Old is new again

[Cookie]

For those who have been in EMS a while my question is: Have you seen things that you learned or did in the past fall by the wayside for new and improved? During a short informative class last night they have brought back the Montana Horse Collar or Roll. For some who don't know what this is, in the past we rolled up a heavy blanket put it around the neck crossed over the ends in front, underneath the arms, and we would use it to pull someone out of a vehicle onto a LSB while keeping the c spine inline. It fell by the wayside for c-collars, head blocks etc.

[RockDoc]

EMS is forever changing.

In 1971, cardiac code was "Draw 2, Push 2, Push 1, CPR and run like hell" Draw 2 red tops, push 2 bicarbs (even on witnessed arrests), push 1 Epi, CPR and transport.

Later I participated in (1) mega dose Epi studies, (2) IV/no IV on trauma situations,and (3) mast trousers/no trousers on trauma, among other studies.

That is why it is called "the practice of medicine" because standards are ever changing.

[romneyfor2012]

Have seen more added than deleted, but things I can think of:

1. Glucose strips, replaced by glucometer

2. Wooden long or short back boards, we used to make our own.

3. MAST Trousers

4. Paper Mapbooks (aero atlas -- but worked in some areas where we used the bank map).

5. Federal Q sirens on ambulances (miss those).

6. D5W as a first-line IV.

7. Cardiac Monitors that weighed 50lbs and did nothing but monitor and dfib.

8. Byrd respirators.

9. Pagers

10. Soft C-Collars and then the two piece foam collar with velcro (burnt orange color)

11. Sandbags

12. M-sized oxygen cylinders, and in the early days the main tank was mounted under the squad bench and you had to lift those giant tanks in and out -- back breaker and knuckle skinner)

13. Jelco IV needles

14. The little bean shaped emesis basins (plastic or metal)

15. Sandbags

That should get someone started as I am sure I forgot alot.

[Just Plain Ruff]

my response below in parenthesis()

Have seen more added than deleted, but things I can think of:

1. Glucose strips, replaced by glucometer (now there are even USB blood sugar monitors that download to the computer)

2. Wooden long or short back boards, we used to make our own. (now you can't get wooden boards anymore. unless you of course make them - but infectious disease control)

3. MAST Trousers(ever seen a nurse or doc cut through the pants?)

4. Paper Mapbooks (aero atlas -- but worked in some areas where we used the bank map). (now gps)

5. Federal Q sirens on ambulances (miss those).

6. D5W as a first-line IV.

7. Cardiac Monitors that weighed 50lbs and did nothing but monitor and dfib. (now there is a machine sold in the airline catalogs on planes that is the size of your cell phone and gives a rhythm just from your finger)

8. Byrd respirators.

9. Pagers (smart phones)

10. Soft C-Collars and then the two piece foam collar with velcro (burnt orange color)

11. Sandbags

12. M-sized oxygen cylinders, and in the early days the main tank was mounted under the squad bench and you had to lift those giant tanks in and out -- back breaker and knuckle skinner) (still work for a company that uses them and they are a heavy unforgiving bitch at times)

13. Jelco IV needles (we use auto cap needles with the small metal needletip cover)

14. The little bean shaped emesis basins (plastic or metal) (only enough to hold your soup and worthless for vomit)

15. Sandbags

That should get someone started as I am sure I forgot alot.

[RockDoc]

I loved the Jelco and Angio-cath needles. They were a lot better than the old Medi-cuts we were issued, the ones with the 10cc syringe attached. We would trade out at our hospitals, 1 box of Medi-cuts for 3 or 4 Jelcos.

[Just Plain Ruff]

I loved the Jelco and Angio-cath needles. They were a lot better than the old Medi-cuts we were issued, the ones with the 10cc syringe attached. We would trade out at our hospitals, 1 box of Medi-cuts for 3 or 4 Jelcos.

That was one way of getting rid of those old dinosaurs right?

[Kaisu]

We still use the jelcos.. and have the been shaped plastic basins too....

*** sigh ***

[RockDoc]

That was one way of getting rid of those old dinosaurs right?

That and we were able to deliver patients to ER with an IV and not so many puncture marks. The old Medi-cuts had a square ended catheter tip, not the beveled tips on modern IV catheters...

[Cookie]

Our barf bags are a large embroidery hoop with a garbage bag attached. Back in the 80's our Medical Director bought mast pants for all of the ambulances in the county, with the condition if we ever saw a nurse or doctor start to cut them off, beat the devil out of them!

[Bernhard]

You mean things that were abandoned and came back later? My personal experiences were:

• Cramer wire ladder splint, were replaced by air splints, those were more or less replaced by vacuum splints, then the Structural Aluminum Malleable (SAM) Splint became common which in basic is the principle of the old Cramer splint again.
  
• Glucocorticoid spray: in my early days it was considered the best thing in world to prevent toxic lung edema when high dosed for smoke inhalations, then it was thrown out because no effect was evident, now it's back because it "at least does no harm"
  
• CBRN awareness: mid 1990ies we didn't need this cold war stuff any more. ~2001 we realized having forgotten hazardous materials in industry usage (and some terrorist media hype adds pressure)
  
• Disaster awareness: mid 1990ies we didn't need our federal wide large disaster unit concept = cold war stuff any more. End of 1990ies we had some larger calls to be forced into having additional response structures again for MCI's, 2001 the attacks on NYC and Washington/DC reminds of probable real high victim number disasters, 2002 floods covered several german states and reminds of probable inter state mutual help requirements. Now we have a strong interstate response concept (partially) alive again.
  
• Wet gel "Burn Pack": first it was the best thing on market for burns, then studies saw no need and maybe more harm than good, now we have it again on board, because "had still several on stock" and "maybe, just in case if...". Never used it any time, though. And probably never will.
  
• Epinephrine dosage: going up and down several times over the years.
  
• Traction splints: had it in my basic education courses, in "real" EMS they told me that this old stuff isn't needed anymore, now since some years it is propagated again (not yet on our ambulances, but we use the air splints a bit in the same sense).
  
• plus some things I even have forgotten to having forgotten once...
  

I've seen a lot stuff first coming and then vanishing, too, but that was not the original question. Now I'm feeling a bit old, thank you...