Donning a Johnny prehospital

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QRScomplex

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When I did my clinical rotation every patient admitted to the ED had to disrobe and don a johnny. It occurs to me that in most trauma cases in order to do a proper head to toe and to aid in exposing an ambulatory and conscious patient getting them into a Johnny in the back of the bus would make sense.

Our protocols don't make mention of this, does anyone have a service that does this as part of their truama SOG?
 
TransportJockey

TransportJockey

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What is a johnny. Are we carrying spare people named john to skin and put their skin on the pt?
 
MonkeyArrow

MonkeyArrow

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What is a Johnny?
 
MonkeyArrow

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Most services will just cut off your clothes or pull them off in a trauma scenario to do the head-to-toe. No one that I know of carries gowns.
 
akflightmedic

akflightmedic

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Are you an Aussie, a Brit or from Ohio?

Donning Johnnys are rare if non existent prehospital...and only speaking from my personal experience of all the hospitals I have worked in, in various states...we did not put anyone in a gown as a matter of routine. That was for the floor to do once they were transferred out of the ED. Occasionally certain conditions would necessitate one to drape across them or to keep shirt clean or to expose an area but donning the gown was not a requirement prior to an exam....especially in the ED.
 
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QRScomplex

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Thanks, that definitely affirms my suspicions that in most if not all services/protocols it wasn't done routinely.
 
NomadicMedic

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When I was doing my paramedic clinical rotation, one of the departments I rode with liked to put patients in a gown. If we did a 12 on a patient, we would take their shirt off and put a gown on. Kind of odd, but we we really only transported to one hospital and we just kept a stash of gowns on the medic unit.
 
Bullets

Bullets

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I do this to my patients stroke and stemi patients. Its one less thing they have to do at the hospital to get the patient up to the surgical suite. Not my trauma patients, they just get naked and then get covered with a blanket. But i am alone in this and my partners think im weird
 
O

OnceAnEMT

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Never heard it called a Johnny...

I can't imagine it being economical for EMS systems to gown-up their patients. In the hospital we have a 3rd party laundry system setup, but I doubt EMS could efficiently set this up. Would be a waste of money. And disposable gowns would just be a awful.

That said, all ED patients are asked to get a gown on within reason. If it is a patient with any torso complaint it makes EKGs and cardiac monitors easier, and of course the physical exam. Same goes for pelvic and proximal leg complaints. As well, avoids issues and speeds the process if they need to do any imaging. If the patient has a complaint where their clothes wouldn't impede (foot complaint, hand complaint, eye complaint, etc.) then they obviously aren't put in a gown. Further, avoids liability of getting blood or betadine on their clothes. Again, "within reason". However, all admitted patients are required to be in a gown before going upstairs, another JCAHO thing.
 
A

AtlasFlyer

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We don't even have PT hospital gowns on our trucks.

I too was in the "What's a Johnny?" crowd...

To me, getting a PT gowned is just another way for the PT's stuff to get lost. Keep their stuff on them as much as possible (within the needs of PT care of course) so ALL their stuff goes into the ED with them.
 
Tigger

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Grimes said:
Never heard it called a Johnny...

I can't imagine it being economical for EMS systems to gown-up their patients. In the hospital we have a 3rd party laundry system setup, but I doubt EMS could efficiently set this up. Would be a waste of money. And disposable gowns would just be a awful.
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We have access to hospital laundry carts and they actually leave gowns for us if we want. It's nice for people that have puked on themselves and the cath lab loves when we bring them gowned patients.
 
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OnceAnEMT

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Tigger said:
We have access to hospital laundry carts and they actually leave gowns for us if we want. It's nice for people that have puked on themselves and the cath lab loves when we bring them gowned patients.
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Do you only transport to that ED though? Eventually it would mess up numbers, one hospital's gowns flowing to another, unless you treat it like spine boards I suppose. Drop one off, pick one up. I see the merit, just some logistical issues that I know the hospital I am at would fret about. Not the ED, but the corporate money folks.
 
Tigger

Tigger

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Grimes said:
Do you only transport to that ED though? Eventually it would mess up numbers, one hospital's gowns flowing to another, unless you treat it like spine boards I suppose. Drop one off, pick one up. I see the merit, just some logistical issues that I know the hospital I am at would fret about. Not the ED, but the corporate money folks.
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For the most part we transport to four different hospitals in two different networks. They all share laundry. Leave your dirty linen, get new ones.
 
O

OnceAnEMT

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Tigger said:
For the most part we transport to four different hospitals in two different networks. They all share laundry. Leave your dirty linen, get new ones.
Click to expand...

For that it could work, just like you don't care where the spine boards go (which are usually owned by the EMS agency anyway). All of our linens are labeled for our specific location, so they aren't re-distributed after the contractor does laundry.
 
Bullets

Bullets

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Grimes said:
Never heard it called a Johnny...

I can't imagine it being economical for EMS systems to gown-up their patients. In the hospital we have a 3rd party laundry system setup, but I doubt EMS could efficiently set this up. Would be a waste of money. And disposable gowns would just be a awful.
Click to expand...
Drop a patient off, pick up a gown, drop the next patient off, pick up a gown. We do the same with sheets and blankets, drop the patient off, get anew sheet from the hospital.

Pretty much every hospital uses the same linen service, Angelica. Its a national company that most hospitals in our area use. Ive dropped of at my local and then picked up 100 miles north and they had the same sheets
 
Jim37F

Jim37F

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Availability of linens and gowns (never heard anyone else call them a "Johnny" before) isn't the issue. I have better things to be worrying about during a transport. I'd rather be coaxing a more complete history (both current problem and past medical hx) out of the patient than trying to coax them into stripping their clothes off, especially when most of my patients seem more interested in asking me for an extra blanket instead!
 
Bullets

Bullets

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If i have the time, and i usually do, to get a CVA or STEMI patient into a gown, that saves the ER time, which save the patient time and gets him to the cath lab faster and get them healthy faster.

Also, sometimes i use them on the old people who fall naked in the shower or the water rescue people who are now in soaked street clothes, i can strip them and gown them to keep them warm.
 
Akulahawk

Akulahawk

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Bullets said:
If i have the time, and i usually do, to get a CVA or STEMI patient into a gown, that saves the ER time, which save the patient time and gets him to the cath lab faster and get them healthy faster.

Also, sometimes i use them on the old people who fall naked in the shower or the water rescue people who are now in soaked street clothes, i can strip them and gown them to keep them warm.
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If you have a the time, you only really would want to change certain patients into gowns prior to arrival in the ED. If you don't have time and you're familiar with equipment used in the ED you're going to, help out with getting the patient settled. It's during this time you can give report and point out your physical exam findings.
 
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