Over the years, pre-hospital care has grown. We’ve moved away from some equipment, and have relegated other to dark corners of cabinets. Patient care is constantly changing. Some of this equipment has been shown to be ineffective, while other inventions have shifted us toward their use. If we still have it, we should know how to use the equipment. There may be times that the newer innovations won’t quite do the job.
We must always strive to be proficient in our craft, and consider non traditional benefits of some of the equipment.
Kendrick Extrication Devices (KED) have been used for many years as a means of immobilizing a patient. Recently it has lost favor because of the amount of time needed to properly fit it to a patient and execute its intended function. But it can still be used to provide stabilization as we try to move our patient from a difficult situation. A KED can also be used as a quick leg splint (secured securely with tape or kling) or as an immobilization device for a small child.
Traction splints have very limited usage, indicated for a midshaft femur fracture only. While I have, in a previous article, rallied against their use, the fact is they are still considered the standard of care. We need to be proficient, whether we use a Sager, Kendrick or Hare device time should be taken to ensure that you know how to properly secure it to a patient. Practice should also be done in less than optimal conditions and determine how to best use your device. In my career, I’ve needed it for only 1 patient. Lack of practice made this one application a thought experiment to remember skills taught many years ago, and only refreshed occasionally.
Some services use Scoop Stretchers routinely, while other’s have probably not removed it from their ambulance for years. If you fall into the later group, are you still familiar with how to adjust the unit? How to open it? Can it in fact be opened. We relegate this device to a cabinet that can collect a lot of dirt that may get into the joints and locks. Does it still work? There are some exciting studies that are using a scoop stretcher in head inclined CPR, while others are showing better spinal safety for immobilization. The Scoop Stretcher should be considered more frequently.
Beyond these large pieces of equipment, there’s far more that we may not be familiar. Many patrollers and medics have begun using automatic blood pressure cuffs exclusively. Do we still know how to take a blood pressure? Can you utilize a BP cuff as a tourniquet if needed? Complacency is one of our greatest enemies.
There are a number of small good items that we need to review far more frequently. When was the last time that you looked at the contents of an OB kit? When was the last time that you looked at some of your more advanced equipment? We should be spending some of our downtime from each shift reviewing some of our less used equipment and practicing for the infrequent need.
I am still looking for ideas that you’d like to see covered in these articles. If you have any suggestions, please email me at jay (at) pinemountainskipatrol.com