November/December 2007

EMS Equipment

by Will Chapleau

What’s In Your Rig? It’s Time To Check

While it’s not spring, any time is a good time to go through your ambulance, see what’s in there and review what should and should not be.

There are several good reasons for this. First, an over all inspection may detect repairs that need doing.

Second, while well intentioned, the way the interior of your ambulance was set up initially may not best serve you and your department.

Third, over time equipment disappears or parts of equipment disappear, and this process will help get it all sorted out.

Pack Rats

Finally, we can be pack rats. Everyone has certain things they like to use or maybe they see something they think they’ll like to use and they end up in places such as under the crew bench. There are places like that filled with stuff that is never used, and we don’t need cluttering up what limited space we have in the first place.

So this month, let’s take a look at the inside of our vehicles and see what we can do to make them serve us better.

The first step to getting your ambulance better organized is empty it out completely – everything. While it’s empty, clean out the compartments and take the stretchers and boards out and do a terminal cleaning – deep and through – inspecting all surfaces. While cleaning, the inspection may turn up things that need attention, such as damaged flooring and exposed padding.

Once flooring is damaged, it becomes difficult to clean and can harbor infectious agents left behind by patients. Thoroughly inspect doors and compartments for possible repairs as well.

Once the vehicle has been inspected and cleaned, it can be repacked. Before doing this however, consider where you’re putting everything. The way the vehicle was set up initially, while well intentioned, may not be the best configuration to serve you today and tomorrow.

For instance, compartments closest to the patient would be the place to store the tools you will need to treat the patient. Compartments nearest the exterior doors should be where you store items you likely will take with you to treat the patient at the scene. That may seem obvious, but a lot of vehicles are not set up this way.

The ‘Junk Drawer’

To help restocking the ambulance, visualize yourself working on a variety of patients in a variety of settings and think about where the equipment would be best placed to perform your job. You might find there are intuitive places for equipment that you wouldn’t have thought about had you not taken everything out and reassessed each piece before it went back in.

Remember, not everything needs to go back in. Don’t be afraid to get rid of stuff. As I mentioned earlier, we can accumulate the weirdest collections.

Just like the “junk drawer” in your house, places like under the crew bench will most likely provide a few surprises when you finally empty them out and see what’s in there.

Besides what is supposed to be in there, you’ll undoubtedly find pieces of things that are no longer in service or used and other things that are inoperable. You’ll also probably find a variety of objects that someone once thought would be useful, but ultimately had little or no utility. Evaluate your equipment list, sort out the gear, recondition it as needed and place it back in a logical manner for easy access.

The space under the crew bench is deep, and I’ve seen many stacked with gear right to the underside of the seat. If you need something that’s on the bottom, you have to pull other things out to get at it. Consider that as you repack the crew bench. Leaving a void is not a bad thing, as it might save time rummaging through useless stuff.

During this process, get all the backboards, scoops, collapsible and stair chairs out of their compartments. Clean and inspect those as well. Not many providers still use wooden backboards, but those who do should make sure they’re free of splinters and the surfaces are clean. Make sure plastic boards are not cracked as the cracks not only weaken the boards, but also make them virtually impossible to disinfect as material can get inside the boards.

No Projectiles

If you have collapsible stretchers, make sure that they are clean and operable. The coated canvas material should be inspected to ensure that it is still cleanable and not coming apart.

Compartments over the patient area may have hinged or sliding doors. Some vehicles have no doors. While cleaning these areas, be sure to remove the debris that has undoubtly collected, including unpackaged airways, gauze and other supplies. Toss the stuff that’s no longer useable and use care to organize these compartments so things needed for patient care are readily available. Items the medic needs should be placed in compartments near where most of the action will be taking place.

It’s also important to remember that things don’t always stay put in a moving ambulance. That’s not just an inconvenience, but a safety hazard. Bins and devices stored in compartments, and even more importantly, on counter space in the open should be secured. This will keep things where they belong and, more importantly, keep them from becoming projectiles in sudden stops and accidents. Even normal road conditions could cause heavy things to fall on attendants and patients.

Outside compartments need attention too. They’re likely to accumulate lots of clutter. Depending on the type of support you typically get on scene, you may need more or less equipment. It’s safe to say some light extrication equipment may be useful.

Things like pry bars, axes, bolt cutters and other light devices that don’t take up a lot of space can be useful. Avoid having too much, as there’s only so much attendants can do until more help arrives with more sophisticated extrication tools or equipment.

And, don’t forget the cab. It’s a place people like to cram a lot of stuff. Keep only what is necessary, such as maps, address guides, flashlights, radios and clipboards, and keep them well organized.

The 2004 Guidebook

All emergency vehicles, including ambulances, should have the 2004 Emergency Response Guidebook from the U.S. Department of Transportation. It’s an easy to use quick reference that can help keep you out of hazardous scenes and let you know what to expect of patients exposed to hazardous materials.

EMS is not a one-size-fits-all business to be sure and you need to ensure that your vehicle is outfitted specifically to your practice.

Editor’s Note: Will Chapleau, who has 30 years of EMS experience, is the Advanced Trauma Life Support (ATLS) program manager for the American College of Surgeons. He is the former chief of the Chicago Heights (Ill.) Fire Department, has served since 1996 as the chairperson for the Prehospital Trauma Life Support (PHTLS) program of the National Association of Emergency Medical Technicians and has been a member of its international faculty since 1984. He is a board member of the National Association of EMS Educators.