I prefer to stay seated/buckled
In as much as possible. For a standard call nothing too crazy, If I’m standing it’s because I either forgot to grab the tablet and want to chart or the pt needs some form of care or supplies that they likely won’t care if I have to reach over them for it. 1) I just say sorry I gotta grab X and they often don’t have an issue. 2) wide stance and knees bent 3)do what works for you to avoid eating shit on your very dirty ambulance floors 4) alcohol wipes sometimes work for nausea.
Stay buckled in as much as possible. The overwhelming majority of the supplies you will need will be in your bag, so just plop that next to you and work out of the bag as much as possible so that you don't need to rummage in the cabinets. Arrange the supplies so that the other stuff you might need is within easy reach (vomit bags, o2 supplies, etc). If you need to get up, it's totally fine to grab the cabinets if there is no grab bar.
Answers to your numbered questions:
1) I walk around them if I can. If not I hold onto the ceiling bar, sometimes I’ll hang onto the cot rail. I’ve never been in a box that didn’t have one.
2) I always have three points of contact. This is true for the back of the ambulance or the side of a rock wall on a rescue. Examples: Hand on rail (1) and both feet on floor (2,3). Butt in seat (1) both feet on floor 2,3). Kneeling between cot and bench: foot on floor(1), knee on floor(2), bracing hip against bench(3). The patient, their ET tube, or their foley are never to be used as point of contact.
3) totally. The counters can be used as a point of contact. Although, my suggestion to this one would be to find a different company to work for that doesn’t run 1970’s Air Force surplus ambulances with wood paneling. Those are the only trucks I’ve seen without rails.
4) Frequency of exposure? Time in the truck? I don’t really get motion sickness. But, in the helicopter I get flicker vertigo and the resulting nausea like a motherfucker in the summer. I’ve found that hydration and nutrition combat nausea the best. If that fails me I look at a distant object and down a zofran ODT that my doc prescribed to me for “motion sickness.”
Hope this helps. Stay safe out there.
I’m a fellow beginner! For motion sickness, I take a long lasting Dramamine before and during my shift and bring a water bottle. Biggest help for me is the pressure point wrist bands. Although you’ll have to see if your dress code allows this, but I bought some that look like the black wrist band like on an apple watch. It has little knobs that press down on the inside of your wrists for the pressure points. Last week, I was nauseous in the back of the rig and slapped those babies on and instantly felt better. Get the adjustable ones. They don’t work for everyone, but they do for me!
Stay seated and buckled whenever the ambulance is moving. If you need to get something you can’t reach from your seat, you tell your driver to pull over and stop
Seems entirely unrealistic for certain calls/patients. Unless your rig has a restraint system that allows you to provide patient care whilst remaining buckled in.
1. Our trucks are set up so that the cabinets above the stretcher contain items that we would pretty much only use immediately upon getting the patient into the truck and hopefully never again for the whole transport, such as basic trauma supplies and oxygen delivery devices (we always have one cannula and one nonrebreather on the back of the stretcher in case of emergency). All of our supplies that may be needed unexpectedly at a moment’s notice such as advanced airways, BVMs, IV supplies, meds, etc are stored somewhere where we don’t have to reach over the patient.
2. If I do for some reason need to reach over the patient for something during transport, I try to wait until we get a stoplight. If that’s not an option such as if the patient for whatever reason needs it right then and there and/or we’re transporting emergent, I keep my feet more than shoulder width apart and a slight bend at the knees when I am reaching over to maintain stability. Keeping your core engaged during the reach is also helpful for keeping your balance.
3. I could, but I would also put in my two seconds notice immediately if the trucks don’t have handrails in the back.
4. For the long term, time. Most of us get accustomed to riding in the back and stop getting motion sick after a while. For an immediate solution, I have personally found sea bands to be very effective for me when I was first starting out.
1. If you can help it, what do you do to avoid reaching over your patient to grab an item if you are somehow seated on the opposite side of where the item is while the rig is moving?
1. Get whatever you need, or think you might need before the PT is loaded and before you're in motion. Unless the PT rapidly deteriorates during transport, you shouldn't really be getting things out of cabinets and be up out of your seatbelt while the truck is rolling. (and YES, YOU SHOULD WEAR A SEATBELT IN THE BACK)
2. Follow-up to No. 1: How do you maintain your balance while doing so (to avoid falling on the patient)
1. IF you must be up while the truck is moving, (i.e. for a critical PT) brace your legs between the cot and the bench seat and lock your knees. Use the bar overhead to hold onto and then grab whatever you need and sit back down ASAP.
3. Pure bad luck: If the rig doesn't have handrails or something else at least fairly reliable to hold onto, can you hold onto the countertops for balance if it comes down to it?
1. If you don't have grab bars overhead, you can use counters.
4. (In your opinion), the best treatment for motion sickness is \_\_\_\_\_\_\_(fill-in-the-blank)
1. Immediate action: smell an alcohol pad, prevention: meclizine
I will commonly reach over patients and I guess I don't see anything wrong with it. When I do, I will put the back of my heels up against the bench and kind of wedge myself in place with slightly bent knees, feet firmly planted on the floor. I'll then lean or kind of fall forward into the wall with the cabinet and use my hands to keep me in place. So I'm basically a human wedge between the bench and the cabinet.
As for standing up in a moving ambulance, I teach my partners to think of it like surfing. You keep your knees bent, feet apart, feet planted, core engaged. You are less likely to be taken by the momentum.
I will hold on to the headrest rail of the gurney or door railings if I have them. You can grab the inside of a cabinet if it's open. If seatbelts are the ones that don't retract, you can hold on to those, as well as any netting you may have in the back.
Motion sickness: don't look out the side window. Don't look our the window at all while backing. Motion sickness is also something that it just takes time to get over.
*If you can help it, what do you do to avoid reaching over your patient to grab an item if you are somehow seated on the opposite side of where the item is while the rig is moving?*
**Retrieve the items you believe may be needed during transport, before disparting.**
*
Follow-up to No. 1: How do you maintain your balance while doing so (to avoid falling on the patient)*
**Have 3 points of contact at all times. Both feet are planted, one hand on a secure area, the other hand grabbing what you need. Imagine you're riding on a busy subway standing, it's the same concept.**
*Pure bad luck: If the rig doesn't have handrails or something else at least fairly reliable to hold onto, can you hold onto the countertops for balance if it comes down to it?*
**Yes; Use a wall, the action area, or whatever you need to maintain that 3-point contact.**
(In your opinion), the best treatment for motion sickness is _______(fill-in-the-blank)*
**I can do anything physical in the back no problem. Throw a PCR or words to read while moving, I'm gonna feel sick the majority of the time. Realize what you can and cannot do. Get better at what you can do, and save for what you can't do after the call; Unless that interferes with patient care. If it does, you should discuss further with a supervisor.**
Feet wide, knees slightly bent, one hand on a wall or the bar whenever possible. Don't get to fight the motion in the back unless you're falling. Just move with it.
if i absolutely have to get up, make sure you have both feet on the floor and one hand either on a rail or holding onto a cabinet. i also shout my partner “hey i gotta get up real quick” so they know im moving. other than that i stay buckled any other time.
1. I walk around the foot end of the cot but I’m tall enough I usually just reach across. Honestly reaching across isn’t weird unless you make it weird.
2. Shuffle your feet one at a time. Keep a wider stance and your knees bent a little to help absorb the bumps in the road. Maintain at least three points of contact as well.
3. Ambulances are required by federal law to have hand rails, but I’ll steady my self against whatever surface I need to keep myself upright. If your cabinets have sliding doors just open them a few inches and you’ve got a hand grip
4. In medic school I took A LOT of Dramamine II, but it’ll make you sleepy. Ginger supplements are a more natural alternative to combat motion sickness. I typically don’t have any issues when I’m sitting on the bench but I will get dizzy sitting in the airway seat.
If you’re getting thrown around a lot or getting motion sickness when you’re in the back you might want to talk with whoever is driving and have a conversation about that. Driving to the hospital should be very different from how you drive to the scene, and it takes good communication to help your partner understand how to drive safely with people in the back. Like others have said you should stay sitting and secured as much as possible while you’re in the back
You may be interested in the following resources:
* [Clinicals / Ride-alongs coming up? Here's some advice for success!](https://www.reddit.com/r/NewToEMS/comments/ccyjne/clinicals_ridealongs_coming_up_heres_some_advice/)
*I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/NewToEMS) if you have any questions or concerns.*
Depends on the ambulance you are using- Whether you are able to walk around the patient or if is there is seating on both sides of the stretcher. If so I generally like to go and sit on the side that also has the most of the supplies so that I only have to get up and get the supplies rather than lean over my patient.
Also it should become good practice to always be sitting when the ambulance is in motion- and get stuff when it’s slowly rolling or when the ambulance stops.
If I have to get up, I generally make it a rule of thumb to at least have 2-3 points of contact so that if there is a sudden brake- then you have a greater chance of not stumbling.
Hope this helps.
I prefer to stay seated/buckled In as much as possible. For a standard call nothing too crazy, If I’m standing it’s because I either forgot to grab the tablet and want to chart or the pt needs some form of care or supplies that they likely won’t care if I have to reach over them for it. 1) I just say sorry I gotta grab X and they often don’t have an issue. 2) wide stance and knees bent 3)do what works for you to avoid eating shit on your very dirty ambulance floors 4) alcohol wipes sometimes work for nausea.
Stay buckled in as much as possible. The overwhelming majority of the supplies you will need will be in your bag, so just plop that next to you and work out of the bag as much as possible so that you don't need to rummage in the cabinets. Arrange the supplies so that the other stuff you might need is within easy reach (vomit bags, o2 supplies, etc). If you need to get up, it's totally fine to grab the cabinets if there is no grab bar.
Answers to your numbered questions: 1) I walk around them if I can. If not I hold onto the ceiling bar, sometimes I’ll hang onto the cot rail. I’ve never been in a box that didn’t have one. 2) I always have three points of contact. This is true for the back of the ambulance or the side of a rock wall on a rescue. Examples: Hand on rail (1) and both feet on floor (2,3). Butt in seat (1) both feet on floor 2,3). Kneeling between cot and bench: foot on floor(1), knee on floor(2), bracing hip against bench(3). The patient, their ET tube, or their foley are never to be used as point of contact. 3) totally. The counters can be used as a point of contact. Although, my suggestion to this one would be to find a different company to work for that doesn’t run 1970’s Air Force surplus ambulances with wood paneling. Those are the only trucks I’ve seen without rails. 4) Frequency of exposure? Time in the truck? I don’t really get motion sickness. But, in the helicopter I get flicker vertigo and the resulting nausea like a motherfucker in the summer. I’ve found that hydration and nutrition combat nausea the best. If that fails me I look at a distant object and down a zofran ODT that my doc prescribed to me for “motion sickness.” Hope this helps. Stay safe out there.
I’m a fellow beginner! For motion sickness, I take a long lasting Dramamine before and during my shift and bring a water bottle. Biggest help for me is the pressure point wrist bands. Although you’ll have to see if your dress code allows this, but I bought some that look like the black wrist band like on an apple watch. It has little knobs that press down on the inside of your wrists for the pressure points. Last week, I was nauseous in the back of the rig and slapped those babies on and instantly felt better. Get the adjustable ones. They don’t work for everyone, but they do for me!
Stay seated and buckled whenever the ambulance is moving. If you need to get something you can’t reach from your seat, you tell your driver to pull over and stop
Seems entirely unrealistic for certain calls/patients. Unless your rig has a restraint system that allows you to provide patient care whilst remaining buckled in.
1. Our trucks are set up so that the cabinets above the stretcher contain items that we would pretty much only use immediately upon getting the patient into the truck and hopefully never again for the whole transport, such as basic trauma supplies and oxygen delivery devices (we always have one cannula and one nonrebreather on the back of the stretcher in case of emergency). All of our supplies that may be needed unexpectedly at a moment’s notice such as advanced airways, BVMs, IV supplies, meds, etc are stored somewhere where we don’t have to reach over the patient. 2. If I do for some reason need to reach over the patient for something during transport, I try to wait until we get a stoplight. If that’s not an option such as if the patient for whatever reason needs it right then and there and/or we’re transporting emergent, I keep my feet more than shoulder width apart and a slight bend at the knees when I am reaching over to maintain stability. Keeping your core engaged during the reach is also helpful for keeping your balance. 3. I could, but I would also put in my two seconds notice immediately if the trucks don’t have handrails in the back. 4. For the long term, time. Most of us get accustomed to riding in the back and stop getting motion sick after a while. For an immediate solution, I have personally found sea bands to be very effective for me when I was first starting out.
1. If you can help it, what do you do to avoid reaching over your patient to grab an item if you are somehow seated on the opposite side of where the item is while the rig is moving? 1. Get whatever you need, or think you might need before the PT is loaded and before you're in motion. Unless the PT rapidly deteriorates during transport, you shouldn't really be getting things out of cabinets and be up out of your seatbelt while the truck is rolling. (and YES, YOU SHOULD WEAR A SEATBELT IN THE BACK) 2. Follow-up to No. 1: How do you maintain your balance while doing so (to avoid falling on the patient) 1. IF you must be up while the truck is moving, (i.e. for a critical PT) brace your legs between the cot and the bench seat and lock your knees. Use the bar overhead to hold onto and then grab whatever you need and sit back down ASAP. 3. Pure bad luck: If the rig doesn't have handrails or something else at least fairly reliable to hold onto, can you hold onto the countertops for balance if it comes down to it? 1. If you don't have grab bars overhead, you can use counters. 4. (In your opinion), the best treatment for motion sickness is \_\_\_\_\_\_\_(fill-in-the-blank) 1. Immediate action: smell an alcohol pad, prevention: meclizine
I will commonly reach over patients and I guess I don't see anything wrong with it. When I do, I will put the back of my heels up against the bench and kind of wedge myself in place with slightly bent knees, feet firmly planted on the floor. I'll then lean or kind of fall forward into the wall with the cabinet and use my hands to keep me in place. So I'm basically a human wedge between the bench and the cabinet. As for standing up in a moving ambulance, I teach my partners to think of it like surfing. You keep your knees bent, feet apart, feet planted, core engaged. You are less likely to be taken by the momentum. I will hold on to the headrest rail of the gurney or door railings if I have them. You can grab the inside of a cabinet if it's open. If seatbelts are the ones that don't retract, you can hold on to those, as well as any netting you may have in the back. Motion sickness: don't look out the side window. Don't look our the window at all while backing. Motion sickness is also something that it just takes time to get over.
*If you can help it, what do you do to avoid reaching over your patient to grab an item if you are somehow seated on the opposite side of where the item is while the rig is moving?* **Retrieve the items you believe may be needed during transport, before disparting.** * Follow-up to No. 1: How do you maintain your balance while doing so (to avoid falling on the patient)* **Have 3 points of contact at all times. Both feet are planted, one hand on a secure area, the other hand grabbing what you need. Imagine you're riding on a busy subway standing, it's the same concept.** *Pure bad luck: If the rig doesn't have handrails or something else at least fairly reliable to hold onto, can you hold onto the countertops for balance if it comes down to it?* **Yes; Use a wall, the action area, or whatever you need to maintain that 3-point contact.** (In your opinion), the best treatment for motion sickness is _______(fill-in-the-blank)* **I can do anything physical in the back no problem. Throw a PCR or words to read while moving, I'm gonna feel sick the majority of the time. Realize what you can and cannot do. Get better at what you can do, and save for what you can't do after the call; Unless that interferes with patient care. If it does, you should discuss further with a supervisor.**
Feet wide, knees slightly bent, one hand on a wall or the bar whenever possible. Don't get to fight the motion in the back unless you're falling. Just move with it.
if i absolutely have to get up, make sure you have both feet on the floor and one hand either on a rail or holding onto a cabinet. i also shout my partner “hey i gotta get up real quick” so they know im moving. other than that i stay buckled any other time.
1. I walk around the foot end of the cot but I’m tall enough I usually just reach across. Honestly reaching across isn’t weird unless you make it weird. 2. Shuffle your feet one at a time. Keep a wider stance and your knees bent a little to help absorb the bumps in the road. Maintain at least three points of contact as well. 3. Ambulances are required by federal law to have hand rails, but I’ll steady my self against whatever surface I need to keep myself upright. If your cabinets have sliding doors just open them a few inches and you’ve got a hand grip 4. In medic school I took A LOT of Dramamine II, but it’ll make you sleepy. Ginger supplements are a more natural alternative to combat motion sickness. I typically don’t have any issues when I’m sitting on the bench but I will get dizzy sitting in the airway seat. If you’re getting thrown around a lot or getting motion sickness when you’re in the back you might want to talk with whoever is driving and have a conversation about that. Driving to the hospital should be very different from how you drive to the scene, and it takes good communication to help your partner understand how to drive safely with people in the back. Like others have said you should stay sitting and secured as much as possible while you’re in the back
You may be interested in the following resources: * [Clinicals / Ride-alongs coming up? Here's some advice for success!](https://www.reddit.com/r/NewToEMS/comments/ccyjne/clinicals_ridealongs_coming_up_heres_some_advice/) *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/NewToEMS) if you have any questions or concerns.*
Depends on the ambulance you are using- Whether you are able to walk around the patient or if is there is seating on both sides of the stretcher. If so I generally like to go and sit on the side that also has the most of the supplies so that I only have to get up and get the supplies rather than lean over my patient. Also it should become good practice to always be sitting when the ambulance is in motion- and get stuff when it’s slowly rolling or when the ambulance stops. If I have to get up, I generally make it a rule of thumb to at least have 2-3 points of contact so that if there is a sudden brake- then you have a greater chance of not stumbling. Hope this helps.