everyone carries trauma shears, but...

[JPINFV]

You would, JP.....

At least when I go full wacker, I do it with style (e.g. I did take a backboard home once...).

 

[boingo]

Hemostats have their place. We use them when we apply tourniquets. We use a long piece of surgical tubing, wrap it twice around the limb, pull tight and clamp where the two sections of tubing cross. Also, when using a sheet to wrap a pelvis, once you pull the sheet tight, cross the two sides and wrap 180 degrees, and secure both sides with hemostats. I wish I had pics, it would probably make better sense.

 

[PrincessAnika]

One thing to keep in mind with trauma sheers.... most providers will use them to cut anything and everything (ie clothes, wires, metal, bandages, etc). How clean are these sheers really?

I bring this up only to provoke thought of cross contamination. It doesn't make sense to use trauma sheers you used to cut a persons chemically contaminated clothes (gas, oil) on one call and than use the same pair to cut a sterile bandage/dressing on another.

So it does make sense to carry two separate pairs... although I don't personally.

i always made it a point to clean them after every call i used them on, and once a wk.

 

[PrincessAnika]

At least when I go full wacker, I do it with style (e.g. I did take a backboard home once...).

ha, i had did that once - had a LBB riding in the front seat of my car for two days.....also have had a peds board in my truck for about a week.....the one co i used to run for was way out in the sticks and got very few calls....they flew a kid and an adult past the local hospital to the big hospital, and i took a transport up to that big hospital with my other company so i brought back the equipment since we rarely ever went to the big hospital....

 

[Hemingway]

Hemostats = bag hangers

Hey everyone, totally new here. Enjoy the forum a lot. I keep hemostats on me because I'm the new guy and I get crap no matter what. Haha, really though we use them to hang NS bags from our lapels or anything else possible. Very useful if you need a third hand to hold up that bag.

 

[18G]

It's nice a lot of ppl clean their shears (as they should) but I know first hand many more don't.

 

[Bullets]

i carry all three. i use the trauma shears to cut off clothes and thicker stuff. the bandage shears are smaller, so i use them to in tighter spaces and for cutting, you know, bandages. i carry a hemostat for a whole number of things. Hanging bags from roof liners during extrication and when we bring pt's in, holding a roller gauze while i rip tape, hanging sheets at a DOA, tarps at a LSI or Fire, landing spot when we drop a bird in, keep nurses happy.

also, if my shears get dirty they take a trip through the hospital autoclave every time

 

[LondonMedic]

Oh no... Not a picc line.

The dude was urinating blood, so there was a dual lumen cath inside his penis so they could have a *big* bag of NS running to flush out the clotted blood, and the other to drain. We couldnt tx the giant bag of NS because there was really no way to, and the ER didn't have the caps for the catheter. So once we unhooked the flush line of the catheter, it backflowed and blood came out.

Stopping irrigation on a PU bleed is not normally the done thing, not until it's running rosé at least. Unless you fancy doing a few hours of bladder washout (or digging it out with a rigid cystoscope).

If they didn't have spigots for the cath did they not have catheter bags? :unsure:

 

[Hellsbells]

cancer wipes

Excuse me? ...the hell is a cancer wipe?

 

[lightsandsirens5]

At least when I go full wacker, I do it with style (e.g. I did take a backboard home once...).

Oh really? Do tell.

 

[l_one]

Shears?

I have tried EMT shears and Lister bandage scissors - they both do what they are supposed to do but there are pros and cons.

It is unreasonably hard to find EMT shears that have QUALITY MANUFACTURING. The design concept is good, sure, but really they are all just stamped sheet metal with in-line bulb bends for reinforcement, not tool steel, not high-carbon steel - stainless, sure - but what grade? They never tell you - certainly not the same grade stainless steel as a good blade.

What I've settled on after spending some time researching is good quality sewing scissors - $15 to $20 titanium, tightness-adjustable sewing scissors that can be sharpened (and come very sharp already). They might not cut through quarters but for the purpose - cutting through clothes and maybe a belt here and there - they are perfect and cut quickly though long lengths of fabric instead of one cutting motion per 1-2 inches. It's what I keep in my larger medical bag.

 

[alphatrauma]

Excuse me? ...the hell is a cancer wipe?

Choose your poison

 

[JPINFV]

Oh really? Do tell.

When working at the waterpark, on a day I wasn't on duty there was a young guest who fell and suffered an open fracture. Responding crews initially transported to one of the local EDs who then transferred her to the main children's hospital on the other side of the county. Due to positioning and concerns over pain, they transported her on the backboard sans other immobilization. So, working at my ambulance job, I come across the head bed (the orange Ferno non-disposable type), call the supervisor, got the story, and end up checking the two trauma hospitals (the ER tech I talked to remembered the patient and thought she was transferred to a trauma center) that were on my way home.

At next shift, I ended up at the hospital attached to the children's hospital (the children's hospital is a stand alone facility, but is attached underground to another hospital which includes emergency services) and came across it in the ambulance bay. Shoved it into the backboard compartment of the ambulance, back at the bay wiped it off with cancer wipes, and then it sat in my front seat over night until I could return it to the park.

 

[Sassafras]

When working at the waterpark, on a day I wasn't on duty there was a young guest who fell and suffered an open fracture. Responding crews initially transported to one of the local EDs who then transferred her to the main children's hospital on the other side of the county. Due to positioning and concerns over pain, they transported her on the backboard sans other immobilization. So, working at my ambulance job, I come across the head bed (the orange Ferno non-disposable type), call the supervisor, got the story, and end up checking the two trauma hospitals (the ER tech I talked to remembered the patient and thought she was transferred to a trauma center) that were on my way home.

At next shift, I ended up at the hospital attached to the children's hospital (the children's hospital is a stand alone facility, but is attached underground to another hospital which includes emergency services) and came across it in the ambulance bay. Shoved it into the backboard compartment of the ambulance, back at the bay wiped it off with cancer wipes, and then it sat in my front seat over night until I could return it to the park.

Wasn't it already wiped down by the hospital? By the time backboards make it to the bays in our local hospitals they have been deconned already. They have signs posted everywhere that things do not get put in the bays until they have been properly cleaned. Who does it, I don't know, but I do know I've never gotten a dirty back board back.

 

[JPINFV]

Wasn't it already wiped down by the hospital? By the time backboards make it to the bays in our local hospitals they have been deconned already. They have signs posted everywhere that things do not get put in the bays until they have been properly cleaned. Who does it, I don't know, but I do know I've never gotten a dirty back board back.

I don't know and don't remember if it had been wiped down by the hospital. I've seen some hospitals just put them out there and others clean them. However I know 100% it's been cleaned if I clean it.

 

[medic417]

Wasn't it already wiped down by the hospital? By the time backboards make it to the bays in our local hospitals they have been deconned already. They have signs posted everywhere that things do not get put in the bays until they have been properly cleaned. Who does it, I don't know, but I do know I've never gotten a dirty back board back.

The hospitals in my area do not clean anything. They stick boards etc with blood, grey matter, etc still on them in the ambulance entrance. You wear gloves while gathering your services equipment.

 

[exodus]

Stopping irrigation on a PU bleed is not normally the done thing, not until it's running rosé at least. Unless you fancy doing a few hours of bladder washout (or digging it out with a rigid cystoscope).

If they didn't have spigots for the cath did they not have catheter bags? :unsure:

Guess not unless our nurse was an idiot. It was easily above my level, so I did what the nurse wanted.

 

[Veneficus]

Wasn't it already wiped down by the hospital? By the time backboards make it to the bays in our local hospitals they have been deconned already. They have signs posted everywhere that things do not get put in the bays until they have been properly cleaned. Who does it, I don't know, but I do know I've never gotten a dirty back board back.

Then that hospital is obviously not busy enough.

I spent most of my life in high volume services and hospitals. No hospital I ever went to used their staff to clean EMS gear.

Most of the EMS services had people dedicated to retrieving their own equipment from various places and cleaning it themselves.

I have also seen hospitals dump contaminated EMS equipment into the biohazard trash when it wasn't removed by the service in a timely manner. (2 weeks)

Some of the flight services I have visited would clean and ship EMS gear back to the original agency as a courtesy, but they were certainly not as busy as the ED staff.

I cannot imagine why a facility would pick up the cost of cleaning EMS supplies (materials, man hours, etc) unless EMS was part of that facility or EMS gave the facility money for it.

 

[reaper]

Actually, Our Level 1 does clean all equipment. Why do they do this? Because it is an OSHA regulation. They cannot placed contaminated equipment anywhere it could come in contact with people.

Had a small rural hospital that used to dump it outside, covered in blood. After the major OSHA fine they received, they were fast to clean all equipment before being placed outside.

Only way around it for them, is if they are placed in a locked area, that public has no access to.

 

[Sassafras]

Then that hospital is obviously not busy enough.


I cannot imagine why a facility would pick up the cost of cleaning EMS supplies (materials, man hours, etc) unless EMS was part of that facility or EMS gave the facility money for it.

I'm pretty sure that the major teaching hospitals we transport to are pretty busy being you can wait hours to be seen if you aren't actually dying on the litter (and even then you may have to wait).

Secondly the hospitals around here DO have their own EMS units. I say "around here" but really our transport times are about 40-60 minutes from our tiny backsticks town. The major hospitals all run their own units. The towns around the hospitals and within treatment range may have smaller paid units (ours is one of the only volley units left), but they are not contracted by the hospital. They simply deliver to whichever hospital is designated for what needs treated (ie. trauma hospital gets traumas, heart attacks go to the hosp known for cardiac, and only two hospitals have the hyperbaric chamber so we divert those cases there).

Third, I'm pretty sure it's an OSHA thing anyway and illegal to throw nasty gray matter in a public place like an ambulance bay (hence the decon rooms at the ER entrances around here). And the following post confirms my suspicions.

Actually, Our Level 1 does clean all equipment. Why do they do this? Because it is an OSHA regulation. They cannot placed contaminated equipment anywhere it could come in contact with people.

Had a small rural hospital that used to dump it outside, covered in blood. After the major OSHA fine they received, they were fast to clean all equipment before being placed outside.

Only way around it for them, is if they are placed in a locked area, that public has no access to.