EMS (Supply) Anxiety
By Alan Perry
February 29, 2016
What causes EMS supplies to be
stockpiled on your medic or in your station? Is it insecurity or anxiety about
a procedure? An unreliable EMS supply system? Lack of communication? A fear of
an MCI event? In the ideal EMS supply system all units carry the same equipment
and supplies, stocked at pre-defined levels, to assure that units can remain
functional without unreasonable delays in restocking them. Unfortunately the
practice of EMS supply hoarding, whether on the medic or in the station,
confounds this goal. It drives up the cost of consumable items by increasing
inventory levels while taking them out of circulation where they frequently
become damaged or expire. That creates some of the very problems that the
hoarding strategy seems to be trying to avoid, namely unpredictable stock
levels or out-of-stock items.
I believe fear can be a factor,
although an irrational one, it seems some of the supplies most likely to be
overstocked are related to ALS procedures (ET tubes), infection control (masks,
gloves, etc.) and trauma supplies (kling, tape, bandages). Could it be that
somehow having more of these items allows us to handle those situations more
effectively, or are they serving as a security blanket?
Communication is also an important
factor; if the apparatus get checked off every shift, supply orders are placed
every shift as well. If the supply system is not responsive, and fails to fill
the orders as they are received, it can easily lead to duplicate (triplicate,
quadrupled…) orders unless providers communicate what orders they have placed
to each other. If supplies are not kept in specific locations in specific
quantities this will lead to items being kept in multiple locations in variable
quantities. The system should define what, where and quantity for items stocked
on each piece of equipment. In most Fire-based EMS systems and volunteer
systems, there is also a high degree of staff variability on each transport
unit, frequently only a single shift assignment a month or pay cycle. In that
situation you have little ownership of the apparatus or continuity in its care
and restocking, both of which further confound the issue.
Most EMS systems now have
dedicated resources they can rely on for MCI events. While a medic may be
sacrificed in some instances to manage an MCI incident the majority of units
will be used for treatment and transport of single patients. There really is no
need to equip each ambulance with enough nasal cannulas, ET tubes and 12x30
trauma dressings to treat a dozen victims –that’s an irrational fear.
The reliability and of an EMS
supply system will affect its efficiency. If your providers know the supply
system is reliable and responsive to their needs they will be far less likely
to set up individual stashes of these precious commodities on the medic or in
the station. Providers should be aware of the consequences of these actions,
which increase the cost to the organization, have a negative impact on its
reliability as well.
Be safe,
Alan
