Tuesday, May 22, 2012

What I Carry

 A reader (Lucus) queried me about what I carry on my when I am on duty:

I have a stethoscope around my neck. In my right shirt pocket, I have four small blank index cards. In my left pocket I have a pen, a pack of gum, and my I-phone.

I have trauma shears on my right side leg pocket. In that pocket I have my sealed controlled substances kit (fentanyl, morphine, ativan and versed), an IV lock, an IV flush, a 5 cc syringe and a 1 cc syringe. In my right small pocket, I have a needle, two alcohol wipes, and a nasal atomizer. I have my narc keys in the left small pocket; in the regular pocket I have a pair of exam gloves. I usually put the patient’s paperwork (W-10s, etc, med lists) in the left leg side pocket when they are handed to me on scene.

Surprisingly(Perhaps), I do not wear a watch. I stopped wearing a watch years ago because I could not afford to keep replacing my watches as I was always misplacing them. How can I work without a watch? When I feel a pulse, I feel for speed. Slow, normal, fast. Regular or irregular. I get a ballpark estimate that once I put them on the monitor is usually confirmed. There is a clock on the monitor. I also have my i-phone as a backup. All of my truly sick patients end up on the monitor.

I wish I carried a pen light more regularly, but those are hard to keep in stock. In the ambulance I have a flashlight, and someone on scene usually has a penlight if I need one.

I used to carry an EMS field guide, but now I use my i-phone to look up anything I need to check.

I am in a fly car mostly these days, so sometimes when I intercept, there are no locks or flushes on the shelves of the transporting ambulance. I find it is easiest for me if I just pull one out of my pocket. The syringes, needle and atomizer are all so I can deliver quick pain relief (IN Fentanyl) or to stop a status seizure (IM Versed). I like to have my kit at the ready to use. I don't like fumbling with the keys to open the lock box or being surprised on a call and not having my kit handy. I use my controlled substances kit, mostly for the Fentanyl fairly often -- at least every other shift, and not infrequently, two times a shift.

On my belt I have my company issued pager and when I am in the fly car, I have a portable radio.

When I enter a house, I always carry my Thomas pack and monitor. If I am the first one arriving, I bring in my oxygen bottle. If I am working the ambulance and it is for a fall, I always bring in the board and collar bag just in case. If it is for a cardiac arrest, I try to remember to bring in the suction.

I am not saying mine is the perfect set up or the recommended set up (I am not going to tell you not to wear a watch), but, based on twenty-plus years or responding, it works for me.

Note: Once upon a time, I did carry a window-punch. I only used it once, and I had a good time using it, but now I leave that to the fire department or other responders, now that we have so many others responding with us these days.