Emergency Kit

nurse2033, MSN, RN · Jun 11, 2012

You can't do CPR without a BVM or pocket mask, and OPAs or NPAs. You might point out that their liability could be higher by not providing the AED, since it is widely expected and common to have one in a facility that has large numbers of people. Ask your paramedic friend, they should be able to help with this.

Altra, BSN, RN · Jun 11, 2012

I would not recommend any of those items other than gloves, just some gauze for a temporary dressing and MAYBE aspirin.. Applying O2 and obtaining vital signs crosses the line, in my opinion, from acting in a layperson "good samaritan" role to acting in a professional capacity. If I were out in a public setting with someone whose condition made me want to get their BP ... the appropriate thing for me to do would be to urge them to seek immediate medical attention or, if necessary, call EMS.

Kidrn911 · Jun 12, 2012

I understand what you are saying, I know we called 911, it took over 20 minutes for them to come, the ER is only 1.5 miles away, it is in a rural area.

I do know many Malls have what I have listed, that also would be considered a layman public setting.

Kidrn911 · Jun 12, 2012

You might point out that their liability could be higher by not providing the AED, since it is widely expected and common to have one in a facility that has large numbers of people. Ask your paramedic friend, they should be able to help with this.

I agree that has been pointed out by my paramedic friend and fellow nurses

Altra, BSN, RN · Jun 12, 2012

I agree with you about the AED. My (small) church has two.

jkr2020788 · Jun 12, 2012

I think the Aspirin, gloves, guaze, tape, kerlix, and the oxygen (maybe Im not sure, still considered a "prescribed" drug, wierd huh?) are about the only things you will need. Aside from the AED, which I definitely do not see why they wont allow it. Anything else is would just be overkill I believe. I dont think you will need a stethescope, unless you expect someone to have a spontaneous pnuemo or flash pulmonary edema. If someone is having a breathing problem outside of the hospital/ EMS area, all you need to do is find out if the person is choking or if they are having an asthma attack, either way, they are going to need the abd thrust or oxygen. Id leave the needle deflation of a pneumo to the EMS team or at the ER. There is alot of liability of doing invasive things. I know you would be trying to do the right thing, but sometimes the "right" thing is the worng thing at the time. Just remember, even starting an IV on someone as a nurse without having the premission from an MD, is illegal. The IV even says Rx only on it. Stat emergency contact, CPR if ness, and supportive care, is all you can do until you are under the coverage of a hospital.

Esme12, ASN, BSN, RN · Jun 12, 2012

I attend a fairly good size church. Sunday there was a medical emergency, fortunately the person did not need an AED. My church refuses to purchase one due to liability. They are afraid some one will use it without knowing how to. I have explained, so has other nurses and a paramedic about the good samaritan law would protect them.
Anyway, we want to put together an emergency kit, something that would be useful, just in case. But we must do it within the realm of our license, thus no drugs, other than aspirin.
The church does have an oxygen tank, so I want a non rebreather mask, aspirin, gloves, stethoscope, bp cuff. I also thought about making a cheat sheet in the box, for CP and stroke guidelines.
Does any one else have any other suggestions?

You have NO need for CHEAT SHEETS for your only obligation is to call 911. I know your heart is in the right place....I know it is.....but as an Emergency Room Nurse I am frustrated by the well meaning intentions of bystanders when it culminates into a delay. Have I done the Heimlich and CPR in the public setting? Yes I have....I happen to be one of those "feces magnets" where people drop in front of me.

Remind your church that AEDs are made for the general public. They are in Airports and Schools all across the country and have been documented to save thousands of lives every year. Young and old alike are saved every day by early defibrillation....this has been well documented.

I do caution you about the use of Oxygen and aspirin as those are, in the medical world, a physicians order. Without and order you are acting outside your "scope of practice" for you cannot give medical orders. EMTs when they are working are under the direction of the EMS director and protocols that is run by an MD.The use of these treatment/interventions and causing a possible untoward outcome from delay of treatment or death from anaphylaxis (aspirin), would increase YOUR liability.

I would have on hand....... gloves, bandages, gauze, maybe a splint or two, a couple of ace wraps and personal protection devices for mouth to mouth. Maybe a bottle of water, juice and hard candy and a prepaid charged cellphone. If a family member wants to give an aspirin let them do it.

Taking the B/P and giving advice (call 911/don't call 911do we give aspirin) IS out of the scope of the layman's "Good Samaritan" law and can buy you more trouble for "Delay in treatment"....... IF you hadn't taken that blood pressure the patient would have gotten to the hospital sooner and the thrombolytic could have been given......now they are paralyzed/dead because you held them up from calling 911.

In the layman's world.....all that is necessary about the B/P is, Do they have one? If they have a pulse....they have a B/P. If no pulse...start CPR. It is well documented that the calling of 911 is the essential key to survival and any delay can be deleterious to the outcome.

If you were over a hour from the EMS response team....MAYBE???? and that's a BIG maybe. But if EMS is a reasonable time away.....call 911 and perform CPR. This is where the AED is valuable and door to treatment is of the utmost importance.:loveya:

Kidrn911 · Jun 12, 2012

I know many have questioned the need for bp and taking VS, funny thing was when we were on the phone with 911, which we called right away and would always be called right away, they asked if we had VS.

BelgianRN · Jun 12, 2012

I think the aspirin comment is based on the fact that in the recent CPR guidelines there is growing evidence of giving prehospital aspirin. I searched the US version of the guidelines to see if it said something similar to the European ones and it holds the following:

To improve ACS outcome, all dispatchers and EMS
providers must be trained to recognize ACS symptoms, even
if atypical. It is reasonable for dispatchers to advise patients
with potential cardiac symptoms to chew an aspirin (160 to
325 mg), providing the patient has no history of aspirin
allergy and no signs of active or recent gastrointestinal
bleeding.

I'm not sure how things are evolving in the US but in Europe it's getting more and more common for EMS dispatch to advise the lay person calling to administer aspirin based on the signs and symptoms he/she hears and asks about on the telephone. Callers are instructed to ask spectators if they have aspirin and if so to administer the above amount.

So in this respect I can imagine it's handy having aspirin at hand in an emergency kit. But at the same time make it clear to everyone with acces to this kit that it should only be administered if prompted to do so by the dispatcher on the telephone after calling 911 so no delay exists.

Altra, BSN, RN · Jun 12, 2012

I think the aspirin comment is based on the fact that in the recent CPR guidelines there is growing evidence of giving prehospital aspirin. I searched the US version of the guidelines to see if it said something similar to the European ones and it holds the following:
I'm not sure how things are evolving in the US but in Europe it's getting more and more common for EMS dispatch to advise the lay person calling to administer aspirin based on the signs and symptoms he/she hears and asks about on the telephone. Callers are instructed to ask spectators if they have aspirin and if so to administer the above amount.
So in this respect I can imagine it's handy having aspirin at hand in an emergency kit. But at the same time make it clear to everyone with acces to this kit that it should only be administered if prompted to do so by the dispatcher on the telephone after calling 911 so no delay exists.

Agree -- I don't have a problem with giving aspirin because the public is urged to do just that in the event of onset of chest pain.

Bottom line, OP -- you have to think BLS here. BLS as it is taught to non-healthcare providers. (The "Heart Saver" course, if you will) Anything else is out of the scope of anyone, regardless of licensure, unless active duty EMS.

Kidrn911 · Jun 12, 2012

Agree -- I don't have a problem with giving aspirin because the public is urged to do just that in the event of onset of chest pain.
Bottom line, OP -- you have to think BLS here. BLS as it is taught to non-healthcare providers. (The "Heart Saver" course, if you will) Anything else is out of the scope of anyone, regardless of licensure, unless active duty EMS.

Exactly,

Another thing I forgot to point out, is we do have a MD available as well, so for the 02 use, we would be covered.