Most under-"utilised" (canadian term) peice of equ

[JonathanGennick]

What about the patient status Lights. Does ANYONE use those? The button that flashes the driver a light? GREEN YELLOW RED BLUE

We have them in at least one of our rigs. I was playing with the switches just the other day. We don't use them though, not for real. We have van-style rigs with an open passageway to the front seat area. It's easier, and probably makes for better communications, for the EMT doing patient care to just tell the driver to speed up, slow down, stop, watch the bumps, etc.

Good point Brentoli, about using the stairchair more often to get people out of their houses. I'm going to file that idea away for possible future use. It might come in handy once the weather warms up and the snow goes away. (We got blasted with close to three feet last week). I don't know that I'd want to transfer a patient from chair to cot out in the cold.

What about soft-stretchers? We carry them in our rigs, and I helped use one for the first time last week. (I've only been running for some 3 1/2 months now) Does anyone use those much?

[FormerEMSLT297]

What did in the Scoop stretcher aka the "Orthopedic Stretcher" in for NYC was the fact that a Doc said it could not be used to effectively immobilize the spine, so we used them for like moving patients from beds with FX. legs and hips and stuff,,,

The other thing was even long ago when you could use it for C-spine, we would rather take a long board into the subway, than a metal conductive scoop. even with power off ,, better safe that electrocuted.

Also the STAIR Chair, is one of the MOST utilized piece in NYC as stretchers and other devices dont fit in many houses.

It is interesting to see the different areas answers.

I agree with the patient status lights,,,, and the Manual BP cuff,, cause we all have NIBP.

[Urbanmedic461]

Here is some equipment we use.

Scoop: My partners look at me like I grew a tumor on my forehead when I suggest its use.

http://www.canada.ferno.com/ie/sub_solutions.php?c=41

Stair Chair: Swivel front wheels, extendible handles, overall better angles for hand grips.

http://www.canada.ferno.com/ie/sub_solutions.php?c=1

I use both very often. I would think the KED is the least used in my service. I have only used it about 10 to 15 times myself.

[AnthonyM83]

We don't have scoop stretchers, though we do have break-aways...which can be quite helpful when delivering the patients to their ER beds. The metal frame makes carrying easier than a stair-chair or backboard...it actually might be the most under utilized...partially b/c it's so difficult to re-assemble afterwards.

[nwoparamedics]

I stole this from another thread, but it seems that everyone believes tha the KED is the most ignored peice of equipment on the rig.

I disagree, I think that the scoop stretcher is the most ignored and under-utilised peice of equipment we have. In so many occasions it would cause less patient movement, and more patient comfort. I find most people don't even know how to use one properly, or when it is indicated.

The KED... one of most used pieces of equipment for our MVC's for extrication. The scoop... definately a plus for those in house falls where space is limited, as well as the ejections from the MVC's along side the road.

Least used... the two bilat. sagars that take up room in the rig.

[BushyFromOz]

What did in the Scoop stretcher aka the "Orthopedic Stretcher" in for NYC was the fact that a Doc said it could not be used to effectively immobilize the spine, so we used them for like moving patients from beds with FX. legs and hips and stuff,,,

wasn't there a JEMS article that said the exact opposite of this recently?

[nwoparamedics]

From the Editor: Out of Sight, Out of Mind

The Pittsburgh researchers used high-tech methods to conduct their study, securing electromagnetic sensors over the nasion (forehead), C3 and T12 spinous processes of 31 adult subjects in a human motion analysis laboratory. All participants were familiar with the rigors and requirements of EMS and were used as both subjects and immobilizers.

With rigid cervical collars in place and their movement recorded by a goniometer (a motion analysis system), each subject was tested on both the LBB and the FSS. The long backboard was applied by logrolling the subject 90°, placing the LBB underneath them, logrolling them back to a supine position and performing a "Z" maneuver to center them on the LBB while maintaining spinal alignment. The scoop stretcher was used as designed, and no subjects were logrolled onto it.

The sagittal flexion, lateral flexion and axial rotation were recorded during each of four phases: 1) baseline, 2) application (logroll onto LBB or placement of FSS around the subject), 3) logroll and 4) lifting.

All subjects were required to remain secured on each device for 20 minutes to simulate time spent while on an ambulance cot during transport. Afterward, they were asked to complete surveys on security and comfort. The subjective comfort scale included overall comfort as well as specific comfort points of the occiput, thoracic spine, sacrum and heels. Participants were asked to choose which device they preferred overall. The comfort and perceived security of each test subject were assessed on a visual analog scale.

The results: The scoop stretcher caused significantly less movement on application and offered increased comfort levels. During baseline conditions (i.e., while subjects lay quietly on the ground), range of motion was less than 1°. The researchers found that the application, logrolling and lifting of subjects on long boards resulted in greater motion in all planes and induced three to five times as much movement as the FSS, primarily because of movement induced during application of the devices.

There was approximately 6–8° greater motion in the sagittal, lateral and axial planes noted during the application of the long board compared with the scoop stretcher. Although greater sagittal flexion occurred at the nasion and T12 (1.2–2.7°) while lifting the subjects on the FSS than on the LBB, this finding was not considered clinically significant because studies have shown that 5° is a safe amount of movement. No difference between the devices was found when a secured patient was logrolled onto their side to simulate a fluid drainage or vomiting episode.

Most participants (24 of 30 subjects) felt that the scoop stretcher offered superior comfort and made them feel more secure in its cradle shape than when they were strapped on a flat backboard. Comfort ratings at each of the body segments, except for the occiput, were also greater after subjects lay on the FSS compared with the LBB. Padding is needed under the patient's occiput with either device to keep the patient from being uncomfortable.

This study looked at complete spinal immobilization, whereas most studies have looked only at the efficacy of specific devices in the immobilization of cervical spine injury. This factor is significant, particularly because we know that up to 10% of people with one vertebral fracture will have at least one other vertebral fracture.

But the most important outcome is the documented reduction in unnecessary movement when a scoop stretcher is used, which can reduce the risk of further spinal cord injury. That brings us right back to the real reason we immobilize patients — to reduce further injury in patients we suspect are already injured.

The study proves that the logroll maneuver we've used for years to place our patients on a long spine board may be outdated and detrimental. It cited another study that showed that just 2.1 cm of lateral movement in the cadaveric lumbar spine during a logroll on an unstable spinal injury completely occluded the spinal canal.

Medline Abstract: Comparison of the Ferno Scoop Stretcher with the long backboard for spinal immobilization.

[scope2776]

Every ambulance here has a scoop here...

Great for lifting the back pain, leg pain, etc, pt of the ground with minimal movement....

I was taught in EMT school that it can't be used for immobilization. I would like to know what my med. dir. thinks thou.... The idea of the multicolored lights seems neat, but kinda dangerous. Really an ambulance should only have 2 modes of response. Emergent and non-emergent. Would a red response be driving recklessly without lights+sirens???

[BushyFromOz]

Medline Abstract: Comparison of the Ferno Scoop Stretcher with the long backboard for spinal immobilization.

Interesting - and there are better scoops than the ferno ones :?

[nwoparamedics]

Don't know if better/worse... but the JEMS article shows the new plastic "Ferno Scoop EXL" and "The Hartwell Medical CombiCarrier" as alternatives.