By Dan White
In my early years few departments used bags, as everything was in some kind of hard box. But the boxes were all heavy and hard to carry. I can remember one ambulance company that manufactured a wheeled cart to carry them and the monster defibrillator of that era. So in the early 80s, EMS providers started switching over to soft cases. The first of these were pretty cheaply constructed, but then along came Thomas Packs and Pacific Packs. People began to appreciate the ease of use and those wonderful shoulder straps. It wasn’t long before most EMS agencies were using soft cases. A good bag, properly engineered to the mission, can help you deliver better care more quickly. But a poorly designed bag can slow you down and create enormous frustration. Here are the top five considerations when selecting a new Trauma Bag or Medical Kit.
1. Consider the context. You must examine each new bag purchase in the context of how everything else is carried. The idea is to balance loads so that “no hand carries more than another.” If you can more equally balance what gets carried, you will have a lot less fatigue and I believe have reduced injuries. This is not always possible; often one item will outweigh the rest.
Examples are when you are forced to carry steel E tanks, or perhaps a full-featured 12-lead defibrillator that will outweigh the other components. But don’t make this situation worse. Some agencies insist on trying to combine everything in one huge bag.
2. Try them on. Buying a bag in a picture book or the internet for the first time is like getting a mail order wife. I highly recommend you get a sample and put your equipment in the bag. Stock it just as you plan to use it, and see how everything lays out. Then think about how you use these items. I’ve found what works best is to look at two specific but very different considerations.
1. Are the things you use the most often easily accessible?
2. Are the things you want instantly when you do need them (like an OPA) only one zipper-pull away?
When I design a bag I often use yellow post it notes to mark all the supplies first. I assign each item that will go inside the bag a score in two categories, for Frequency and Urgency. I use numbers to grade how many zippers I can use to organize the specific item. For example, an Oral Airway is not something I use very often. But when I do use it I want it right now. So I need to make it available with only one zipper between the rescuer and the airway.
A portable oxygen tank is something you use on almost every call. So it too needs to be immediately accessible. The oxygen supplies for it need to be right next to it. If you had to open yet another zipper to get the mask out for it, it would really slow you down.
3. Look at the details. Look carefully at the side and corner seams for signs of irregularity or puckering. A bag that isn’t cut correctly won’t assemble correctly.
Look at the handle attachments and shoulder strap mounts. Will they hold up to the weight you plan to load in it?
Look at the inside of the bag where the main zipper attaches. Is it single or double stitched, and how straight do the sew lines run? This is one spot on most bags where shoddy construction will be revealed most easily, particularly around the corners.
Check the impact liner. Is it cheap open cell foam they goes “pop” between your fingers and soon stops providing protection? Or is it high-density foam that will take years of abuse?
Is the bottom double-layered or reinforced in some manner? This is a primary wear point on many kits. It should also be constructed to resist fluid penetration.
4. Don’t put a pig in a thimble. I’ve long suspected that the Hepatitis B vaccine is strangely contaminated. I have no other explanation for the apparent pathogen. It seems like all EMS people and only EMS people will always try to put 15 percent more stuff in the bag than it was designed to hold. It must be a virus. I’ve seen oxygen bags with 15 oxygen masks. This is ridiculous, but I think I know why some do it. It’s because they don’t want to restock promptly after each call.
I worked at a station where if I was gone for a few days, the bag would inexplicably grow. So did the weight and also my frustration level when later on that shift I was trying to find something. If you overstuff your kits you make them harder to use and they also wear out sooner. Periodically go through your kits to look for items you never use. If you have not used it once in years, maybe it can stay on the truck.
5. Get everyone onboard. This is one purchase that you would be well advised to seek consensus on. EMS providers are deeply affected by changes in deployment systems. I suggest you leave the stocked “new” bag in the kitchen or somewhere for a few days. Give everybody a chance to see his or her stuff in the bag before you buy.
If you take a little extra time making a new bag purchase, you will potentially be rewarded with happier staff and a better-controlled budget. Failing to do a little homework can turn an organization into a simmering cauldron of discontent. A bag is used on every single call every single day. It’s a personal extension of what we do and our principle means of affecting it. I can think of few purchases that can more deeply affect your daily work life.
Any other suggestions? Anything we missed in the list above? Leave a comment below or email products@ems1.com with your feedback.
