Is there an ambu bag in your office?

  1. If not, why?

    My family practice clinic runs an all-day walk-in as well. Last week a lady came in with unstable angina and was carted away to the hospital by ambulance. After she left, I started thinking that I had no idea where the ambu bag was kept. I know where the O2 and masks are but not the bag. I asked the office manager and she said they don't have one. (I've been there for 10 months and all this time I assumed they had one....guess the old addage about assumptions is right...when you assume you make an "a$$ out of you and me" :imbar ) I asked one of the the head docs why not and he said something about not needing it and that if someone does stop breathing at the clinic the ambulance can be there within 3 minutes. He didn't want to assume the legal responsibility of having to resuscitate someone and if we have an ambu bag we are liable. I asked if we could at least have those disposable masks for doing mouth to mouth. He said he would look into it. (which for him means forget it)

    Is it just me or does it seem to be pretty foolish to run a walk-in clinic without the proper resuscitation equipment available?

    What do you all think?
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  2. 15 Comments

  3. by   kyti
    I would think you would be more liable for not having one. What if it took 5min. for ems. How many min. does it take for brain damage. I would rather go to court and explain my actions to save someone than my lack of action. :uhoh21:
  4. by   laurasc
    Well, I talked them into it. We wil be receiving one of those disposable ambu bags sometime next week.
  5. by   traumaRUs
    And if you see kids in your clinic even as visitors, ensure you have pediatric sized ones also. I have to share this story with everyone...in 1994 my 14 y/o son had an anaphylactic reaction to an allergy shot in the allergist's office. They had no RNs or LPNs on staff, just MA's, no ambu bag, no oxygen, no EPI-PEN - incredible! I used my son's own epi-pen on him and was just about to start rescue breathing (he has been intubated before). I reported this gross negligence to the state board! To this day, I can't believe this happened. Good luck...don't let a tragedy be the event that rallies your office to action.
  6. by   qc rn
    I am supervisor of a walk in UrgentCare clinic. We have everything we need in case of emergency and have had plenty, Everything from seizures to MI in progress. We have crash cart, ambu, I have incorporated a crash box that has everything we need except defib. and that is on the cart. If you have walk ins you need to be prepared for anythig. We have people walk in with swelling of the tonguesooo bad they can not speak. As for only MAs that makes my hair stand on end
  7. by   kids
    I worked in a large (>100 practioner) multi-specialty clinic.
    Every department (from Peds to OB/Gyn to x-ray) had their own crash carts with equipment and drugs to cover all sizes (infant to adult). The only thing we didn't have in house was a defibrilator but more than once a 12 lead was placed and EMS was met at the door with a strip.
  8. by   laurasc
    traumaRUs: Yes, we are getting a paed mask as well. I actually managed to get the adult one for free and the paediatric one for $20.

    qc and Kids: crash CART? We have a crash BOX. When I started it contained an epipen, gravol IM, Benadryl IM, epi vials and baby ASA. I have since added nitro spray and PO Benadryl. If someone walked into our clinic with swelling of the tongue we would be helpless. It's really scary. My office manager was amazed when I asked her about the ambu bag...she said their last nurse (2 years ago) never mentioned it.

    I'm working on it slowly. (too slowly IMO, but I am making some headway) I've implemented a lot of changes in that clinic but it's been an uphill battle all the way. You should have seen what I went though with the vaccines we have in stock! (I won, of course....when the health department comes to inspect us, they will love us! )
  9. by   qc rn
    Laura, Keep up the good work. Believe me they will apprietiate it someday. Well maybe not. But at the least you will be prepared believe me if you have walk-ins something will happen sooner or later.
  10. by   laurasc
    Well, things are starting to happen at work. I talked to the doc the other day and told him that if someone were to come in with a swollen tongue we would be totally helpless. What would we do, use a tongue depressor? I think that did it. I have "permission" to put together a crash CART. :chuckle

    Now, my question is this: bearing in mind that we will be giving only the very basic of emergency care until the ambulance arrives, what's appropriate for a family practice/walk-in clinic crash cart? I'm going to be ordering a variety of pre-drawn syringes (bicarb, 50% dextrose, etc), ambu bags, airways, basic meds like epipens, benadryl, gravol, salbutamol, nitrospray and ASA. What else should I include? I wanted to order a couple of 250cc or 500cc bags IV N/S or D5 or R/L along with tubing, angiocaths, etc. Is that necessary or overkill?

    TIA!
  11. by   qc rn
    Ok,In my crash box I have all sizes of angios 18 to25,Benedryl,Epi,solumedrol,nitro,adenecard,asa,p ravachol,alcohol wipes,needles,tournoquet,also you need o2,IV .9NS, We usually do not know much about the pts. so .9 is best. Also need albutrol for inhalation and nasal canulas and masks....We have 12 lead ekg machine. Sit down and think of possible emergent problems and make a list of what you may need....Good luck
  12. by   ImaEMT
    I just wanted to add that if your EMS providers run only basic EMT's, they will not be doing IV's at all. So the IV supplies are a good idea, even if it's just to put in a lock so it's available at the ER when the patient arrives. We had all the things mentioned in the other posts when I worked at a small rural clinic. We had 2 MI's and a seizure patient with a compromised airway in the 2 years I was there. We had all the meds, but no oral or nasal airway and of course, that was no good. I wouldn't go without a fullc rash cart. You never know if EMS is going to be delayed, of if your patient is going to circle the drain quicker than you'd thought. I can't believe any clinic would operate without one.

    Take Care
    Lisa
  13. by   chatt94
    Quote from laurasc
    If not,


    My family practice clinic runs an all-day walk-in as well. Last week a lady came in with unstable angina and was carted away to the hospital by ambulance. After she left, I started thinking that I had no idea where the ambu bag was kept. I know where the O2 and masks are but not the bag. I asked the office manager and she said they don't have one. (I've been there for 10 months and all this time I assumed they had one....guess the old addage about assumptions is right...when you assume you make an "a$$ out of you and me" :imbar ) I asked one of the the head docs why not and he said something about not needing it and that if someone does stop breathing at the clinic the ambulance can be there within 3 minutes. He didn't want to assume the legal responsibility of having to resuscitate someone and if we have an ambu bag we are liable. I asked if we could at least have those disposable masks for doing mouth to mouth. He said he would look into it. (which for him means forget it)

    Is it just me or does it seem to be pretty foolish to run a walk-in clinic without the proper resuscitation equipment available?

    What do you all think?
    I am going through this same thing currently where I work. We do at least have the ambu bag, because of a previous administrator. I doubt my boss would have felt the "need" to purchase one, if the decision were left to her. Every office should have both and adult and a pediatric version of ambu bags, with an accompanying 02 tank. I've done emergency for 18 years. I can't tell you how many doctor's offices or urgent care clinics that I responded to, when I was a paramedic, that couldn't even maintain an airway for the patient, because they didn't have the supplies to do so. The feeling was "we don't need it". I always thought, "okay, I'll remind you of that when I respond to your next code". The rule is: C.Y.A.
  14. by   Achoo!
    We have ambu bags, and AED, IV supplies, the standard cardiac meds, intubation equipment, O2 supplies,and a manual defibrillator.

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