The EDC med kit thread

[Okie4570]

If intubation is needed, conbi tubes are super easy, cheap and fool proof, no scope needed. Popular out here in the rural areas where it can be 15-30 for an ambulance.

http://www.nextag.com/combitube/stores-html

 

[MDT]

Geez guys...Seriously?!? There is no such thing as a "fool-proof" airway.....you guys are gonna go intubate a patient in BFE without any confirmatory measures or ability to have a prolonged management option? Combi-tube have a place, but when you say super easy, I've taken care of too many combo-tubed patients who have aspirated as a result of incorrect placement. King airway? Sure...if you know when to place and how to manage. I would put out there that most of us cannot manage these devices without significant back up (end tidal CO2, ABG's, suction, etc). And again, I manage airways as part of my job. I've tubed, I've done crics, I've done it all. Heck, most military field medics have run circles around me...But if you start taking about pining a tongue to your lip as management of a non breathing patient, please just let me die. Sometimes injuries are far beyond what can be taken care of in the field. Those people die. It's not good but it happens. Being able to field triage is just as important as getting to use the cool stuff in your kit....

 

[Okie4570]

Not sure what your talking about..................the lip/tongue?????? WTH???? Anyway, what have you seen as far as incorrect combitube placement? They're used often here, we've got one paramedic, he'll intubate if on scene, if not we'll combitube, the rest of us are basics. Our medical director is an ER doc and a good friend, we review our medical runs with him, incorrect use has not been an issue. I've obviously had a different experience with them than you have. Asking about what you've seen so that mistakes can be prevented in the future, thanks.

 

[Norman]

Geez guys...Seriously?!? There is no such thing as a "fool-proof" airway.....you guys are gonna go intubate a patient in BFE without any confirmatory measures or ability to have a prolonged management option? Combi-tube have a place, but when you say super easy, I've taken care of too many combo-tubed patients who have aspirated as a result of incorrect placement. King airway? Sure...if you know when to place and how to manage. I would put out there that most of us cannot manage these devices without significant back up (end tidal CO2, ABG's, suction, etc). And again, I manage airways as part of my job. I've tubed, I've done crics, I've done it all. Heck, most military field medics have run circles around me...But if you start taking about pining a tongue to your lip as management of a non breathing patient, please just let me die. Sometimes injuries are far beyond what can be taken care of in the field. Those people die. It's not good but it happens. Being able to field triage is just as important as getting to use the cool stuff in your kit....

Why are you so wrapped around the axle about ABG? That's awesome for a hospital setting, but nothing discussed here has been about definitive care. I have never seen anyone in the field, managing any type of airway, have anything to do with ABG's. Capnography? Suction? Absolutely. Don't blur the line between definitive and field care, as they are vastly different. Field care is to keep them alive long enough to make it to you.

As for the bolded, duly noted.

okie 4570,
It's commonly referred to in military, wilderness EMT and TEMS. Far from ideal, but far better than letting them die. It's a true emergency airway, and I've first heard about it being taught and done in Vietnam.

 

[Okie4570]

Why are you so wrapped around the axle about ABG? That's awesome for a hospital setting, but nothing discussed here has been about definitive care. I have never seen anyone in the field, managing any type of airway, have anything to do with ABG's. Capnography? Suction? Absolutely. Don't blur the line between definitive and field care, as they are vastly different. Field care is to keep them alive long enough to make it to you.

As for the bolded, duly noted.

okie 4570,
It's commonly referred to in military, wilderness EMT and TEMS. Far from ideal, but far better than letting them die. It's a true emergency airway, and I've first heard about it being taught and done in Vietnam.

I see, thanks Norman.

 

[MDT]

Why are you so wrapped around the axle about ABG? That's awesome for a hospital setting, but nothing discussed here has been about definitive care. I have never seen anyone in the field, managing any type of airway, have anything to do with ABG's. Capnography? Suction? Absolutely. Don't blur the line between definitive and field care, as they are vastly different. Field care is to keep them alive long enough to make it to you.

As for the bolded, duly noted.

okie 4570,
It's commonly referred to in military, wilderness EMT and TEMS. Far from ideal, but far better than letting them die. It's a true emergency airway, and I've first heard about it being taught and done in Vietnam.

You are missing the point entirely. If someone jacks something up in the field, if they have no idea what they are doing, but they have really cool toys in their med bag they bought off off of the intrawebz and they think "hmmm, I've got this thingy that goes into this hole" but really have zero idea of how it works, they're gonna kill someone. If this does not apply to you, great. If you're a competent field medic/trauma doc/whatever, then it clearly doesn't apply to you, because you'd already know when to intervene and when to move to the next most critical patient.

 

[Norman]

You are missing the point entirely. If someone jacks something up in the field, if they have no idea what they are doing, but they have really cool toys in their med bag they bought off off of the intrawebz and they think "hmmm, I've got this thingy that goes into this hole" but really have zero idea of how it works, they're gonna kill someone. If this does not apply to you, great. If you're a competent field medic/trauma doc/whatever, then it clearly doesn't apply to you, because you'd already know when to intervene and when to move to the next most critical patient.

I'm far from a trauma doc, but I'm not missing any point. This is from my first post.

This is pretty good stuff, but proper training on how and WHEN to use this stuff would be much more beneficial.

 

[fustigate]

My take? The current trauma acronym is CAB instead of ABC.

Wow, I totally missed that memo; really glad I was skimming through to see this. Thanks!

For a basic kit you can get away with very little since the majority of injuries are going to use the same supplies.

1. Emergency Shears
2. High quality "super stick" medical tape (if you skimp on this you might as well skip it)
3. Sterile 4x4 pads (as many as you can carry-these are the mainstay of trauma bandaging)
4. Sterile assortment of various size pads
5. Rubber/latex/nitrile gloves (get good ones-skimp on this and they WILL break)
6. Sterile water to irrigate wounds or eyes
7. Gauze rolls for wrapping
8. An ACE bandage
9. A tourniquet
10. Blood clotting agent

From my experience (8 years Fire/Rescue/EMT) these 10 items will be enough to stabilize most injuries short term.

While doing some tornado cleanup, I helped with stopping an arterial bleed in a guy's arm. That made me realize I needed to stop thinking I should have a basic first aid kit in my car and actually get one (and brush up on my first aid training!). Most in stores are geared for the office (12 7/8"x7/8" circle bandaids?).

So I'm appreciating the discussion here.

 

[expertzx]

Pinning the tongue to the lip? WTF? I understand the reasoning and principle behind that but I guess that wasn't stressed during my ATLS training.

 

[MDT]

Pinning the tongue to the lip? WTF? I understand the reasoning and principle behind that but I guess that wasn't stressed during my ATLS training.

Mine either...glad it wasn't just me