My FAK (with pictures! yahtzee!) *UPDATE PAGE THREE*

[HurricaneDad]

Veritas, hit up your local American Red Cross office for "CPR for the Professional Rescuer" and you'll learn about NPA and OPAs as well as some other fun stuff.

I wouldn't bother with the C-collar, since the likelihood of you needing it are extremely low. Besides, they come in a variety of sizes and you need to have the appropriate size for the patient.

Good luck!

medic, NREMT-B, Red Cross insructor.

[GanaEMT]

Yeah, I have no idea how to use the thing,

Even more reason to get rid of it.

I understand that NPAs are better, mostly from reading stuff on this forum.

Personally, I find NPA's to be mostly useless, but some people will swear by them. To each their own, but I've never seen any real critical benefit from it. I have seen plenty of bloody noses caused by them, as well as making even half conscious patients pissed off and aggressive because you're causing them pain (and they fight and pull out the tube anyway). Now the OPA, however, can make a difference.

However I have no formal training and I don't want to just read about something, spend money on a bunch and feel like I understand how they work. I might file this in the same category that I listed the c-collar I almost bought for $7. If I ever need to use it, I would rather just spend that time finding qualified help than try to fix the problem myself. What do you guys think? Are these things a little too advanced? Or is it better to be prepared just in case that help does not arrive?

You're using good, egoless, logic. Operating inside your skill level is what makes someone helpful. Trying to be more then what you know and have experienced makes you malignant to the scene.

Go to the red cross and take courses and learn how to use that stuff you have, or go get an EMT-B cert and start riding with a squad. None of those items you have are "advanced". They're very basic and easy to use, you just need someone who knows to break it down for you and then you need practice. All of that is available to anyone (in the US at least. I can't speak for other countries EMS systems), it's just a matter of how much you really care to seek it and learn.

[Veritas]

Sweet, I will definitely do the Red Cross classes, I did not know they taught these sorts of things. I graduate in December, so I will have eight full months before school (hopefully) starts again in August. I had planned on doing phlebotomy until then, because one of our local blood banks allows you to become certified and work for them while you are doing it. Should I try getting an EMT-B in that amount of time instead?

[GanaEMT]

Depends on your situation. Getting your EMT-B is a step towards a more rewarding medical career (especially if you continue up the ladder), but many Basic's start as unpaid volunteers. If you are in a position where you don't need a steady income, or you know for certain you can get a paycheck from it, go for the EMT-B cert.

If that's not the case, get the phlebotomy cert and support yourself and get the EMT-B later on. Be honest about what you need out of life at the moment and make decisions based on that.

Either way, if you're going to pick a career in medicine, my personal suggestion is to pick EMS and come ride with the big boys. It offers more career choices (EMT-B up to Paramedic, over to nursing if you like and a CEN & PHRN cert., etc).


...And we're just a lot cooler then the rest.

[Veritas]

Sage advice...thanks a lot, it is going to give me something to consider, that is for sure. Thankfully I have a job right now and can mull it over for a few months.

[HurricaneDad]

Sweet, I will definitely do the Red Cross classes, I did not know they taught these sorts of things. I graduate in December, so I will have eight full months before school (hopefully) starts again in August. I had planned on doing phlebotomy until then, because one of our local blood banks allows you to become certified and work for them while you are doing it. Should I try getting an EMT-B in that amount of time instead?

Unless you WANT to be an EMT, don't take the class to get the EMT license. Yes, there's a lot of good/useful/interesting/"fun" stuff that you learn in EMT-B class, but most of it you can get the jist of by reading any of the EMT training books. Not only that, but EMT class can take as much as 6 months to complete, depending on the policies of the place that you can get the class through... And then, it might not be offered in the time you'd want.

The Red Cross classes, however, are one or two days (depending on the class schedule, full day or two half-days), and a lot cheaper, besides. My EMT class was about $400 if memory serves, plus books. My Red Cross chapter offers CPR Pro for $70.00

HTH, Good luck!

[HurricaneDad]

Gana, I can't PAY to ride locally! None of the ambulance companies want Basics, none of the FDs want straight EMT, only FF/EMT.

So, when next fall comes around, I'll be taking EMT-P class. (while that's going on, I'm working on pre-med requirements. I still haven't decided if I want to go RN or MD/DO, but I want emergency medicine. )

[GanaEMT]

Yes, there's a lot of good/useful/interesting/"fun" stuff that you learn in EMT-B class,

Yeah, it's called a state certification.

[HurricaneDad]

Yes, there's a lot of good/useful/interesting/"fun" stuff that you learn in EMT-B class,

Yeah, it's called a state certification.

Actually, I was thinking about strapping someone to the long-board and leaving them leaned up against the back wall.

We got to play with Combi-Tubes in Illinois, and we learned about giving Glucagon injections.

[GanaEMT]

We got to play with Combi-Tubes in Illinois, and we learned about giving Glucagon injections.

But did you learn about Glucagon? That's infinitely more important.

Combi-tubes are... eh. I don't like "dumb-down" tools.

[Tac Medic]

Paul,.....................you gonna be alright, alright young Jedi.

[HurricaneDad]

We got to play with Combi-Tubes in Illinois, and we learned about giving Glucagon injections.

But did you learn about Glucagon? That's infinitely more important.

Combi-tubes are... eh. I don't like "dumb-down" tools.

We learned some basics about Glucagon. Nothing high-level of course, since it was EMT-B class. Were told that Glucagon interacts with liver-stored glycogen to release glucose, in order to give a short boost to blood sugar. No high order enzymatic discussion, etc, but that's for P school and RN/MD/DO school, not lowly Basics.

Combi's: Good when that's the thing available or the ETT doesn't work.

Speaking of airway, what's your opinion of LMA (if any)?

[GanaEMT]

Ian--- hey, as long as I ain't no ewok, I'm cool

I suppose it helped that my instructor was/is a tactical paramedic who taught the class with a .45 holstered on his side and blasted AC/DC when he rolled up to school.

Then again, I also heard those tactical medics are full of it.

[Tac Medic]

LMA should not be used pre-hospital. It doesn't protect the patient's airway and PROTECTION is necessary for us..................Try adding a bugee to your airway gear.

[GanaEMT]

We learned some basics about Glucagon. Nothing high-level of course, since it was EMT-B class. Were told that Glucagon interacts with liver-stored glycogen to release glucose, in order to give a short boost to blood sugar. No high order enzymatic discussion, etc, but that's for P school and RN/MD/DO school, not lowly Basics.

The important thing is to know why you're giving a medicine. Good to see that you know why--- it's what separates the professional from the protocol monkey.

Combi's: Good when that's the thing available or the ETT doesn't work.

I don't think they're great no matter where they are. Shoving a piece of plastic and rubber down someone's throat with a "hit-or-miss" attitude is just bad medicine. It's made for sub-par paramedics who routinely can't get the ETT and constantly using the thing winds up as a crutch and decaying intubation skills. I think anytime someone uses a combitube, they should get points on their paramedic cert that they have to work off through extra training.

Sure, some people are harder to tube then others, but a paramedic should be able to routinely intubate difficult airways in tough situations.

Speaking of airway, what's your opinion of LMA (if any)?

I suppose they're good for an operating room.

If a person accepts an LMA then they don't have a gag reflex so they really should just be tubed.... at least pre-hospital & in the ER. No gag reflex means they can't protect their airway. If they can't protect their airway, we must. LMA's don't protect an airway.

[Jorian]

Does anyone else use Opsite? (Before you ask, Doc Simon - NO we don't sell it) Veritas' kit seems fairly comprehensive, but I always carry a sheet or two of that stuff, plus some tincture of benzoin ampules. (Which work real well with steri-strips too) Never had a problem with Opsite other than one case of apparent allergy to the adhesive (local redness), and it has performed in ways no other dressing I know of could do. Highly recommend it for light weight, versatility and the fact that if properly applied to some wounds it can be left in place for days. Tegaderm is a similar product, but I find it harder to handle (Opsite takes some practice/experimentation too) which can be a real concern in extreme cold or low-light conditions.

[GanaEMT]

Never even heard of the stuff. What exactly is it?

[19kilo]

Isn't it for pressure sores? I've helped nurses put it on pt's before who had pretty bad sacral wounds.

[GanaEMT]

You mean stuffing sheets under them like a car jack isn't enough?

[Jorian]

Never even heard of the stuff. What exactly is it?

I've heard it called "micro-thin bandage" among other things*. It's a waterproof, breathable (vapor-permeable) urethane sheet. (Look at the link) IIRC it was originally used for covering IV sites. Works well on burns and abrasions and I've used it as a closure on lacerations. Can be cut to almost any size and shape and used on really tough spots like between fingers and toes. 3A ointment keeps it from adhering, so it's best on wounds that can be well cleaned with iodine solution. Tincture of benzoin helps it stay in place, but you want to keep that stuff away from the wound (it burns). I've left it on for almost a week, sometimes squeezing excess exudate out of a tiny pinhole (they say it will "dry" without doing that , but not IME). Healing has been excellent and it survives showering etc. Since it weighs next to nothing and takes up no significant space, I've taken to including it even in my little dayhiking FAK.

* Some of the "other things" are not fit for repetition in mixed company - it can be extremely frustrating to handle. One false move and it likes to turn into a wad of useless gummy stuff.

[Veritas]

I have seen the stuff that they use to cover where the sub-clavian (triple lumen...whatever it's called) goes into the body, I think that is kind of the same thing. I passed on that stuff because it seemed too thin and difficult to deal with to be practical in the field. Of course I am just guessing, I have no personal experience with the stuff.

And just to remind everybody:

What I need advice on: A bag to hold all this stuff.

I checked with the local Red Cross, they do not offer a class that deals with airway management. I found an ACLS class at the hospital, but I need to take Basic Arrythmia and 12-Lead Interpretation first...so they say.

*Edit: I found two bags at Galls that are essentially what I am looking for, in both price and size. This is nice looking and so is this

[Jorian]

I have seen the stuff that they use to cover where the sub-clavian (triple lumen...whatever it's called) goes into the body, I think that is kind of the same thing. I passed on that stuff because it seemed too thin and difficult to deal with to be practical in the field. Of course I am just guessing, I have no personal experience with the stuff.

Yeh, I think that's the stuff. The "Opsite" version has a relatively stiff plastic backing and is easier - though not exactly easy - to use. Most useful for minor wounds, though I've heard improbably tales of the proverbial sucking chest wound being "plugged" with it. Probably impractical for Tac-Med, better for Wild-Med.

What I need advice on: A bag to hold all this stuff.

Doc Simon will probably have me banned if I post a link, so I'll just ask you to visit our site again, and look at Stat Packs. Or better yet, go to Stat Packs' site and let me know if there are some that we should be carrying that we're not.

[Veritas]

Stat Packs are nice, but I can think of better ways to spend $265. Unless you wanted to send me one, you know, to review, I will prob end up with one of those from Galls.

BTW, I would do a great review of that pack...
...and I would have to post a link to your website in my review...you like links...
...and I like black...

[Jorian]

BTW, I would do a great review of that pack...

By "great" do you mean "glowing" or "accurate"?

"That pack" would be the Perfusion? You sure you want to lug a 4800 cu in pack around? It's usually used for ALS. Maybe this one? Only 1900 cu in.

...and I would have to post a link to your website in my review...

Tryin' ta get me banned eh?

you like links...

Not THAT much!

...and I like black...

Could happen... how much actual field testing would it get?