stashed in it somewhere? If you were locked in your own trunk, could you use D50 and baby aspirin to live an extra few days?

    (Bonus question: how much of your kit is stocked with supplies you paid for?)
     
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  3. flighterdoc

    flighterdoc Rocket Scientist
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    Yes, just the usual. Cuff/Scope, ET Tubes and laryngoscope set, chest tubes, foley's, O2, Hetastarch, D5, D50, NS, RL, pressure infusers, rizzoli saws, gallon of betadine, KED/Stokes/short and long backboards, 300' Rescue Rope, lifepack, drugs, portable CT scanner, etc. Just the basics.

    Oh, yeah. A copple of bandaids, too.
     
  4. EMT036

    EMT036 MS-III/AEMT/Rescue Diver
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    Yeah, but even more basic than the last poster..... Super-D O2 tank, Adult/pedi BVM, OPA's/NPA's, NRB's, NC's, Sterile H20/Saline, Gauze of various sizes/kling, SAM splint, trauma shears, penlight, B/P cuff, stethoscope, glucose tubes, gloves/PPE, but no bandaids... No ALS gear either -- county won't allow it...


    Just noticed the bonus question -- Yup paid for all of it... including mini-green light bar, antenna, scanner, and all of the rest of the usual volley acoutrements... However, paid for it by volly corps "Incentive Points" earned by going on extra calls, extra shifts, committee work, etc.
     
  5. PluckyDuk8

    PluckyDuk8 Pluck of all Plucks
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    A related question...what have you used from your trunk? :cool:
     
  6. lytesnsyrens

    lytesnsyrens The Phoenix...
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    i got a first aid kit and sometimes my scope. but i try not to carry too much. people like to break into cars around here.
     
  7. flighterdoc

    flighterdoc Rocket Scientist
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    Are you kidding? The bandaids.
     
  8. OSUdoc08

    OSUdoc08 Membership Revoked
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    All BLS supplies, including an OB kit, burn sheets, bandaging/splinting and related.
    ALS supplies to include IV's w/ fluids, intubation kit, blood glucose monitor, oral glucose, charcoal, nitro, aspirin, tylenol, advil, and albuterol inhaler.
    I can only perform to the EMT-intermediate level off duty, so I only carry such items.

    I also have a respirator, gas mask, chemical suit, and radiation suit. (I'm on a disaster team.)

    --------------------------------------------------------
    What have I actually used? BLS bandaging/splinting stuff and all als supplies minus the intubation kit
     
  9. Febrifuge

    Febrifuge Grizzled Old Newcomer
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    I am obviously way, way behind, then.

    (Apropos of just nothing at all, my birthday is in about three months...) :D
     
  10. EMT036

    EMT036 MS-III/AEMT/Rescue Diver
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    Used pretty much everything so far.... (including the BVM - first on-scene to cardiac arrest) I first respond for my volly ambulance corps, and I was also on first-response teams in college.
     
  11. oudoc08

    oudoc08 Please pass the gas...
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    I carry my stethoscope, a couple pairs of gloves, WelchAllyn otoscope/opthalmoscope, pathophys text, as well as my time card (gotta get paid)
     
  12. OSUdoc08

    OSUdoc08 Membership Revoked
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    Why do you need an otoscope/ophthalmoscope if you aren't in medical school yet.


    -------------------------------------------------------------------------
    Oh and the stuff in your truck does count if you are a first responder---because you vehicle is an emergency vehicle at that point, and is supposed to be stocked.
     
  13. niko327

    10+ Year Member

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    When i was still actively volleying, i had alot of [email protected]:
    BLS: 4x4s, 5x9s, kling, ACE bandages, sterile saline, trauma dressings, ob kit, tape, burn kit, splints, KED, collars, stethoscope, b/p cuffs, charcoal, ipecac,oxygen, oral and nasal airways, BVMs, masks, cannulas, portable suction.

    ALS: Drug bag (ACLS, AMS,Anaphylaxis, Saline Bags, etc...), adult and Peds Intubation kit, cricothyroidotomy kit, Defibrillator/EKG, pulse oximeter, ALS trauma bag. Lights, siren, radios, Paid for none of it though.

    Nowadays I think I got some bandaids in the glove compartment, and blinders on my glasses. Paid for those.
     
  14. cgEMT

    cgEMT Junior Member
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    Are you guys serious with all this equipment? Seems a bit much, maybe you all live in rural areas and thats how it works there. I'm an NREMT-I for a hospital based EMS service in a medium sized city and have never had the need to use even a bandaid in my POV. Just what is a reasonable BASIC personal jump bag consist of and how do I obtain it all for a reasonable price. Maybe I missed the sarcasm in the previous posts.
    Thanks
     
  15. flighterdoc

    flighterdoc Rocket Scientist
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    LOL, you've got to understand the mind of the inexperienced medic, driving around with an entire ED's worth of crap in their car (like I did), waiting, hoping for someone to use it on. For most of us, it wears off after awhile - for some, it's a lifelong affliction.

    It's similar to the amount of stuff carried on the person - the batman utility belt with more pouches than a grunt in Iraq, pockets full of checklists and procedures guides, three or four flashlights, etc. After awhile, you're lucky if you have a pen that works, and expect your partner to have all of that.

    If you want to get a bag, I'd suggest just basic stuff. Build it yourself (it's cheaper, especially if you restock from the rig or ED). Find a suitable container - I'm partial to soft bags, some like hard tackle boxes. Think about what you'd really need to keep someone alive until someone shows up with more stuff - gloves and mask to protect you, maybe a BVM, 4x4s and kerlix to stop the leaks, a blanket of some sort. A BP cuff and scope are kind of uneceessary except to let whoever shows up to take over that you might be more qualified than a Red Cross first aider (which is how I started, so no flames). O2 is at least a little hazardous and can be problematic, drugs are kind of a no-no, anything else is up to you.

    I do search and rescue, so I have a few more things in my bag(s).
    I carry extra chapsticks, sunscreen, a small smoke flare (for helos), SOAP notepad and pencil/spacepen, lots of triangulars, SAM splint, KTD, OTC pain and other meds, sting-eaze, and OB brand tampons (for those who need them, and to tamponade serious epistaxis). Oh, and tape (waterproof, 2"). A couple of large EKG pads for sucking chest wounds (better than vaseline gauze). A Sawyer extractor, 2 epi-pens (for me), two 500 cc bags of NS (for irrigation).
     
  16. cgEMT

    cgEMT Junior Member
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    Ha Ha
    Gotcha, we're on the same wavelength then. I do see the hard-core medics go all out. Thanks for the follow-up, I was thinking about putting together a more than adequate first-aid kit and that helps.
    I appreciate it.
     
  17. Krazed_Medic

    Krazed_Medic Registered Banned User
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    Nah, I don't carry anything myself, not even a pair of gloves. Probably should, but...i'm just not gonna do it. hehehe....
     
  18. bandaidsNhoses

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    basic BLS stuff: bvm,few nrbs/cannulas, opa's, d-tank, bew bandages, a couple of WaterJel packs as I'd prob run into fire victims, 1 adjustable collar, SAM splint cuff / steth & of course the bandaids! I guess I should shove a tube roll & Ringers bag in there now since I became an "I" since I created the bag... :rolleyes:

    Oh and everything, except the bag was ACQUIRED from work... :laugh: But at least I've used everything at least one point in time!
     
  19. Apollyon

    Apollyon Screw the GST
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    I have a pocket mask on the floor of my pickup that is 10 years old and never been out of the case.

    Otherwise, my stethoscope is on the seat ('cause I won't leave it in the hospital), and my white coat has the pockets full. I don't lock my truck (because it's 10 years old and has 114,000 miles on it, and the driver's door lock doesn't work well), and my prescription pad is in my coat...so, if some tool had even a 1/4 of a brain, it would be good times.

    In other words, I don't care.
     
  20. OSUdoc08

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    at least have gloves and a c-collar-----have never ever come upon a wreck? at least the c-collar for yourself in case you wreck.

    and basically most of the stuff is for me anyways.
     
  21. 12R34Y

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    I have a hard time believing that all of these medics have used any of these things ie. OB kits, nitro? d-tanks......come on.


    anway. personally i've got a box of gloves and a pocket mask..

    that's it.

    only thing i've ever used ............gloves.


    where do you people live that where after calling 911 you don't get help from PD, FD or EMS within at least 10 minutes? dang.

    maybe i'm just jaded and rarely if EVER stop for accidents any more.

    later
     
  22. emedpa

    emedpa GlobalDoc
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    had a pretty nice trauma kit with iv's,littmann steth,trauma shears, etc in the car until it was stolen....now just basic 1st aid stuff( gloves, gauze, tape, etc)
    last time I stopped for a trauma pt there was already a trauma surgery fellow on scene so I took off as I had nothing to add to what he was already doing
    ( except my gloves(he didn't have any.....)
     
  23. Notzfall

    Notzfall NREMT-P, MS-IV
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    A box of gloves, stethescope, BMV, OPAs, ETTs (7.0/8.0), Laryn handle and 2 blades (MAC3/MIL2), trauma pads, hemostats, and a couple of 14G IV caths. That's about all. The rest of the stuff can wait until the EMS unit gets there. From time to time I have 1:1 with me.

    Yeah, I still stop after almost 7 years. Yeah, I've used the stuff too - not everything though, thank God. Being a paramedic on the scene somewhere without equippment when you know something needs to be done is torture.

    It's better to have the gear and not need it than to need it and not have it.

    I just hate it when I stop to help and people drive by cursing and almost hitting us. Maybe I should get an emergency light. However, to me that's going too far, unless it saves my butt one day.
     
  24. 12R34Y

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    like i said.........gloves are all i carry.

    won't ever change either.

    i think there is just no realistic situation in which i'm going to tube somebody on the roadside before EMS can get there........so i tube them...then what?

    if you really wanted to help we should all be carrying AED's around. that's one of the few prehospital interventions that makes a huge impact.

    ALS stuff for trauma is way overrated. it's all bls in the field. if it's done right.

    gloves and a face mask and all your trauma patients should be fine.
     
  25. Notzfall

    Notzfall NREMT-P, MS-IV
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    EMS arrival in Atlanta traffic is definitely greater that 6 minutes when irreversable brain death starts to occur. Bagging or a facemask is poorly effective unless you have a peds. Tube them and then, you've got a secure airway and you know you're not bagging half of the air into the stomach and you don't need an extra pair of hands to hold cric pressure or airway positioning.

    AEDs; good for a restaurant, bad for my trunk. Never had to stop to find someone who has had a cardiac event on the side of the road, much less in V-fib.

    For ALS trauma; a chest decompression or pertrach/needle cricothyrotomy for a smashed larynx has saved someones life. ABCs of ALS covers that, not BLS. Happen often? No. But as I said, better to have it and not need it...
     
  26. flighterdoc

    flighterdoc Rocket Scientist
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    Interesting. In California, an EMT-P has the same scope of practice as an EMT-B unless they're on duty, so any ALS is without legal backing, malpractice, etc. If it goes badly for the pt. you're totally screwed. California is pretty bad that way.

    Have you ever stopped and used your stuff (off-duty) to do any invasive airway? I might see dropping a tube, but a needle cric?
     
  27. 12R34Y

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    Oh, seriously now...........

    pulling over to an accident and cric 'em? seriously.

    I also cannot imagine pulling over to an MVA and tubing anyone. first of all how are you going to get them out safely with some semblence of c-spine stabilization and no board.

    who's going to hold your head for c-spine stabilization while you are tubing them........seriously. this just doesn't happen.

    trauma is BLS. the mortality differences in BLS and ALS systems is pretty nil. reason.....it's mostly load and go. Obviously, a crushed larynx can't wait, but come on. I just can't believe people when they ride around with a fully stocked ambulance and you are going to extricate them, tube etc....

    Pocket masks work MUCH BETTER than one person BVM. i don't know about you, but one person BVM is not an easy effective technique unless you are a CRNA or anesthesiologist. I'd rather have my TWO hands to make a nice seal with the mask (also would then be able to do a jaw thrust which would obviously be indicated right?) little difficult to do a jaw thrust and bag one handed.

    Have i mentioned this already............seriously, come on....
     
  28. oudoc08

    oudoc08 Please pass the gas...
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    Oklahoma as well considers your paramedic license to be valid only on-the-clock, which is fine with me.
     
  29. Apollyon

    Apollyon Screw the GST
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    Consider me heathen, but what is "1:1"?

    And, in NY, having IV's in your vehicle, which isn't part of an agency, is a BIG no-no. Even if YOU'RE certified, your vehicle isn't, and there is a section of the NY Public Health Law (Article 30), that covers EMS, and one section is what is needed to be a response vehicle - and virtually everyone that uses their POV is not in compliance.
     
  30. EMT036

    EMT036 MS-III/AEMT/Rescue Diver
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    In Upstate NY you can do ALS "off-the-clock" but only if in you are in your home REMO area, where you are certified.
     
  31. niko327

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    I totally agree with you, except for the pocket face mask thing. A BVM can be a very effective device even in one person rescuer mode, if you have good technique. Sometimes a little practice can make all the difference. I don't know about you guys, but I'd never get my mouth that close to the patient's mouth despite the one way valve!
     
  32. Febrifuge

    Febrifuge Grizzled Old Newcomer
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    I can't think of a better motivation for getting a good seal than avoiding spew or toxic out-gassing from the patient...
     
  33. EMT036

    EMT036 MS-III/AEMT/Rescue Diver
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    Actually, my volly ambulance corps in Upstate NY has "first responders." Each vehicle is certified by the Dept of Health to be Part 800 compliant and is marked with a decal. They are then considered to be Emergency Ambulance Service Vehicles and are allowed to have red lights/siren and EMS gear (all BLS though.) Local REMO (not NYS) won't allow ALS gear in POV's, for some unknown reason.
     
  34. kylek044

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    Let's bump this one up to the top of the list... I'd like to hear this more (there's nothing on TV)

    Any suggestions on where to get a good bag to keep some very BASIC stuff in? right now a BVM, some gloves, a scope/cuff and gauze are rolling around in my trunk.
     
  35. igcgnerd

    igcgnerd Hawkeye
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    I think the fewer things you got, the better. In all seriousness all i have is a CPR mask and a pair of gloves its all you need when the average EMS response time where I live is 7 min.
     
  36. greytmedic

    greytmedic Faster than you
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    I carry a cell phone.
     
  37. jbar

    jbar Senior Member
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    I'm a ski patroller, so I just leave my patrol pack in the car (if you have the stuff, might as well have it with you.) It has the normal first responder stuff, kerlex, gloves, guaze, OPAs, etc. Much more important is the safety stuff I have in my car in case I come across an accident or blow my own tire: road flares, work gloves, fire extinguisher (found a cheap one, impulse buy). I also leave one of those orange reflective vest in my car.
     
  38. TerraMedicX

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    Ditto! Calling 911 so someone who is actually equipped to provide care is the most important thing I can do!

    Nate.
     
  39. leviathan

    leviathan Drinking from the hydrant
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    I carry a portable cath lab in the trunk of my Honda Civic. You just never know...
     
  40. psychbender

    psychbender Cynical Member
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    You got rid of the portable operating theatre? For shame.
     
  41. 146233

    146233 Phthirius pubis

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    He sold it to me for $45 and an iPhone. :hungover:
     
  42. leviathan

    leviathan Drinking from the hydrant
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    Just think how much it would screw up research on "door-to-cath" time by doing them on the street. :laugh: Although I guess you could use car door to cath time...
     
  43. leviathan

    leviathan Drinking from the hydrant
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    In all seriousness I carry a little kit with a pair of gloves, some simple bandages for hemorrhage control, a pocket mask, and a few other odds and ends. Carrying any drugs in your car is a bad idea, unless you have a 24/7 climate controlled vehicle that will prevent the meds from being destroyed by temperature.
     
  44. alyssadk

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    I have a BP cuff, pocket manual, and stopwatch, but that's mostly because I bought them for the class and they're in a bag I keep forgetting in the car.

    I'd like to get from bandages, tape, pocket mask and maybe some little odds and ends for small splints (finger splints, etc) Maybe a cheap little blanket. Really nothing else though.
     
  45. Burned Out

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    Keep in mind, you get out with nothing, and you help as a good Samaritan.
    You get out with equipment, and you help as a professional. You'll get your butte sued off.
     
  46. pseudoknot

    Physician PhD Faculty Lifetime Donor Classifieds Approved 10+ Year Member

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    Can you provide a source for this? I don't believe that's correct. Nothing in any Good Samaritan law I've seen makes any reference to the presence or absence of equipment.
     
  47. kylek044

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    No.
    That's a really faulty understanding/knowledge of the Good Samaritan Laws.
     
  48. Burned Out

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    A good Samaritan law covers an average person from being sued, when attempting to aid someone by means that would be considered common sense by an average adult.
    Once you use equipment, and I don't mean gloves or a pocket mask but advanced level equipment not found in a standard first aid kit, you have now gone beyond the scope of an average person.

    As a medic, if you are off duty, you are not working under the scope of your EMS Director. Unless, they have it in writing that they expect their medics to perform off duty.
    As a licensed DR. you are working under the scope of your license. If you are not an emergency medicine specialist. a Lawyer is going to use that against you.

    Now, as long as you act within the scope of your training, you have a good chance of being ok. But, just doing it opens the avenue to be sued.
    Acting as joe average person does not.
     
  49. pseudoknot

    Physician PhD Faculty Lifetime Donor Classifieds Approved 10+ Year Member

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    Again, that's not in the text of any Good Samaritan law I've seen. Some of the stuff you're talking about relates to issues of scope of practice: in California, for example, a paramedic is only a paramedic when on duty, so if they decided to carry around an ET tube and laryngoscope and then intubated someone off duty, they would be practicing medicine without a license. But in general, Good Samaritan laws do apply as long as you remain within your scope.

    I think that carrying stuff around for invasive procedures and the like is pretty stupid, but if you happened to have a BP cuff or whatever, that's not going to affect your status under Good Samaritan laws.

    EDIT: Also, some states specifically do include those with medical training in their laws. For more info, see:
    http://www.ama-assn.org/ama/pub/category/18209.html
    And here is an overview from the AMA of all 50 state Good Samaritan laws:
    http://www.ama-assn.org/ama1/pub/upload/mm/395/goodsamaritansurvey.doc
     
  50. Burned Out

    2+ Year Member

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    Pseudo: You are confused on semantics, and making my point.
    Yes, scope of practice is exactly what I am talking about. When you act, outside of your assigned work, you are acting outside your scope of practice.
    At that point, you are not working as a good Samaritan. Now even if you can prove you didn't violate the scope of your practice, it is mere perception of going beyond the scope of a good Samaritan, and you will still incur the costs of a lawsuit.
     
  51. pseudoknot

    Physician PhD Faculty Lifetime Donor Classifieds Approved 10+ Year Member

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    There is no "scope of practice of a Good Samaritan." Good Samaritan laws and the laws that deal with scope of practice are separate. Also, you will never get into trouble by carrying equipment that is used within your scope of practice. For the last time, if you can find a law or any reference supporting your position, please post it.
     

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