What I Carry

A reader (Lucus) queried me about what I carry on my when I am on duty:

I have a stethoscope around my neck. In my right shirt pocket, I have four small blank index cards. In my left pocket I have a pen, a pack of gum, and my I-phone.

I have trauma shears on my right side leg pocket. In that pocket I have my sealed controlled substances kit (fentanyl, morphine, ativan and versed), an IV lock, an IV flush, a 5 cc syringe and a 1 cc syringe. In my right small pocket, I have a needle, two alcohol wipes, and a nasal atomizer. I have my narc keys in the left small pocket; in the regular pocket I have a pair of exam gloves. I usually put the patient’s paperwork (W-10s, etc, med lists) in the left leg side pocket when they are handed to me on scene.

Surprisingly(Perhaps), I do not wear a watch. I stopped wearing a watch years ago because I could not afford to keep replacing my watches as I was always misplacing them. How can I work without a watch? When I feel a pulse, I feel for speed. Slow, normal, fast. Regular or irregular. I get a ballpark estimate that once I put them on the monitor is usually confirmed. There is a clock on the monitor. I also have my i-phone as a backup. All of my truly sick patients end up on the monitor.

I wish I carried a pen light more regularly, but those are hard to keep in stock. In the ambulance I have a flashlight, and someone on scene usually has a penlight if I need one.

I used to carry an EMS field guide, but now I use my i-phone to look up anything I need to check.

I am in a fly car mostly these days, so sometimes when I intercept, there are no locks or flushes on the shelves of the transporting ambulance. I find it is easiest for me if I just pull one out of my pocket. The syringes, needle and atomizer are all so I can deliver quick pain relief (IN Fentanyl) or to stop a status seizure (IM Versed). I like to have my kit at the ready to use. I don’t like fumbling with the keys to open the lock box or being surprised on a call and not having my kit handy. I use my controlled substances kit, mostly for the Fentanyl fairly often — at least every other shift, and not infrequently, two times a shift.

On my belt I have my company issued pager and when I am in the fly car, I have a portable radio.

When I enter a house, I always carry my Thomas pack and monitor. If I am the first one arriving, I bring in my oxygen bottle. If I am working the ambulance and it is for a fall, I always bring in the board and collar bag just in case. If it is for a cardiac arrest, I try to remember to bring in the suction.

I am not saying mine is the perfect set up or the recommended set up (I am not going to tell you not to wear a watch), but, based on twenty-plus years or responding, it works for me.

Note: Once upon a time, I did carry a window-punch. I only used it once, and I had a good time using it, but now I leave that to the fire department or other responders, now that we have so many others responding with us these days.

6 Comments

  • Rich says:

    What iPhone app(s) do you like the most?

  • Matt says:

    I’ve stopped carrying a watch, too. I think it was Mark Glencorse’s blog that I was reading at one time about what piece one piece of equipment was truly important, and he argued, as you do, that relative heart and respiratory (etc.) rates were more important than absolute numbers. Then when my last watch died, I didn’t replace it.
    It’s been six months or so, and I’ve found I have been able to become more intuitive and more readily develop a gestalt. Unless perhaps I work somewhere in the future than requires a watch as personal equipment, I don’t think I’ll go back.

  • Lucas says:

    Thanks for the post. I always find it interesting to hear what senior medics carry and find important. It’s LucAs by the way. I’m about 50 pgs to being done with your latest book. Great read I started this morning on my 11 hour trip to pick up a patient.

  • BH says:

    Moved you out of the city, eh? That must be a nice change of pace.

    • medicscribe says:

      No, actually, I am in a city fly car, which I am enjoying, although it can be tiring. There is not a lot of down time.

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