Street Lessons #4 Carry Your Gear

Always carry your gear into calls.  I know it can be a pain to do, but nothing is worse than suddenly needing your equipment and not having it.

A woman calls 911 and says “my baby is sick!”  You get dispatched for a sick baby.   You think if it is a sick baby, what do you need equipment for?  Most likely the baby is not really sick, but if the baby is really sick then you can, as my preceptor once said to me, “O.J. it.”  This of course was when O.J. Simpson was known for running and leaping faster than any other human and not known for slashing throats.  “O.J it” meant grab the baby and run for the ambulance.

Many times in my early years as a medic I “OJed” it with sick kids, sometimes doing CPR and tiny breaths as I went, hurtling toward the ambulance, my office where the gear that made me a medic was stowed.  Aside from that clearly not being the ultimate way to resucitate a baby or anyone for that matter, the “sick baby” call doesn’t always turn out to be a sick baby.  The sick baby can be anything from a 300-pound fifty-two-year old son in cardiac arrest to a vomiting parrot.  The 300-pound son you clearly wish you had your gear for.  The vomiting parrot?  Well,  that’s another story.

When I started there was one paramedic who always carried all his equipment in on every call.  Back then we had a black hard suitcase called a biotech for the meds and IV supplies.  We had an intubation kit, we had a large house bag with the oxygen and bandaging supplies, and we had the Life Pack 5 and then the Life Pack 10 monitor.  We also had an orange tackle pedi-box.

Now this medic didn’t bring the pedi-box in on every call unless it sounded like it might be a pedi.  For the sick baby that turned out to be the 300-pound fifty-two-year-old son, he would have had the pedi box there along with everything else where other medics would have had to send their partners running back down to the truck.

He also– and this is what impressed me the most — he always carried the portable battery-operated suction machine in.  Every call.  Me, I only bring it in to a known cardiac arrest, and I can tell you to my embarrassment, two of the last three difficulty breathings I’ve been too have turned out to be cardiac arrests where my preceptee has said, “I need suction!” when he has put the larengyscope in and seen nothing but murky waters.  “I need suction now!”  On its way. but not here yet.

We had a paramedic here who was fired for not bringing equipment in.  She sometimes brought equipment in.  Say it was a known cardiac arrest, she would put a larengyscope, a tube and a 10 cc syringe in her pocket.  I kid you not.  She also downgraded a stabbing because the hole in the chest was “just a little hole.”  Lazy paramedic.  Bad paramedic.

I carry in the house bag and the monitor, and the 02 if the fire department hasn’t gotten there yet, although there have been times when I have climbed up three flights of stairs only to find the fire department also didn’t bring in their 02.  I hate not being prepared.

I carry my controlled substances on me when I go into a call.  While there is some lack of clarity as to what exactly the rules are in our state governing the securing of controlled substances — it ranges from they must always be secured doubled locked in the ambulance unless you have the intention to use them to its okay to secure them on yourself as long as you are on the clock and capable of being dispatched to a call where you might need them.  The issue here is:  what if you respond for a person vomiting and after wheeling your stretcher down many halls and up a couple different banks of elevators in a big insurance company, you find your patient is actually seizing?  You can either 1) Put the patient on your stretcher and wheel them seizing all the way back out to the ambulance.  2)  Give the controlled substances keys to your BLS partner and tell him to get the kit and hurry.  3) Or you can take the controlled substances kit out of your own pocket and stop the seizure now.  I hate being without my gear when I need it.

Many years ago, I was working with a partner named Steve. Good partner. We had lots of fun together. We get called to an assault in the north end. This is a pretty common call. Someone gets punched in the face or scratched — the cops call us, we go. The patient is giving a statement. We either get a refusal or we walk the patient to the ambulance. No problem. Most of the time they are sitting on the front stoop. Anyway, we get called, and the cop coming out of the apartment building says nonchalantly, “he’s up on the 2nd floor.” We walk up there nonchalantly. See a cop writing up a report. He nods down by his feet where a man in laying prone with gurgling respirations and an ever growing pool of blood around his head. “He got the shit kicked out of him,” the cop says — “steel toed boots.”  “Uh-o,” Steve says to me. “Go get the gear,” I say to Steve.

We work together the next week. No “uh-o” moments we both agree. We’ll bring the gear in on every call. First call of the night is for a “woman drunk wants to go to rehab.” This is a call we do all the time too. We walk in, meet the patient, who says, “I want to go to rehab.” And we take them to the rehab place. Piece of cake. But this time, a man meets us at the door — also up on the second floor. “My daughter is an alcoholic,” he says. “She needs to get cleaned up. I don’t think she’s breathing.” Uh-o. Go get the gear.

I know the gear is heavy, but look at it this way, you are in physical training.  Carrying all that gear up and down stairs will get keep you in shape and keep you young.  Do enough calls, walk up and down enough staircases and you can skip the gym after work and spend the time with your family.

2 Comments

  • Jim says:

    As a new firefighter in a combination department it took me about three runs to figure out the primary skills I needed for the bulk of our responses. A FF needs to be able to carry heavy things and be able to walk backwards without tripping (backing the ambulance). But hey, we’re glad to take the load off the EMTs shoulders so that gear is always on scene.

  • The jump bag and the monitor go in with me on EVERYTHING. I’ve been dispatched to one too many “falls” that have turned out to be cardiac arrests. I keep a kit of first-line drugs in my jump bag, along with an EZ-IO and all of the other assorted gear. My goal has always been to walk into a house ready to work the first three rounds of a cardiac arrest without needing anything else from the rig.

    As far as my narcs, the way they are secured makes it prohibitive for me to either take them inside on every run or to carry them on my person. I usually take the time to pull them out when dispatched for a seizure or another run on which I think I might need them. I’ve had to double-back once or twice. I hate back-tracking. I’ve been trying to get the rules changed for some time but so far, no dice.

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