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Training Day: Why 1-for-1 documentation is important

Inventory management technology can help your agency keep track of what needs to be restocked without a time-consuming manual count


Inventory management technology is available to help you keep track and reorder supplies and equipment without having to physically count it, which means every shift can start with the confidence that they have all the supplies they need.


Sponsored by Bound Tree

By Tim Nowak for EMS1 BrandFocus

We’ve all been there ... it was almost a guarantee to be successful at the IV attempt, but for whatever reason you were unsuccessful (ugh).

Now’s the point of contention: Do you document this unsuccessful attempt? Why or why not?

By all means – and medicolegally – you absolutely should be documenting any of your missed IV attempts for a number of reasons beyond the quality assurance data metric of IV success rates. This is a point of contention because, let’s face it, this documentation point is often overlooked because of providers’ fear of ramifications for low success rates.

While that’s an article for another time, the focus behind documenting all successful and unsuccessful interventions – including the 1-for-1 equipment used – is rooted deeper in the capabilities of today’s technology platforms, including your electronic patient care report and daily equipment and inventory management platforms.

Overcompensation: The ‘C-Shift’ Effect

Being a former A-shifter, it was only appropriate to blame all of my station’s problems on the C-shift (sorry!). Coming back from a day off to find the ambulance crammed tight with an abundant overstock of IV catheters, gauze rolls and other miscellaneous items became a point of frustration. How is having 10 of an item better than its usual stock level of two?

The issue of overstocking ambulance cabinets and med bags is frustrating for more than just field crews, but for logistics staff as well. Without a formal system in place to fully track equipment use and provide for a satisfactory 1-for-1 exchange of items, the risk of logistics freelancing runs high.

(By the way, B-shift had the opposite problem, as they were notorious for not replacing their used items, which is probably why C-shift – out of frustration – overstocked equipment. A-shift, as you can imagine, was always perfect.)

Technology as an inventory management solution

Returning to our IV scenario: One attempt equals to, at a minimum, one angiocatheter, one IV start kit and (if not included in your start kit) one saline lock set (i.e., extension tubing, lock, 10mL saline syringe). An unsuccessful attempt, therefore, should equate to at least these items, plus another angiocatheter and saline lock set.

In a small system where you’re able to physically count your inventory on a weekly basis and place a product order, verifying all of this is pretty simple. Once you start involving anything beyond a piece of paper to track your order needs, it’s time to incorporate inventory management technology.

Let’s start with your ePCR. This system already accounts for your skills/procedures performed, so how about beginning the replacement/ordering process there?

Coupling your ePCR with inventory management software can provide your EMS agency with a dynamic, real-time view of what is being used within your system and how often and when. As your crews replace items via vending machine or daily ordering processes, equipment tallies can be accounted, and orders can automatically be made to vendors on a weekly (or more frequent) basis without having to physically count each item in your supply/warehouse stock.

Automation: Data in, order out

As long as crews appropriately document their 1-for-1 items used (including those unsuccessful IV attempts), today’s inventory management software can act as an always-on-duty partner (who always follows proper ordering processes) and submits an automated order based on the actual items consumed.

Beyond this, advanced inventory tracking software for EMS agencies can be expanded to account for expiration date monitoring, controlled substance cradle-to-grave labeling and logging, and asset tracking for any durable item that your agency has in circulation. Some even offer integrated RFID tracking technology for further automation.

If you can imagine all of the moving parts and pieces involved in keeping your units fully staffed and equipped, it makes sense to incorporate some form of automation software that helps you fully stay on top of your agency’s operations. For example, controlled access pharmacy dispensing machines that integrate with monitoring software not only help you manage your stock but provide oversight that helps cut down on waste and outages by alerting managers when items are about to expire or run out.

As with all software, inventory management tools are only as good as the data they receive, which is why it’s important to truly document your 1-for-1 equipment use. This isn’t to say that your providers need to count each adhesive bandage stocked within the ambulance, but if you did something, then document it. If you used something, then document it (and replace it).

With inventory management technology available to help you keep track and reorder supplies and equipment without having to physically count it, every shift can start with the confidence that they have all the supplies they need.

Visit Bound Tree to learn more about inventory management solutions.

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Tim is the founder and CEO of Emergency Medical Solutions, LLC, an EMS training and consulting company that he developed in 2010. He has nearly two decades of experience in the emergency services industry, having worked as a career firefighter, paramedic and critical care paramedic in a variety of urban, suburban, rural and in-hospital environments. His background includes nearly a decade of company officer and chief officer level experience, in addition to training content delivery and program development spanning his entire career. He is experienced in EMS operations, community paramedicine, quality assurance, data management, training, special operations and administration disciplines, and holds credentials as both a supervising and managing paramedic officer.

Tim also has active experience as a columnist and content developer with over 200 published works and over 100 hours of education content available online, and is a social media influencer on LinkedIn within the EMS industry. Connect with him on LinkedIn or at