What's missing on the ambulance and why?

[aussiephil]

How many services actually carry epi pens?

What is so hard about having an amp of epi and a syringe?

I have used both. An epi pen, especially for anaphalaxis, is far quicker & effective as it can be used through clothes. We are encouraged to use a pts epipen before we draw up our own.

[JPINFV]

I can't fathom the idea of an ambulance without an AED. But then again, NYC isn't known for being a model of EMS...more like fail central, along with Fail Jersey, Maryfailand, Failiowa (for calling NREMTP-99's "paramedics"), and who can forget Failifornia.

California requires additional paperwork and certification at the company level for the company to become an "AED service provider." Thinking as a businessperson, why go through the expense and effort to add non-required equipment that requires extra paperwork, statistics tracking, education (beyond a quick inservice) and testing for a piece of equipment that, if everyone (including facilities requesting services) are doing their job properly, should never be used?

Here's one local EMS agency's ('county EMS') procedure for becoming an AED Service Provider.

http://www.co.fresno.ca.us/uploadedFiles/Departments/Public_Health/Divisions/EMS/content/Policies,_Procedures_and_Memos/content/Fresno,_Kings_and_Madera_Counties/200_-_299/211-1.pdf

Edited August 3, 2010 by JPINFV

[wvmedic]

do anyone know where i can find case studies on this subject as in what was missing and what was the repercussions of not having what was needed also what displinary actions was taking thanks trying to put a powerpoint presentation togather of why truck check off is so important

[Richard B the EMT]

trying to put a powerpoint presentation togather of why truck check off is so important

First off, welcome to the city.

Somewhere, somebody convinced a medical board, or a medical board convinced the health regulatory agency, of what should be carried on an ambulance, as recognized at a county, Parrish, state, Provence, or national level. Therefore, to be a registered, certified, or both, service, that list of items must be on board, with minimum item count on some disposable items like 4x4s. If you don't start the tour with them, here in NY State, you and your partner can be written up and fined, or lose license/certification. The vehicle can be taken out of service, until Department of Health inspectors are satisfied the vehicle has those minimums on board, and the ambulance agency can be also fined.

As new protocols are added, and older ones removed, the list will change. NY State used to require both ipecac and activated charcoal, and Medical Anti Shock Trousers. Ipecac is gone, at the state level, and MAST is gone at the NYC level (training still has the protocols for MAST, at state level).

"Because I said so" may not b e a good answer, but if required to be carried, carry it, in good working order, if required by regulation. If nothing else, it will keep you, your partner(s), and your service out of trouble.

[HellsBells]

(an AED)...a piece of equipment that, if everyone (including facilities requesting services) are doing their job properly, should never be used

This seems like a silly argument, no one can completely predict when a pt may go into cardiac arrest, particularly facilities where the majority of pts are elderly people with multiple medical problems, no matter how benign the reason for the original transport is.

[Richard B the EMT]

I'll speak anecdotally, that I have had too many times,when the call came in as a patient reportedly breathing with difficulty, but because the caller delayed calling because they thought the patient just had a cold, I find a DOA in Rigor. What was scary was, on 2 of them, the call was in a group home, in the room next to the supervisor's desk.