Equipment for medical responders at special events

By Dave Konig

Whether you are at a high school football game, a music festival or a major league sports event, EMTs providing event medical services need to be able to respond quickly to any call for help. Responding quickly is half of the equation to success. Having the right tools to render the appropriate care is the other half.

The majority of responses or patient contacts often don't require a visit to the onsite medical office, much less transportation to an emergency room. Improving a guest's condition so they can enjoy the rest of their time in the venue is the primary goal of every event medical service provider.

Standard Items
In order to meet expectations of the organizer and their guests, event medical service providers need to have the tools on hand to be prepared to face a variety of possible issues. Knowing the organizer's expectations for event medical services, as well as the capacity of on-location medical services and the availability of a dedicated transport unit is important to fine-tuning the supply list.

Here is a list of typical supplies for quick response by an event medical service provider on a posting:

Circulation: Bleeding control supplies

• Adhesive bandages 1x3" (20)
• 4x4 gauze (10)
• 5x9 gauze (5)
• 10x30 trauma dressing (1)
• 1-inch medical tape (1)
• 2-inch medical tape (1)
• Triangular bandages (4)
• Burn sheet (1)
• 1-inch roller gauze (3)
• 2-inch roller gauze (3)
• 250 mL sterile saline (1)
• Trauma tourniquets (2)
• Trauma shears (1)

Airway: BLS management

• Oropharyngeal airways (OPA) sizes 0-5 (1)
• Portable handheld suction unit (1)

Breathing: Ventilation and oxygenation

• D-size oxygen cylinder with oxygen regulator (1)
• Adult BVM w/ 2 masks (1)
• Pediatric BVM w/ 3 masks (1)
• Adult non-rebreather mask (2)
• Adult nasal cannula tubing (1)
• Pediatric non-rebreather mask (2)
• Pediatric nasal cannula tubing (1);

Additional items for assessment and care

• Adult blood pressure cuff (1)
• Pediatric blood pressure cuff (1)
• Adult stethoscope (1)
• Pediatric stethoscope (1)
• Chemical ice packs (4)
• Small splint (1)
• Small red infectious waste disposal bag (2)
• Notepad for documenting patient information (1)
• Black ink pen (1)
• Penlight (1)
• Flashlight (1)
• Personal protective equipment kit including gloves, gown, goggles, and respirator (1)

The following should be carried if allowed by local protocols:

• Nebulizer and albuterol sulfate doses (1)
• Nasopharyngeal airways airways sizes 16F-34F (1)
• Adult epinephrine auto-injector (.3 mg) (1)
• Pediatric epinephrine auto-injector (.15 mg) (1)
• Blood glucometer (1)
• Pulse oximeter (1)

An AED with each medical provider is ideal but not a necessity. The venue may have public access AEDs readily available to use. For venues without AEDs, overlap concentric circles of coverage with 50 percent of your postings equipped with AEDs.

Increasing Options Through Supply
While traditional emergency medical services often stock to regulatory minimums with just enough to get the patient to the hospital for definitive care, event medical services workers often add additional items so that guests who have received treatment can stay and keep enjoying the event. While remaining in the venue is not always possible due to the guest's condition, transporting every patient that comes to a first aid station is simply unnecessary.

Part of the reason for this philosophical difference is reimbursement models. While the emergency medical service is reimbursed on a transportation fee-for-service model, the vast majority of event medical service providers are reimbursed on an hourly or per-event basis. By doing this, event medical services do not depend on patient transportation for financial solvency.

Some ambulance transport agencies may reduce their pricing for staffing an event under the assumption that there will be some number of patient transports resulting in reimbursement. Agencies should never count on patient transport reimbursement when bidding and budgeting for events. Doing so incentivizes the providers to the traditional emergency medical services philosophy to transport patients to a hospital, which is a disservice to the event organizers and their guests.

One way to be sure you can address the needs of the guest is to have the additional items on hand to care for them in the best manner.

Specific items for event coverage

• Knuckle articulated adhesive bandages 1½ x 3" (5)
• Fingertip adhesive bandages 1¾ x 2" (5)
• Adhesive bandage strips ½ x 4" (10)
• Triple antibiotic ointment .5g (10)
• Sterile saline irrigation solution 30 mL (5)

Over-the-counter medications
There is usually a debate surrounding over-the-counter medications and whether or not they can be furnished to guests. Some argue that providing these medications is drug administration, while others, me included, view the drugs as just being dispensed.

The four over the counter medications most commonly requested are acetaminophen, ibuprofen, diphenhydramine, and aspirin. One way to avoid any and all legal issues is to not offer any over-the-counter drugs.

Unfortunately, just as we wonder why the public can easily access naloxone for drug overdoes, the public you come into contact with will wonder why we can't provide them a packet of aspirin for a headache. The worst part is that your level of service will appear sub-par to those guests when compared to the local 24-hour convenience store.

Some ways to resolve the arguments on this topic include providing only individual dose packages. Some services charge the requestor a fee for each packet while others roll the cost of over-the-counter drugs into their fee to the venue and dispense it gratis.

The provision of drugs may require standing orders from a medical director. In some extreme situations a complete patient assessment and a patient-signed refusal of medical aid are also required. Ultimately refer to your local protocols and your legal counsel when making the decision whether or not to include the over-the-counter medications.

Kit bag considerations
There are a number of factors to take into consideration when choosing the type of bag to hold your response kit. Providers posted without a patient transport device will likely request a hands-free, backpack-style bag.

Another kit consideration is organization of the bag. The majority of injuries and ailments that providers respond to are minor aches and wounds. For this reason a bag with easy to access outer pockets where the adhesive bandages, tape, triple anti-biotic ointment packets and chemical ice packs can be reached is a great choice.

When opening the bag you don't want the contents spilled out all over the concourse, street or festival field where guests are walking or risk items falling behind seats. A bag with individual removable interior pouches, preferably color-coded for quick selection, is again ideal in this type of environment.

The material the bag is made of makes a difference, especially in stadium and open air settings. Precipitation often will cause a spike in call volume and you want to make sure that you protect your supplies against those elements. A non-porous, water-resistant material is the best choice to defend against bad weather and for the easy decontamination.

Regardless of bag type, do not overload the bag. Excessive contents lead to broken straps, blown-out stitching, holes and rips. Just as it matters in the traditional emergency medical services, appearance and perception to the public are important in the event medical services.

Cell phone video and livestreaming puts event medical providers under a microscope to the world. Make the best impression you can with your gear, your uniform, and most importantly, your attitude towards the guests.

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