AlmostJesus

Buy side-zips, you will be happy you did, especially after your first night shift. I had 5.11 Haste side zip boots, they were okay once I put in an expensive set of insoles, I think this was because I ordered the wrong size. If you are willing to spend a little money, danners will last you a long time. When you are looking for pants, I definitely recommend the 5.11 EMT pants, they are very comfortable and functional.

I am just doing this to get a guesstimate to give to the boss. It is his responsibility to make it happen. This would be very few hours a month, so its not worth it for me to go through an extreme amount of trouble to build this. I have already came up with a model set of protocols, went through and made this equipment list, worked on my licensing information, etc. Not trying to sound lazy, but much more than this is getting out of my arena. That being said, I am still open to feedback and I will keep things updated.

This is what I have so far, IV and Medications are a separate list and will be addressed separately and can be taken from existing stocks, I am mostly looking at what it will cost to outfit the bag the first time. I am very open to your feedback. Also, what do you guys do for your ALS peds with a small service/limited budget? Item Price from EMP THOMAS ADVANCED LIFE SUPPORT PACK ULTRA, BLUE 472.45 KING AIRWAY LTS-D, SUPRAGLOTTIC AIRWAY KIT, SIZE 3 48.95 KING AIRWAY LTS-D, SUPRAGLOTTIC AIRWAY KIT, SIZE 4 48.95 KING AIRWAY LTS-D, SUPRAGLOTTIC AIRWAY KIT, SIZE 5 48.95 Medline Huge Bulb Syringe 4.95 LIFEPAK 12 EtCO2 Smart CapnoLine Plus Adult/Intermediate 10 pack 120.00 LIFEPAK 12 EtCO2 FilterLine SET Adult/Pediatric 25 pack 215.00 ALUMINUM "D" SIZE OXYGEN CYLINDER W/TOGGLE VALVE 82.60 CARE2 CONTINUOUS CARE NEBULIZER, HAND HELD x2 3.50 ET tube holder, Laerdal, Thomas Holder, adult 3.47 O2-RESQ BITRAC ED MASK W/ 5.0CM CPAP VALVE, ADULT LARGE 84.00 O2-RESQ BITRAC ED MASK W/ 5.0CM CPAP VALVE, ADULT MEDIUM 84.00 ARS for Needle Decompression (14 gauge x 3.25 in.) x2 29.90 ARGYLE SALEM SUMP TUBE, 16FR, 48" LONG 2.85 CARDINAL CATH-N-GLOVE,18FR 1.29 WOLFE TORY MAD NASAL ATOMIZATION DEVICE x2 8.98 NELLCOR EASY CAP II END TIDAL CO2 DETECTOR, ADULT 12.15 Total 1271.99

Thanks for the input I am unable to find much information about the required equipment from our state, I had a list of required equipment, but it is universal to ambulance and I misplaced it and can't get it from the state website. The state I am in (SD) currently has a lazy state EMS director which is just counting his days until he retires. This makes things harder for getting information from the state regarding setting up an ALS level service. I am mostly going off of what equipment they had when I worked at one of the bigger services in the state for my internship. As far as equipment suggestions Cric Kit- I wasn't planning on having this due to the complexity of the procedure and lack of experience, my proposed protocols don't include RSI Chest Decompression - I am including 2 NRP decompression needles Like I said, No RSI, in the future I could look at doing RSA, but I don't think the medical director would be up to it, especially considering how few we would do and the lack of a 2nd medic For airways, I was going to go with Kings LTS-D's initially, this should help with footing with the medical director and will have a lower initial cost with not that many disadvantages. This is especially important with the ease of putting in a king working in a single medic system. I was looking at this for CPAP: http://www.buyemp.co...t/11230839.html We wouldn't use it a ton, but I want it available The hospital has a LTV1000 that if we had to transport a patient, we have an RT that works with the ambulance and would probably use the hospitals vent to transfer The ambulance already has infusion pumps because of the nurse level transfers it does, they are compatable with the hospital sets but unfortunately are plumsets which are tough to run free-line, thus we would use the pump a lot for infusions in the field. Ill try to get my full list up later tonite On the other front, I was notified today that one of the other places I applied to is interested in hiring me pending farther up approval, this will give me an additional spot to practice to keep my skills up.

I have been working on putting together a list, Ill post it when I feel like I have everything, then you can tell me what I am missing. To clarify, we already have 4 BLS rigs which at the minimum have a Datascope Passport and a defibrillator. We recently got two Lifepak 12's with NIBP, ETCO2, 12 Lead, SpO2, Biphasic via the Helmsley foundation and the AHA Mission Lifeline grant for SD. Thus, I think we have that area covered. Currently, for ALS level transfers we use hospital nurses. Thus, the ambulance has some basic ALS equipment, but not set up for ALS calls. We have an agreement with the hospital which they provide us the medication boxes and bill us for what we use. I would like to change those into medication bags that the medic checks out at the beginning of the shift and then returns at the end for charging. We are also able to draw our disposable supplies from the hospital purchasing department, thus we would not need to order bulk for items which the hospital already stocks. (IE King tubes, BVMs, Defib pads, etc) I am mostly interested in what I need to have equipment wise for this to work, in case I am missing something. The reason why this is prompted is the hospital has been calling an ALS/Paramedic ambulance 50 miles away for transfers, undermining the previous agreements. Thus, he is losing many transfers which are the cash cow, add on ALS ambulance calls and the cost benefit should beat the initial costs plus the hourly cost of the paramedic. Thanks for the help, hope that clears things up, Michael

Hey guys/gals, While I was in high school, I took an EMT-B course and worked for my local small-town ambulance service my senior year of high school. I am now in working on my bachelors in nursing and while I was doing that, I took a paramedic course. Unfortunately, it is difficult to find a job in the city I go to school at because I can only work part-time and I am straight out of school in a paramedic saturated area. Thus, I am working with some of the outlying areas to find a job working in an ALS service. The service I worked for in HS was BLS except they used nurses for transfers. Now that I am a paramedic and a couple others that work there are pursuing their paramedic, I am going to talk to the director about upgrading to ALS with eventually a paramedic on call 24/7. I have been working on protocols and other business issues. The one issue where I am falling short is finding out the cost of outfitting some ALS bags. Currently, for nurse transfers, the hospital keeps a drug box that they sign out to the ambulance and then bills for the medications they use. I was thinking we could do a similar situation, but put the meds in an ALS type bag and check out the bag to the paramedic on call. I was wondering if you guys could come up with a rough estimate that it would cost for a decent ALS bag set up for medications, O2, King tubes (no intubation), IVs, and any other equipment required of an ALS provider. I can draw the minor supplies from our stock, but I am mostly looking into the costs for the major equipment upgrades. Also, if you guys have anything I could use as justification for upgrading to an ALS system, I would be open to hearing it (My boss is money minded, so things of that nature are better) Thanks Michael

Thats the advantage of our service, though we rural BLS only and we have a low call volume, the owner lets 4-5 people go on a call, which is a tremendous help. It helps improve the level of care and allows experience, the only thing is, when the owner doesnt take the call, its hard to establish a leader in those situations. you can never have enough hands on things like car accidents.

I got issued a radio. I usually go to calls wearing my coat which I carry some gloves in my size and sometimes a Benchmade Rescue Hook I also carry a personally stocked STOMP-II in my car The director of my Ambulance Service gave us a helluva deal on the class I thought ($300) so I can't complain, although I would really like to get a shirt out of him so I could wear it on my calls at night, I have also thought about getting a coat and getting my name embroidered on it so I could put my EMT patches on something. Really in the rural setting, its hard to have a set uniform for EMS.