Published Aug 16, 2004
Hi everyone! Ok, here's my story: I'm driving home from visiting with some nursing-school friends when the van in front of me hits a 12 year old riding his bicycle, and hits him hard: bad enough to throw the kid into the other lane of traffic and to damage the front-end of the van such that radiator fluid is leaking from under the hood. (By the way, that slow-motion stuff really does happen! I could see the entire thing coming and it was painful to watch.)
Now, I'm a brand-new emergency room nurse (out of school in May), which means that I know diddly squat about what I should do, but I do manage to get to the kid, check ABCs (relatively easy, given that he was conscious and talking, and there was no obvious major bleeding), keep him calm (and try to keep him from moving), call 911, and generally hold down the fort until the medics arrive (which, thank God, was very quick). From what I saw, the kid is going to be fine, but holy cow...what a scare!
Anyhow, I was talking it over with my Dad (former EMT) and he felt that I now have a "moral obligation" to keep some tools with me in the car, in the event that this kind of thing happens again, and in a more remote location. Personally, I agree, but I was wondering how many of you do the same? And if so, what do you keep in your kit?
First a word of caution ... the more supplies you have the more you will be held responsible for using them. Most states have Good Samaritan laws to protect ... but you still have to do what you have been trained to do (especially if anyone finds out that you are a nurse)
That being said, my husband teases me about the suitcase in the trunk, and about not being able to take me anywhere because I'm always finding someone that needs help. (Unconsious woman in a river off a bike trail last, but that's a different story.)
I do have a small kit with wound stuff (bandaids & butterflies, 3x abx & anti-itch, sterile gauze, larger bioocclusive sheet), instant ice, SAM splint, ace bandage, gloves, CPR one-way mask, tweezers, scissors, small bottle with motrin, tylenol & asprin.
I have the big medic type one that I take on trips or to sports matches. It has a bigger assortment of the above, plus a couple small bottles of saline & cleansing stuff, stethescope & BP cuff, accucheck monitor (couple family members i worry about), large sterile burn sheet, finger splints, couple vials of Demabond, splinter extractor, thermometer, safety pins, razor blades, alcohol pads, etc.
I'm sure there's more in there, but that's pretty close. anyway ... i'm pretty obssesive, and hate getting caught short ... but the best tool you can take with you is your wits & your compassion ... that helps all the time.
I'm not an RN (hopefully in a few years), but as an Emergency Medical Technician with about 3 years of experience, I feel at least qualified to chime in on this discussion. If you don't want to carry a big orange or blue trauma bag's worth of stuff in your car, you will do fine if you own a small kit with several things to keep the ABC's intact. The ABC's are like a tightly interconnected triangle. If one element fails, the patient is either dead, or is as good as dead. From what you said about the accident, you already know that if you are functioning as a first responder (i.e., on-sighting an accident or medical emergency before EMS gets there), maintaining the ABC's of a patient takes precedence over everything else (besides keeping the patient warm in a cold environment- which you know to do anyways). So, here are my recommendations for stuff you can keep in your car if you want to:
First and foremost, always keep a box or two of latex or non-latex gloves in your car. If you can swipe 'em from your hospital, than they are easily bought at Walgreens.
1)For airway- Buy one of those full-size pocket face masks from the American Red Cross or another medical company. These work sooooo much better than those flimsy faceshields that you drape over the patient's face and mouth; like the mask of a bag-valve-mask device, face masks make a much better seal (when, of course, you use proper technique to seal the mask around the patient's mouth and nose). Also, if you are trained to do so, buy a set of Oropharyngeal Airways, or just oral airways for short. These airways are inserted into the patient's mouth and their curvature is great for keeping the tongues of unconscious patients from obstructing their airways.
2)For Breathing- Unless you can somehow get authorization to carry a portable O2 tank in your car (believe it or not, some people actually do- don't ask me why), a full-size CPR face mask will help you ventilate someone who is either not breathing or has shallow or slow respirations.
3)For circulation- it was apparent from your assesment of the accident victim that you checked the patient for obvious external bleeding. Strong work. You probably know that the number one thing that you want to worry about in terms of the above is whether or not the patient has a pulse. Other than that, your second priority (again- you probably know it already) is checking for obvious, life-threatening external bleeding. To this end, I'd have a dozen 4x4 sterile gauze pads, a few 5x9 gauze, and about 2 8x10 trauma pads. Also have roller gauze handy. Failing all the other gauze pads, just 2 8"x10" pads will suffice. Failing all that equipment, remember that you can still apply direct pressure to (and elevate) the site of the bleeding (if the site is small enough or on an extremity) with your gloved hand. Otherwise, use pressure points to control any major bleeding that comes from medium or large size lacerations.
Hope this helps,
Oh yeah, I forgot to mention, here are a few sites that you can go on to shop for first aid equipment:
a box of gloves and some isolation masks, in case these terrorists get bio's released. (in NYC)
teeituptom, BSN, RN
I carry my golf clubs
I carry my golf bag
I carry my golf balls
I carry my golf shoes
I carry my golfers sunscreen
I carry my aspirin
But I carry no medical supplies at all
and I never stop for accidents or emergencies anymore
I roll down the window and yell "someone call 911" as I drive off. If you have half a dozen certs and stop at a scene with supplies and you are asking to get sued. Make sure someone is calling 911 and move on. The guy collapsing with chest pain in Wal-Mart is no different. You can always walk by and say "he's kinda blue...why don't you (pointing to a person) call 911" and go home or the mall or wherever you were going.
I'm reminded of a story I heard from a trauma surgeon at a seminar. When he was a resident, he was driving around and stopped at an accident scene and did a needle decompression on a guy. Years later (today), he says he now rolls up the window and speeds up when he sees an accident.
I carry my golf clubsI carry my golf bagI carry my golf ballsI carry my golf shoesI carry my golfers sunscreenI carry my aspirinBut I carry no medical supplies at alland I never stop for accidents or emergencies anymore
I'm with you.
I also carry my gym bag in my car.
Wow. Thanks for the responses. The thread was dead for a couple of days, so I let it lie, but I'm glad I came back to take a look!
I'm a little bummed by the legal fears. I suppose everyone thinks that the risk of helping someone and being sued are much greater than the risk of not helping and being sued?
Even so, you can call me naive and idealistic (I guess that's what being a new nurse is all about), but I would feel extremely guilty NOT helping if something similar happened again. I was shocked that only one other person came to this kid to try to help; everyone else watched. I was also shocked that I was the first person to get through to 911 (I fumbled with my phone a little bit). This was a very visible accident in the middle of a very busy road.
In the future, I'm at the very least going to keep a face mask and gloves (and maybe a little sugar for the diabetics) in my car. But I might not be as forthcoming with telling people that I am nurse. It's so sad that the world (or at least the country) as come to this!
Thanks for your responses...they've given me a lot to think about.
CraigB-RN, MSN, RN
I think this thread should be changed to the ethics of good samaratins. After 25 year as a Paramedic, then a flight nurse, I don't worry about getting sued. What I DO worry about is getting waffled by someone stopping at an accident scene. So at accidents I' pull to were it is safe and call 911. As to getting sued for not helping hte guy having the the big one in the mall. I'm not worried. I know my scope of practice inside and out and won't ever cross that line with anyone but my family. I'll do CPR till I'm blue in the face but unless I'm on duty I wouldn't even think of spearing a chest.
As to what I carry in my car or motorcycle. I cary a BLS first aid kit. Lots of gloves, bandages, a SAM splint, sling, pretty much the same things a Boy Scout would carry.
In most cases as long as your not negligent in what you are doing your as safe as you can be in this world. I'm way more worried about getting sued fro something that happened at work than I am with something that happens on the street.
P_RN, ADN, RN
This OLD nurse has some certs too, but I stop,I call 911, I've done chest compressions in the back seat of a hearse....driver had an MI and died but I tried. I've helped pull a mother and baby out of a swampy area when her car ran off the road. I've held pressure on heaven knows how many bleeders. If someone doubts what I do so be it. *I* know I did my best and did it within standards of practice for an RN.
I have my bag in the trunk at all times, so I have my steth, hemostats, scissors, and ever present tape. Also have a small kit in my glove box with gloves, 4x4s, bandaids, and mask. Not too prepared for large emergencies, but am for small ones. Also have my phone so I can call 911!!
I'm with you.I also carry my gym bag in my car.
My Gym bag is usually there too, but I do take it out for cleaning
Create well-written care plans that meets your patient's health goals.
This study guide will help you focus your time on what's most important.
Choosing a specialty can be a daunting task and we made it easier.
By using the site, you agree with our Policies. X