Posted by: medicblog999 | January 10, 2010

I need your opinion!

question-mark3aI want to ask you all a quick question please.

For those Ambulance staff who read this, you can give your honest answer, for those non medical/ambulance staff, then just give it a bash.

I have a post I want to write, but I would like to judge opinion on this question first:

What is the most important piece of equipment available to a paramedic?

Have a think about it then please  leave a quick comment and let me know what you think. The more comments the better for this one folks, as I am wanting this to be a bit of a survey if I get enough responses.

Thanks!

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Responses

  1. The Ambulance… You can have all the latest and greatest EMS toys, but if the toy box has a flat tire well then what? When this all started we had little equipment and even less training, but we had an ambulance.

  2. The Ambulance… You can have all the latest and greatest EMS toys, but if the toy box has a flat tire well then what? When this all started we had little equipment and even less training, but we had an ambulance.

  3. Your pen!

  4. Close call between the monitor/defibrillator and the bag-valve-mask.Tom

  5. your eyes and ears. They'll soon tell you if someone is big sick or little sick.

  6. I usually say the things you can't improvise: 1) exam gloves, 2) pocket mask, 3) watch, 4) pen, 5) cardiac monitor/defibrillator

  7. Hhhmmmm….good question there!! I'll have to answer it two ways:1) Tangible assets- Monitor…in an assessment you can get a baseline with the five senses, but to look at the ticker and determine if that's the problem, got to have one.2) Non-Tangible asset- A differential and some intuition

  8. Hi Mark Your skills!! ok its not equipment but you need them to make full usr of what u have got to work with! take care from joan in snowy midlands

  9. Your brain. What use is all the kit if you dont know how to use it!

  10. I was also tempted to answer – brain, empathy, listening skills, etc. – but wanted to stay true to Mark's question about equipment. But I am with Joanlundbrook and brokenangel being a paramedic is about what you know, applying your knowledge and experience, and listening.

  11. Non-ambulance person response – the knowledge you've gained through training and doing the job.

  12. Got to be the monitor, but I feel lost without the little things – Tuff Cuts and my pen torch

  13. It's a close one, between a BVM, and the autonomy to act as a paramedic, based on experience and skill.

  14. A blanket. Warmth, comfort, protection of dignity, support an injured limb or improvise headblocks.I'm sure there's more but I'm woozy and full of morphine so can't round up my thoughts.

  15. I really want to make a smart alec remark here, but am afraid my answer skirts your definition of equipment. I think the most important THING a Paramedic has is a supportive company. A company/agency/Department that values their skills, provides them with a safe working environment, the proper tools to do their job and a trusty rig and partner to get the job done. You can have all the best equipment, but without a system in place to train you on it and maintain it, it is nothing. Your ambulance could be top notch, but if no one is tracking the mileage and maintenance, it is nothing. And so on, and so on.There you go, Bud. Sounds like a post brewing about what YOUR most important piece of equipment is. And I wish you could say CPAP.

  16. I change my vote to blanket. Nice.

  17. 1] suction unit, 2] cloth cot sheets, 3] BIG side-view mirrors, to avoid the big orange muni trams.

  18. I would say the most important would have to be your self (experience/knowledge). Of physical things I would say it would be the ambulance to get the casualty to more advanced care, or O2 therapy. Who does not feel better after a whiff of oxygen 🙂

  19. your brain

  20. your brain

  21. I am absolutely SHOCKED and APPALLED that there are people who are purporting themselves to be PROFESSIONAL EMS PEOPLE on this blog who have missed the MOST OBVIOUS AND VITAL answer here!Mark asked “What is the most vital piece of equipment available to a paramedic”.And you all, you who are calling yourselves “Medics” have YET TO ANSWER this most obvious of questions correctly…(sigh)Hello?? Coffee maker, anyone?(Y'all know I'm having fun with you, right?) (Either that or a radio… because you can't make it to any calls if you don't know about them in the first place)

  22. Your brain. A good support system/service. A good partner. Equipment – probably monitor, but I'd feel a bit lost without a stethescope.

  23. Common Sense mixed with a good dose of experience!

  24. To me it has to be a good stheoscope and b/p cuff. and good set of eyes and ears are important set of equipment to me I need my basic stuff before I break out the ALS stuff I need or the patient needs.

  25. A lot of people are saying monitor…curious what that includes? 3-lead, 4-lead, 12 lead, pulse ox, capnography, auto-BP, CPR metronome(a la Lifepack 15)? That being said, after a functioning, well-trained brain using common sense and all my other senses, my monitor (Lifepack 12 with capnography) as a diagnostic tool and my ambulance, without which I could not get my pt to definitive care.

  26. Gasoline.

  27. For the Paramedic or EMT your brain engaged – situational awareness

  28. An EMT!

  29. Training and instinct.

  30. Excepting all the obvious answers (partner, brain, etc.), here's my opinion.The most important piece of equipment to a paramedic is the EKG (12 Lead in particular).We can determine perfusion status by skin parameters, pulses, capillary refill, mentation, etc.We can determine ventilatory status by work of breathing, skin color, respiratory rate, depth, etc.We can determine the presence of a pneumothorax by percussion, holding an ear to the chest, Beck's triad, etc.One of the few truly time sensitive conditions that we have no way of physically diagnosing without the aid of a machine is a myocardial infarction. Sure, we can go by patient presentation, but an EKG allows us to DIAGNOSE a probable MI and get the patient to definitive care faster. And that time difference actually matters…..

  31. Well, you said *equipment* and *paramedic,* so I'm going to say cardiac monitor.What is the most important equipment for an *EMT*, and I'd say watch, pen, and BVM.Of course, none of that is a substitute for using your brain, and engaging two ears and one mouth in the proper ratio…

  32. Your brain. Without it and your composure everything else is useless.

  33. Excluding the brain, I would say the pen

  34. Excluding the brain, I would say the pen

  35. So intuition and training goes a long way, but as far as equipment goes, I'm going to have to say it's either gloves, bvm, or (my favorite piece of equipment)…the cardiac monitor. We have the LP12s (so you can see why I like it so much!)Love the blog by the way :)Naomi…Michigan, United States

  36. At my company, we run with LP12s or Zolls…both of which hold capabilities to do 4 lead, 12 lead, capnography, SPO2, auto BP, temps (that's a nice option on the zoll). Personally…I'd go for the LP12 because I've been using them for the best part of 10 years…call it a comfort level?!

  37. Er…the ambulance! Oh, and a good stethoscope and the ability to use it…

  38. I'll go with many others and say your brain, with all its accumulated knowledge, skills and common sense.If you just mean non-human stuff, then I WAS going to say your defib/ECG/monitor. However, I reckon it's your communication equipment, whether that be a moby (cell phone), radio or ruddy semaphore flags.If your car breaks down, your Lifepack dies, you run out of oxygen or the patient is a lot worse than expected, you can call for help and improvise in the meantime. Without your comms you won't even know about the job.

  39. I will be a bit of a smart alec here and say:An EMT-B! We are rather simple minded (Or so a Medic once told me) and just concentrate on the ABC's. You know, airway, breathing and circulation! Paramedics save lives, EMT-B's save Paramedics!!Don't stone me now guys!

  40. I forgot about a good ol' stethoscope and of course! A blanket!Wrap it around the neck and under each arm in a figure of 8 and it can be used for rapid extrication whilst keeping C-Spine still. Genius.

  41. After a firmly screwed on head, 2 inch Tape, if it can't be done with 2 inch tape its not worth it. It goes along with Americans love affair with duct tape LOL.

  42. My first response was to answer brain when I read the question but I want to expand on that but adding common sense. I know a lot of smart medics; and a lot more who think they're smart but without the common sense (which isn't so common) to treat the patient not the monitor. Having the brains to treat your patient is wonderful but if you don't know when to keep it simple and elegant rather than “fun” and complicated then are you really using your brains to the benefit of your patient?

  43. Easy…your brain.

  44. your assssment skillz

  45. Anything that goes “beep.” Or “whirrr”. Yeah, beep or whirrr.

  46. Anything that goes “beep.” Or “whirrr”. Yeah, beep or whirrr.

  47. his/her brain

  48. his/her brain

  49. The TV remote. LOL. In all seriousness. In 20 years, I've worked for several companies, bothe ground and air. Some bought the best equipment there was, and some didn't. What it all comes down to in the end is the best asset you have is your brain. Recognizing what to do, or in many instances, what or when NOT to do something is paramount. Also, being able to improvise, adapt, and overcome is what makes you the best medic. Good luck.

  50. A good partner one that knows what you are doing before you do it, and can sense the Pick Up Haul A**(PHUA) situations.

  51. Monitor. Definatly the monitor. All our equipment is useful, and definitely necessary for the job, however for the time critical pt, this gives us the vital tool to keep an eye on their heart rhythm, and the ability to defibrillate if required.Having said this, as others have noted, problem solving skills and clinical knowledge are also vital to paramedic practise, and sometimes it's more how you deal with a situation, than the wizz bang gadegts you use.

  52. 1/ His or her brain and senses – particularly their ears! You need to see, hear, smell (maybe not taste, but each to their own!) to be able to get a proper idea and history of the event. 2/ Some common sense and the experience to know when to say NO to skills and just GLF3/ A good crewmate to remember all the crap you forget and remind you to say NO…4/ A blanket (or decent sheet in warmer climates) and a pack of triangular bandages…5/ A working truck & comms…6/ A decent monitor (12-Lead, NIBP, EtCO2, pacing, cardioversion, SpO2…); a BVM and a stethoscope Just my twopenneth worth :o)

  53. Hrm.I've worked in the back of ambulances alongside Paramedics with all of the toys. I've worked on the side of a hill in torrential rain, gale force winds and freezing temperatures where nothing electronic works and you can barely hear the patient's screaming.I honestly believe that there's not a single piece of equipment that's absolutely essential – the less you have, the simpler the care, but you can still do something to keep them alive until they get to definitive care – so the obtuse answer to the question is a brain.The less obtuse answer – transport. Whether that's a bicycle, motorbike, car, ambulance or helictoper, if you can't get there you can't do anything and if you can't get the patient to definitive care, you're prolonging the inevitable.Ta,Aled.

  54. So many options here, I too wanted to say your brain, but that is not a piece of equipment. The one piece of equipment I use the most is my stethoscope, so I guess that's the most important piece of equipment. I can use it for multiple applications (I love a tool that is multi functional) from BP to lung sounds, bowel sounds, auscultating the heart and other non medical uses (they make great ear plugs so long as you don't tap on the diaphragm).

  55. Good idea, leave the radio off the ambulance and they can't give me runs! Maybe replace the mobile radio with a coffee maker? Now we are talking! LOL

  56. So many options here, I too wanted to say your brain, but that is not a piece of equipment. The one piece of equipment I use the most is my stethoscope, so I guess that's the most important piece of equipment. I can use it for multiple applications (I love a tool that is multi functional) from BP to lung sounds, bowel sounds, auscultating the heart and other non medical uses (they make great ear plugs so long as you don't tap on the diaphragm).

  57. Good idea, leave the radio off the ambulance and they can't give me runs! Maybe replace the mobile radio with a coffee maker? Now we are talking! LOL

  58. Stethoscope. Thats the one thing I use the most.

  59. A Basic EMT!

  60. Your right foot, and knowing when to put it to the floor. I suppose that comes hand in hand with the experience to know when to leave the toys in the bag and go.

  61. BVM without a doubt. When a patient's condition goes south, I revert back to my ABCs and airway always comes first.

  62. Totally agree

  63. A blooming good technician, One who knows what you want and when you want it, One who knows what you once knew but occasionally forget, One who knows when you have something on your mind, One who knows when something is not right and One who appreciates your knowledge and learns as much as you want to teach them.

  64. A good Basic EMT partner

  65. BGL monitor

  66. I've got to say your own two hands. With them you can diagnose a lot, you can take a pulse, you can maintain an airway, c-spine immobilisation, do chest compressions, put a patient in the recovery position, and you can hold a hand a reassure someone. As cheesey as it sounds I think they're the best pieces of equipment you can have. It's surprising what touch can do. However, if I had to pick a real piece of equipment, I'd probably say vomit bowls. Keep your ambulance and uniform clean on a Friday night! And can be useful for lots of things. They also make stylish hats lol!

  67. You realize of course, this means war. My “Weekend Fun Survey” for next week was going to be the opposite of the one I did this past weekend. There goes that idea, now I have to come up with some original content.

  68. It's kinda hard to define equipment…Assessment tool: Good stethoscopeDrug: toss up between oxygen and aspirinTransport is always important too. Overall, I'm the biggest fan of my steth.

  69. A good partner with a pen!!

  70. A good partner with a pen!!

  71. I'd say your brain, followed by your hands.None of the equipment a paramedic has to hand is any good if it stops working. None of it is any good if basic life support isn't kept up while the advanced stuff is being set up. None of it is any use if you come across something off duty and don't have it with you.Your brain allows you to analyse the situation quickly and determine what's needed, your hands allow you to carry that out, whether it's opening an airway, putting pressure on bleeding or simply holding someone's hand.

  72. Before I read everyone's post: brain/experience, good partner, & airway equip. Still the same with maybe communication added.

  73. I think the most important tool is CONFIDENCE! You can have all of the skills in the world, and know the book inside and out, but without the confidence to perform those skills when needed, you're more likely to flop!

  74. Gloves to protect myself.Everything else is gravy.

  75. Gloves to protect myself.Everything else is gravy.


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