Prehospital Equipment And Adjuncts

Daniel G. Hankins



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Early emergency medical services (EMS) equipment began as hospital equipment that was extrapolated to the field. It soon became apparent that hospital equipment did not always perform under the more rigorous conditions of out-of-hospital care. Over the last 25 years, equipment has evolved specifically for EMS that is better adapted to field use in terms of size, weight, and durability. This equipment is designed for resuscitating and packaging the patient for transport to the hospital and for maintenance of stability during emergency or interfacility transport.

Much EMS equipment has been placed in vehicles without clear-cut proof of efficacy. More and more equipment will be scrutinized for effectiveness, with good equipment being kept and useless equipment being discarded.1 Reimbursement for out-of-hospital transports is changing, and the cost-benefit ratio becomes important in the face of ever-tightening EMS budgets. The EMS medical director should be actively involved in evaluating and choosing equipment for use in the field. The nature of EMS equipment is changing due to the expanded scope of practice by paramedics and the blurring of care levels between basic and advanced life support personnel. Equipment once considered only for advanced level care (e.g., defibrillators) is now being carried routinely on basic life support ambulances. There are still differences in the equipment carried by providers of the two levels of care, primarily due to differences in the demographics of prehospital care. Advanced life support (ALS) services tend to be paid, full-time, and urban, while basic life support (BLS) services tend to be volunteer, part-time, and rural.

There are four basic questions that must be answered about EMS equipment: (1) Does it do the job?, (2) Is it safe?, (3) Does it do the job and is it safe in the field environment?, and (4) Does it do the job and is it safe in the field environment in the hands of field personnel? 2

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