Equipment for rural ambulance service

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bushinspector

Forum Crew Member
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In the process of attracting Paramedics to our rural ambulance service. Before you would consider to work in rural EMS, what equipment would you want in place? Transport times would be between ten minutes to our local hospitals, up to 90 minutes to our only trauma center in the state. In the near future we will have a helo service 45 miles away and will transport by them if needed.
 
T

TRSpeed

Forum Asst. Chief
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Pay, shedules, benefits, retirement, rigs, protocols are gonna be your most frequently asked questions. Post them here and you won't get repeat questions.
 
RocketMedic

RocketMedic

Californian, Lost in Texas
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You need power cots, waveform capnography, sensible epcr and vents capable of cpap or bipap.
 
RocketMedic

RocketMedic

Californian, Lost in Texas
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Spend money on good supplies and reap rewards.
 
J

johnrsemt

Forum Deputy Chief
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Make sure that people understand the transport times; I love long distance transports, but a lot of EMS people get scared of them; and helicopter services have been known to laugh at some calls from rural services due to nervous medics. I have seen helicopter crews refuse to waste their time with a patient, and make ground crews transport them
 
S

savemachine

Forum Crew Member
48
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Here is a "crash cart" list for in the hospital, but basically the same equipment list applies for medical transport.

Equipment
  • Airway (oral and nasal) all sizes
  • McGill forceps, large and small
  • King Airway Set (3) Eliminates the need for Laryngoscope and Endotracheal tubes
  • Bag Valve Mask (Adult and Pediatric)
  • Nasal Cannula
  • Non Rebreather Oxygen Face Masks (3 sizes)
  • IV Start Packs
  • Normal Saline Solution (1000ml bags)
  • IV Tubing
  • Angiocaths (various sizes)
  • 10ml Normal Saline Flush Syringes (3)
  • Gauze
  • Alcohol Preps
  • Monitor with Defibrillator (preferred) or AED
Drugs
  • Aspirin 81mg Tablets
  • Nitroglycerin Spray or 0.4mg tablets
  • Dextrose 50% (Dextrose 25% if treating pediatrics)
  • Narcan 1mg/ml (2)
  • Epinephrine 1:10,000 Abbojet (3)
  • Atropine Sulfate 1mg Abboject (3)
  • Amiodarone 150mg Vial (4)
  • Epi Pen (2)
  • Epi Pen Jr (2)
  • Solumedrol 125mg Vial
  • Benadryl 50mg Vial (2)
  • Adenosine 6mg (4)
  • Lopressor 10mg (2)
  • Cardiazem 20mg Vial (2)

Basically stolen from
https://www.acls.net/acls-crash-cart.htm
 
P

pwt57896

Forum Ride Along
2
1
3
I work in what we consider a semi rural service, my transport times range from ~15 minutes to upward of 45-60 minute transports sometimes.

If you spend a little money on quality equipment up front to make the job easier, you'll end up with happier employees.

Vent capable of multiple modes
EZ IO
Video Laryngoscopes
Disposable CPAP
CPR device


All of that's in addition to a typical ALS loadout on an ambulance, and a set of very progressive protocols will hopefully attract a decent group of Paramedics. And you can't forget to have nice boxes to work out of.
 
RocKetamine

RocKetamine

Forum Crew Member
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I would look into getting a LUCAS device if your service doesn't allow for backup to arrive quickly. They're very expensive but running a code with two people sucks. After that I'd get a vent, as bagging someone for a prolonged time also sucks and not in the best interest of the patient.
 
OP
OP
B

bushinspector

Forum Crew Member
39
4
8
RocKetamine said:
I would look into getting a LUCAS device if your service doesn't allow for backup to arrive quickly. They're very expensive but running a code with two people sucks. After that I'd get a vent, as bagging someone for a prolonged time also sucks and not in the best interest of the patient.
Click to expand...
We just put Lucas (1st generation) on our primary trucks along with vent on the paramedic trucks. We saved HUGE $$$$.
 
OP
OP
B

bushinspector

Forum Crew Member
39
4
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IF we had trees, bears would be a issue. Instead we have rattlesnakes.....and NO we don't allow our medics to pack!!
 
DrankTheKoolaid

DrankTheKoolaid

Forum Deputy Chief
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Pre-existing good relationships with volunteer fire and local law enforcement. Comfortable seating InThe front of the box with cup holders.. Your going to spend a lot of time in your home away from home.

Solid mapping of the area

Progressive protocols due to lack of communication via radio/cell if in a truly rural/frontier area

A very strong FTO period to train people especially if taking urban medics as this is a worlds apart from the 15 minute medic job

Monthly CE offerings and a strong QA process with the medical director included and include volly fire in these training
 
medicaltransient

medicaltransient

Forum Lieutenant
162
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succinylcholine, vec or roc please.

Anyone read the research on using vec or roc without sux in the pre-hospital environment?
 
STXmedic

STXmedic

Forum Burnout
Premium Member
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medicaltransient said:
succinylcholine, vec or roc please.

Anyone read the research on using vec or roc without sux in the pre-hospital environment?
Click to expand...
Are you talking about using Succ with Roc? Or comparing depolarizing against non-depolarizing?
 
NomadicMedic

NomadicMedic

I know a guy who knows a guy.
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medicaltransient said:
I read some research on facebook that said you don't need succ at all it should only be used in the OR and is pointless in emergency situations.
Click to expand...

Who wrote that? Tor Eckman?

You have a much better chance of a successful intubation with both an induction med and paralytic.

During the great succinylcholine shortage of 2010, we used roc in it's place with no difficulty.
 
STXmedic

STXmedic

Forum Burnout
Premium Member
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medicaltransient said:
I read some research on facebook that said you don't need succ at all it should only be used in the OR and is pointless in emergency situations.
Click to expand...
Haven't read that. You're saying Succ specifically, right? Or are you saying paralytics have no place prehospitally?
 
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