On the page titled "A Day in the Life of an Advanced Life- Support Paramedic"
we gained important insights pertaining to the work that our first responders do. We decided to follow this by also developing a page and creating some awareness of the types of equipment you are most likely to find at the scenes of road crashes:
Emergency Medical Services require specialized equipment to aid in the provision of emergency care. Despite some of this equipment at times being seen on television programs or in news features, what the equipment is and what it is used for by the paramedics is not generally well known.
This article will identify some of the common equipment used by EMS, and describe what it is used for.
This equipment can vary from basic stretchers to complex equipment used in intensive care units and theatres. However, all the equipment is collectively important. The ability to use certain equipment may depend on the paramedic’s qualifications. Importantly, the electronic equipment used by paramedics needs to have built-in batteries for use in the pre-hospital environment.
This is a bag used to carry most of the surgical sundries, which includes bandages, drips, syringes, etc., and which are taken to the client’s side by the paramedic. The bag which is normally quite large has several pouches, where the sundries are kept. These bags are substantially more comprehensive than a typical first aid bag and may weigh as much as 20 kg with the equipment packed inside.
Bag Valve Mask
This is a device which is used to manually give rescue breaths to a patient who is not breathing or is breathing inadequately. There are several sizes, depending on whether the patient is an adult, child or baby. The device is connected to an oxygen cylinder. The mask is placed over the patients face and the device is squeezed by the paramedic, allowing oxygen to follow into the patients lungs.
A suction unit is used to suction secretions and fluids from a patient’s airway, which may obstruct the patient’s airway, causing severe respiratory complications. A sterile catheter is attached, by surgical tubing, to the suction unit which generates suction so that the sections can be suctioned from the patient's airway and collected in a container attached to the unit.
This is a handbag-sized bag which is used to carry the medications that paramedics may need to administer to clients. The bags are padded to protect the ampules in the bags. The medications are kept either in individual pouches or under elastic straps. All paramedics use these bags but the size and the amount and type of medications carried depend on the qualifications of the paramedics.
These are unpadded patient-handling catty stretchers used to provide rigid support in patients who have suspected spinal injuries. They can be used in conjunction with a ‘spider harness’ and ‘head blocks’ which are used to further secure the patient to the board. Despite their being designed to be used with patients with possible spinal injuries, they can be used to carry any patient over a short distance.
ECG Monitor With Defibrillator
There are several models available ranging from automated basic models to advanced multi-parameter monitors. The most basic models are automated and the paramedic attaches the monitor to the patient and follows the voice prompts from the monitor, while the advanced monitors have other patient-monitoring equipment built in to the monitor. The main function of the ECG monitor is, however, to display the patient’s ECG on the built-in screen so that it can be monitored by the paramedic, and the defibrillator is used to shock cardiac arrhythmias. It is not used to ‘jump start’ the heart as depicted in television programs, but rather to ‘stun’ heart arrhythmias so the heart’s normal electrical impulse can make the heart beat normally.
These are used to keep neonates warm while being transported in the ambulances. The neonates are placed in the incubator, which provides a warm and safe environment for the neonate and the babies are transported inside the incubator during the trip, which can be from a pre-hospital scene to hospital, or on a inter-hospital transfer. Intermediate and Advanced life support paramedics are trained to monitor neonates in an incubator.
Ventilators are medical machines used by Advanced life support paramedics and are designed to mechanically move air into the lungs of a patient who is not breathing or is breathing inadequately. There are multiple settings that need to be adjusted by the attending paramedic, which include being able to change the rate and depth of the ventilations given by the ventilator. An oxygen cylinder is connected to the ventilator to provide oxygen.
Infusion Pumps And Syringe Drivers
These are devices that control the rate at which an infusion is infused to a patient. They are used by Advanced life support paramedics, normally when transferring patients between hospitals. The device controls how much fluid from a drip, which normally also has medication added, follows past the device to the patient. The rate and the amount of fluid delivered through the device are controlled by changing the settings on the devices.
The Haemogulcometer will be one of the better known devices used by EMS, especially by diabetic clients. The Haemogulcometer or HGT meter is used to check a client’s blood glucose level. A small drop of the client’s blood is dropped onto a disposable strip which is inserted into the monitor and the client’s blood glucose level is assessed and displayed on the monitors screen.
Kendrick Extrication Device
Also known as a K.E.D. , This is a device that is used to remove victims of traffic collisions from motor vehicles. This semi-rigid brace secures the head, neck and torso in an anatomically neutral position. This position reduces the possibility of additional injuries to these regions during extrication out of the vehicle.
A Cervical collar, also known as a neck brace, is an adjustable collar which is skillfully placed around the neck of patients who have a suspected head or neck injury, to minimize movement of the head and neck, which could worsen the injury. There are several sizes and slightly different looking brands available but they serve the same function.
The equipment discussed is just some of the many pieces of specialized medical equipment used in EMS. Despite some of it looking basic, it plays an important role when paramedics are treating patients. Paramedics receive training on how to use the equipment during their studies. Continuous use of the equipment, as well as internal and external continued training and studying, ensures that paramedics maintain their skills using the equipment.
[A word of appreciation to Robert Mckenzie, KZN EMS Media Liaison Officer, for supplying us with these insights]