Bag Baggage

I am not a fan of all the crap we have to carry around.

We carry the worst case scenario into every single call mainly because the manner in which we are assigned calls for service, by first come first served.  Add to that the impossibly broken categorization of calls into little boxes that has never, ever, EVER, been accurate or efficient.

Because of all that I have to carry my cardiac monitor/defibrillator, Oxygen, clipboard and ALS bag on every. single. call.

Why?

Because you never know what is waiting for you.  The 62 year old male with a headache you were dispatched on?  That's a 34 year old woman in active labor.

The unconscious man in Apartment 4H is actually the 5pm dialysis transfer wanting to get in early.

 

Since my attempts to change the way we dispatch failed in the design phases, perhaps there is a short term solution to all the gear we carry.  Here at my current assignment I oversee between 2 and 5 ALS first response units depending on staffing.  It seems each crew has their own way of stocking the bags.  We do a lot of hiking with or bags since our call may be to Gate 67 but the patient is now closer to gate 82.

This means all our stuff needs to be carefully stocked and easy to carry long distances.

The roller bag version was suggested, but the size and need to carry it up sometimes very steep jetway stairs made that solution unfeasible.  I know everyone seems to run a different bag in a different set up, but that's only because we all have different priorities and specialties when on scene.

For example, all my assessment gear is in the top compartment of my bag along with my oral glucose.  That's my "This part gets opened on all calls" part.  Then inside is my IV bag, meds and intubation kit on the bottom.

I'm not looking to wake the sleeping dinosaur of EMS opinion on bags and bag set ups, just wondering if I'm the only one frustrated that we carry everything everywhere.

On the engine I don't take a ladder inside every fire, I can go back out and get it, but for EMS, we carry cardiac arrest meds to stubbed toes.

0.5% of my call volume gets in my way the other 99.5% of the time.

"But if it saves one life...?"

But what if it negatively impacts another?

Am I over reacting, whining, or should we try something new?

Comments

Andy said…
I don't think your off base at all. I worry about back injury carrying bags and monitors around. I know people that would carry everything and the kitchen sink if they could. I think you hit the nail on the head that coding the call is the short fall. Our bag is standardised by our service, which is great for when we backup crews I know where everything is. Though they are heavy, little bit of everything, and the bag isn't very ergonomic, but do have shoulder straps and are good first response. Our service also gives us discrestion, except in cardia arrest, what we chose to carry in. Mostly the bag and monitor and maybe 02 for shortness of breath. I normally am willing to go back to the truck to grab anything. My bag for my other work in the wilderness is made up very different and with a much better pack for long distances.
Skip Kirkwood said…
We have recently scaled back what is in our bags. We now take a "first 10 minute" bag that is a good bit lighter than the old ALS bag. If we're going to be there for a longer time we will either go back and get the secondary bag, or on a complex call we will have a supervisor and/or second unit who can bring the secondary bag with them.

Reducing the load should be a priority! And use the stair-chair as an equipment cart!
John said…
I'm with you on this. Not only is it hard to carry, it's difficult to store on the rig in a way that it stays easily accessible and climate controlled. We have an IV kit and ET kit in the ALS bag and the pediatric bag, more liters of fluid than can ever be used by a first response/non transporting agency , and enough c-collars for the once in a lifetime bus crash. I've thought of building a compartment in the engine for a hand cart to carry it all.
Grizzly MEdic said…
Years ago, we had a ‘first in bag’. BP cuffs, stethoscope, a few 4x4s, D cylinder, pocket mask, NRB, nasal cannula, nebulizer, albuterol, and stuff for epi in anaphylaxis. Nothing else.

LP10 with the usual accessories and supplies.

Airway kit with intubation stuff, Combitube, BVMs.

ALS kit with IVs and drugs.

Trauma bag with 4x4s, 8x10s, Kerlix rolls, triangular bandages.

You took what you needed.

We did not have MPDS and never were ‘surprised’ on calls, at least not that I can remember.

Now we have a big bag with everything, another bag with airway stuff, a very heavy monitor, and protocols and SOP/SOG that say “take the stretcher and all of the stuff to the patient every time.”
And we are constantly surprised on fall calls and sick calls because Grandma fell down...when her heart stopped, or Grandpa doesn't feel good...because he is not breathing.
Steve said…
The only people at my service with a decent bag is the supervisors. It's still over packed but at least the back pack has better ergonomics. Otherwise for a bls call it's O2 bag aed and a patient moving device no matter what. ALS units have all that plus an ALS bag and Zoll. It's too much for 95% of calls.
My vollie has started using a smaller drug kit with first line meds that can get you through most calls with a niv start kit and our regular out bag. But then there's still the redundant peds bag ALS peds bag and trauma bag.
Doc Alvarez said…
Take a lesson from military docs. I've run EMS for civilian and military reasons. Why not look to convert to an aid bag (backpack style) and use a small O2 bag for all airway? Thats how I used to run callls and it worked for me.