Check that gear

[Topher38]

So I was doing volunteer ride time with a paramedic at the local EMS company. Typically the day starts off with a gear check (EKG check and test, O2 full and working, ect..) and setting up the rig the way they want it.

I typically ride with a medic in my VFD but unfortunatly could not that day. I was riding with a "NEW" medic, he JUST got his paramedic patch and was a joyfull fellow.

As some what of an observer/assistant I had put my gear (stethescope, BP buff, pocket guide) where I had always put them in the back of the rig.

He didnt really check anything, Just got his medic bag he was assigned off the rack and put it in the back of the rig, got his EKG and did the same. Didnt check O2 or anything (not saying it was a BAD thing, just something I was in the habit of doing)

So we get dispatched for a difficulty breathing, I carry the EKG into the house, the elderly (very overwiegh) woman is obviously in need of O2, Boom, O2 is completely empty and we had to get her outside and into the back in order to use the large O2. So we did that. Ok she is stable, he wants to hook her up to his EKG, He puts a few nodes on and then soon realizes that he is missing quite a few of them. And no spares in the bag.

I took vitals and we were soon about to arrive at the hospital, He put her on a breathing treatment (nebulizer).

We pull in and open the doors to get her out, and into the hospital, he left her attached to the O2 non-rebreather while he pulled her out forgetting that he didnt use a small O2 cylinder. She was still hooked up to the large tank, he starts pulling her out and I start yelling but it was far too late. She started grunting and moaning as the mask dragged across her face and then the cord popped off the hook up to the large tank. I was in aw .

Long story short, after that he always checked his gear afterwords.

Have any stories of forgetting to check gear?

Any examples of not having the equipment you need that you should have?

Any bad days?


Im listening intently ^_^

 

[Epi-do]

All I can really say is that he is an idiot for not checking his truck and gear out. The only time I don't check my stuff out before a run is if we get toned out as I walk through the door. Even then, as soon as we get back to station everything is checked out.

After dropping the patient at the hospital, we restock our airway bag/drug box from the ambulance cabinets. If we end up with several back-to-back runs, or a really bad/messy run that significantly depleats supplies, we won't mark in until we have restocked.

Like anyone else that has done this job for very long, I know turns my truck over to me in good shape at shift change, and who says it is in good shape with dead batteries in the monitor, no fuel in the truck, etc. Despite knowing that, the truck check is done, regardless of who was on it before me. Once I am on duty for the day, that truck is my responsibility, and "Billy-Joe-Bob EMT extraordinaire said it was ok" just won't cut it when the permanantly injured/dead patient's family decides to sue because your equipment wasn't properly working.

As for the guy forgetting to swithch the O2 over from the onboard to a portable - at some point we have all done it. It happens, then you apologize to your patient for your mistake and move on.

Can't really think of any stories to tell you about not having equipment that should be there, but that goes back to always checking your equipment. I know I have had bad days, where things just don't seem to go your way no matter what you do, but even then, can't really think of any specific stories to share.

 

[Airwaygoddess]

Patient care!

This was one of those life's little lessons that affected giving the proper care to the patient, and could compromise the outcome for that patient's survival. I don't find any humor in this situation, I hope that this "Newbie" will learn to do the required inventory and check out for all of the equipment and supplies that are to be used. There is no excuse for laziness. :angry:

 

[LucidResq]

Tsk tsk. Oh well, he learned and she lived. It's a pretty stupid mistake, but who hasn't made one? He was lucky that his error wasn't a deadly one, though.

Here's a good gear-checking mistake of mine... thank god this one happened at a training...

My SAR team was doing a plane crash rescue training in the mountains with plenty of snow on the ground. Everything was going fine, we made a find really fast, and my team was sent back for bash (gathering all the medical supplies and the litter). So for snow rescue... we use a thompson litter. It's like a basket sled for patients. They go in it on a backboard, are strapped in with webbing, and pulled on the snow by two people.

So I pull the thompson out of the truck and make a horrifying discovery. The webbing isn't there, so there's no way to secure the patient. Fortunately we had our rock gear with us so I improvised and used some rope, but it was not as effective as the webbing would have been.

Whoever separated the webbing from the litter made a big mistake, but this was obviously my error because I'm the EMS officer for the team and I didn't check the litter before we left headquarters; it would've been pretty obvious too. Now I keep some daisy-chained webbing attached to the litter at all times.

 

[KEVD18]

everybody will cannulate(strangulate with a cannula(or mask)) a pt. it happens. theres a lot going on and sometimes you forget to switch to the protable. not the end of the world, apoligize and move on.

not checking the truck, well that happens too. its never appropriate or acceptable but it will happen. you will do it. i have done it. everybody here too. unfortunatley, it takes getting caught with your pants down to wake you up. at a job i used to have, i got my truck hand off from the prev crew as it was a 24hr rig. the off going crew consisted of two women whom i was friendly with. i cant count how many times i trusted them when they said "the rigs all set" and it wasnt. it was very rarely a major deficiency, ususlly cleanliness or fuel. one time though, they left the primary portable o2 tank at the cascade station. we have the spare on the bus, but no regulator. i got caught with my pants around my ankles for that one.

a story about not having equipment and a bad day. two questions, same story:

most folks here have heard this one as i posted it the day after it happend and was torn to shreds over it.

dispatched to apt building for M pt c/o abd pain s/p surgeory. now, we put a little too much faith in our chief complaint as dispatched. we expected to find our patient sitting in a kitchen cair waithing for us. subsequently we brough nothing but the stretcher in with us. monitor, o2, drugs etc, all in the bus. o/a found 56y/o M pt supine on floor. pt CAOx1, cool pale and diaphoretic. sig other states he recently had his 11th abdominal surgeory(unable to elaborate). she was napping on the couch, and awoke to find him in current state. vs on scene: 90/50, pr 110, rr12. dispatched to apt building for M pt c/o abd pain s/p surgeory. o/a found 56y/o M pt supine on floor. pt CAOx1, cool pale and diaphoretic. sig other states he recently had his 11th abdominal surgeory(unable to elaborate). she was napping on the couch, and awoke to find him in current state. vs on scene: 90/50, pr 110, rr12.

so we figure, unwitnessed fall, altered mental etc, we'll board him. so i run back down to the rig and grab the cspine stuff. another oppurtuinty to grab the als gear, which i didnt.

pt > lb with c-spine and secured. lb > stretcher and into the elev we go. me and the medic are discussing wheat we are going to do from here( iv o2 monitor etc) just dividing up the work. this is where things go sideways. two thing happened silmultaneously. 1) the elevator got stuck between two floors. 2) i looked over at the pt and noticed there was minimal, if any chest rise. after exchanging "oh s h i t" looks, we reevaluated. pulseless and apneic.

elevator unsticks after about 10sec and we run through the lobby into the rig. call for another truck. asystole on the monitor. begin cpr. medic goes to intubate. tubes the esophagus. when we go to check placement with the bag and etco2, two breaths and he volcanos an absolkutely ridiculous amout of blood from his stomach. right out of the tube over everything. two more attempts at eti with no sucess. so now im bagging, suctioning and compressing while the medic searched for a line.

seconde truck shows up. one really strong basic whom ive worked with for some time and a second day rook. rook drives, other b with me. so now i have the airway and giving directions to the driver. other b has compressions and -p spend the rest of the ride<5min attempting iv access s sucess.

o/a at H, pt > bed and code team goes to work. still asystolic. er doc cant tube either. resp ther ends up getting it fiberoptically. still cant get periph iv so they go with a fem cutdown. first round of drugs delivered at 50min down, asystolic the whole time.

moral of the story, never trust your dispatcher has given you the right information. it was determined after the fact that the pt had blown a AAA. he died in his apartment and nothing we would have done would have saved him. but we still could have done our jobs better. i learned that lesson the hard way, but have never made the same mistake again.

 

[skyemt]

So I was doing volunteer ride time with a paramedic at the local EMS company. Typically the day starts off with a gear check (EKG check and test, O2 full and working, ect..) and setting up the rig the way they want it.

I typically ride with a medic in my VFD but unfortunatly could not that day. I was riding with a "NEW" medic, he JUST got his paramedic patch and was a joyfull fellow.

As some what of an observer/assistant I had put my gear (stethescope, BP buff, pocket guide) where I had always put them in the back of the rig.

He didnt really check anything, Just got his medic bag he was assigned off the rack and put it in the back of the rig, got his EKG and did the same. Didnt check O2 or anything (not saying it was a BAD thing, just something I was in the habit of doing)

So we get dispatched for a difficulty breathing, I carry the EKG into the house, the elderly (very overwiegh) woman is obviously in need of O2, Boom, O2 is completely empty and we had to get her outside and into the back in order to use the large O2. So we did that. Ok she is stable, he wants to hook her up to his EKG, He puts a few nodes on and then soon realizes that he is missing quite a few of them. And no spares in the bag.

I took vitals and we were soon about to arrive at the hospital, He put her on a breathing treatment (nebulizer).

We pull in and open the doors to get her out, and into the hospital, he left her attached to the O2 non-rebreather while he pulled her out forgetting that he didnt use a small O2 cylinder. She was still hooked up to the large tank, he starts pulling her out and I start yelling but it was far too late. She started grunting and moaning as the mask dragged across her face and then the cord popped off the hook up to the large tank. I was in aw .

Long story short, after that he always checked his gear afterwords.

Have any stories of forgetting to check gear?

Any examples of not having the equipment you need that you should have?

Any bad days?


Im listening intently ^_^

be careful about being so judgmental... you too will make mistakes you wouldn't think possible... we all do... we hope they don't influence patient care...

just remember, after you make your bonehead mistake, you might not appreciate being the subject of someone else's post, even though you might be a really good emt.

 

[Topher38]

be careful about being so judgmental... you too will make mistakes you wouldn't think possible... we all do... we hope they don't influence patient care...

just remember, after you make your bonehead mistake, you might not appreciate being the subject of someone else's post, even though you might be a really good emt.

I know I will make mistakes, Im prone to them :lol:.

I was a little judgemental that I will admit, But I did not intend on sounding that way. I just read my post over again and it was a wee bit judging him.

I never called him a bad EMT and niether did I think he was after his bad run, I understand that his faults where just simply mistakes.

 

[skyemt]

I wasn't calling him a bad EMT-P or an idiot, I didnt want to insult him hense why I didnt give a name or company name. I only posted this situation to start a discussion on gear checks and bad days, thats all.

And if one day a post is about me because I screw up, atleast other people will learn from my mistakes as well as I will.

I didnt make this post to insult him in any way, as you can see I didnt call him any names and All I did was tell you what happened that day on that shift. I wasn't "Judging" anyone, and if I made it look like so, Im sorry.

you wanted to see if it is a good idea to check gear? right...

if you want to judge others, that's fine... call it what it is, but remember, you will be there too..

i doubt you thought it a thought provoking topic, whether or not to check your gear... more like, "hey look how this guy screwed up, he won't do that again."

 

[Topher38]

Sorry you think of me that way....But Ill be the "adult" here and not argue with you over a post....Sorry I mislead you.

If you think this is that bad of a post then hit the little red thing under your avatar and Im sure an administrator will delete the post.

No one said you had to read it, and No one said you had to reply.

 

[KEVD18]

do you realize that every time you get an answer or response that you dont like, you get defensive and argumentative? and then frequently proceed to make an *** of yourself by acting like a three year old who got a toy taken away?

just checking to see if your aware of a behavioral trend of yours ive noticed since you started posting here....

 

[Topher38]

Sorry you think of me that way....But Ill be the "adult" here and not argue with you over a post....Sorry I mislead you.

If you think this is that bad of a post then hit the little red thing under your avatar and Im sure an administrator will delete the post.

No one said you had to read it, and No one said you had to reply.

Its not that I did not like his response, I actually admitted I was a little judgemental, and I apologized for it. I tried to clear up my stand on that the best way I know how, letting the person know that it was a misunderstanding and at the time I was not aware of the way I had represented my stance. My apologeez (<--spelt wroung) again.

Sorry that you feel that I am a child, But as I said before I wont argue with anyone. If you dont like me. Report me to an admin if you truely feel I am too immature for this site. If you look at what I have posted in response to people not liking me, I am only trying to defuse an argument from starting, not fueling it like you are trying do by insulting me.

 

[Flight-LP]

Well you know what Topher, you shouldn't be apologizing for anything. Judgemental or not, that is left to the perception of others, your partner that day was / is an idiot. There, I said it and I'll stand behind it! Everyone keeps saying that "your time will come" and it "will happen to you". BULLS@#T!! I have never been caught with "my pants down" (well maybe literally, but thats another story all together!) nor will I ever be. It's called taking accountability and responsibility for your actions as the in-charge of your unit. Check yo' dam# truck off, every day, every time. This attitude of half arsing things is sickening. If you actually take the word of your off going relief saying your truck is fine, then you too are an idiot. If I can't trust you enough to check off your truck in a systematic manner, then how can I remotely trust you with the care of my loved ones?

Those were some pathetic responses. Maybe you should lay off pointing out other individuals' faults and look at your own!

 

[Topher38]

I have never been caught with "my pants down" (well maybe literally, but thats another story all together!)

Haha ^_^

That kinda stinks if that really happened.

 

[triemal04]

Interesting responces all around so far...nice to get an idea of how people react when they hear of something going wrong, and a couple of great learning points if anyone cares.

Tophers original post- Not checking your equipment at the beginning of your shift is wrong. Plain and simple. Got to agree with Flight 100% on that, and personally, if the supe heard about that, in my opinion, the minimal acceptable responce would be a write up, followed by suspencion and termination for subsequent times. It doesn't take that long to check your equipment, to ensure that your laryngoscope, monitor and suction work, that you have adequate O2 levels in all tanks and in the rig itself and to do an eyeball inventory of all the equipment; I do it every shift in under 30min by myself. To do any less is to not do your job and put your patients at risk. And as Flight also said, it is extremely rare that I have ever been surprised by something being missing on a call...as in maybe 1 time and that only because we went straight out and I didn't have time to do a rig check. (I have been surprised in the middle of another call, but that was my own d@mn fault for not replacing a piece of equipment and easily remidied)

The flip side to this is also that the crew that left the equipment in that condition should also land in some hotwater...there is no exscuse for leaving equipment in anything other than working order and for leaving a rig other than fully stocked. If for some reason circumstances dictate that you can't (and I mean really can't, not that you don't want to go to extra distance) then you had better be sure and make sure that information gets passed on to the next crew. Even if you have to leave a note taped to the kit. To do otherwise is (surprise) to not do your job and put patients at risk.

KEVD18's post- This is a great example of why you should never put to much stock in what dispatch tells you, and be prepared for something completely different and bad. Abd pn? I don't give a rip if it's post surgery until I assess the patient. Up till then it still could be cholecystitis, kidney stones, appy, bowel obstruction, incision that's ripped open, internal damage from the surgery, pancreatitis, gastritis, ulcers, anything that normally could be a cause of abdominal pain. Go in prepared for that and you'll be ready when things head south in a hurry. (not to mention that even if you did believe it was surgery related a lot more than the cot should have been brought in...nothing like finding someone who's septic from a post-op infection or bleeding internally because the sutures ripped to ruin your day.)

Good learning points on both. Bottom line though: complacency will kill. It may not be you that dies, but it very will could be someone you are responsible for.

 

[Jon]

Sorry to bring a thread back from the dead...


Anyway... I just started a new job. On one of my first shifts, I didn't really check the truck... after our first call, our trucks O2 alarm went off for low O2 tank pressure. I checked the pressure and it was <500 lbs, and we'd barely used it. I assume that it should have been swapped out before we left station, but because I didn't check it, we didn't swap it out.

Anyway. I've realized that my partners (Medics) rely on me to check the BLS side of things... O2, Long Boards, fuel, etc... it only takes a few minutes to do a quick walkaround and check all that. I was humbled and reminded about good rig checks.

 

[LucidResq]

Bottom line though: complacency will kill. It may not be you that dies, but it very will could be someone you are responsible for.

OH MY GOD. Yes.

Thanks to gear-checking I discovered a potentially fatal equipment problem. I practically shat myself when I found this malfunction.

I recently took over the position of "emergency care officer" for my SAR team. Basically, I am responsible for all of our gear, planning trainings, and collecting PCRs.

It was time to do an inventory of all of our e-care packs... the packs that we rely on to provide emergency care whether we're in the middle or the city of the middle of nowhere. Dynamics of care change drastically when you have to condense what one would stock an ambulance with into a single backpack. The stuff in that pack is often all you have available to care for a patient for HOURS. (carry-outs often last around 6 hours)

Each pack is supposed to have one adult BVM. So I was examining one of the packs and I tried to assemble the BVM only to discover it was flat-out broken and COMPLETELY inoperable.

All I could think about was how lucky I was to discover this problem at headquarters rather than while sitting in front of an apneic patient on the side of a mountain 6 hours out from civilization.

So the lesson is don't get complacent with checking your gear. Check it thoroughly. Had I just looked over the BVM briefly rather than actually trying to assemble it, I would've missed this problem and someone may have died.

Don't trust the people that were supposed to check or checked the equipment before you. Check it again. I don't know if the officer before me failed to check the equipment thoroughly, failed to check it all, or if the BVM magically broke on its own, but either way that thing was broken.

 

[Ops Paramedic]

I would be lying if i said nothing tike this has ever happened to me!!

At 0700 i removed my personal kit from the car, including my drug bag, as i was awaiting my relief who was late as per normal. I had a 2nd & 3rd year student on with me for one of their training shifts. Dispatch phoned and asked if i was willing to service the call. Hoping that there will be something for them to do and learn from, i said yes. About halfway there, travelling against the flow of peak hour traffic and no posibility of turning around, we realised we don't have the drug bag.

We quickly changed our minds, hoping there is nothing to do for them, which will mean we don't need the drug bag. On arrival we are the first vehicle, and it turns out the patient is urgent need of definative airway management, i.e. ETI. Alls good, we reasure ourselves that not all patients needs medications to be intubated. Well, this patient did, if "Murphy" was on scene that day, i would have most certainly murdered him and did the jail time with a smille on my face!!!. Yes, if you take a 4 pound hammer and chisel through his teeth it solve the trismis problem, because dentist also need to work, you would be able to pass a tube (just some humour)!!

Fortunatly for the patient, and us, another ALS arrived shortely after us and we used his drug bag. What did the students (and me) learn from this call?? Don't remove any of the kit until the keys of the vehicle are in the relief's hand and that "Murphy" is a...

 

[firetender]

...but have never made the same mistake again.

This is why even God makes mistakes.

 

[tydek07]

Check the truck, Check the truck, Check the truck...

This is how people learn. I bet, or at least hope, that he doesn't blow off checking out the truck before his shift from now on.

This is one thing that I do not blow off. I always check out my truck before my shift. I know that some people try and put the responsiblility on the crew before them and say that the other crew should have done it, so everything is fine. DO NOT rely on others, its going to be your butt in court, not theirs.

Anyway, its not good that things like this happen, but also it is in a way.

People learn from their mistakes, its life.

 

[Ridryder911]

Sorry to bring a thread back from the dead...
I assume .

Well, there is your life lesson. You know what they say about ***/ u/ me