One does not have to be an EMT or medic long to notice that ambulance shift checks are not created equal. I’ve had the fortune of working in a number of different services over the years and have seen a variety of rig check styles.
Some people did complete checks and made sure their truck was safe and ready to go, while others barely stepped into the ambulance, doing just enough to fill out the shift check documentation form. Unfortunately, I’ve witnessed items checked off when I knew the cabinet or kit had not even been opened, while oxygen and fuel level numbers were simply carried over from the previous shift. The previous crew didn’t run any calls during their shift, how could it have changed, right? These weren’t bad EMTs or medics; they had just gotten into a dangerous routine.
Needless to say, doing a rig check, shift inspection or ambulance sign-off is an important part of the job we do, as there is a lot at stake. Here are the top five reasons, in no particular order, why good rig checks should be a priority:
1. Shift checks are often required by law and expected by patients
Most services have some sort of policy or rule that requires the ambulance to be checked, inside and out, on a regular basis. Whether you are a low-volume volunteer squad or a full-time staffed service, your manager, chief or municipal leadership has an expectation that the ambulance rolls out the door ready for whatever type of emergency it encounters.
In addition to an individual service policy, most states include a regulatory requirement for ambulance checks. In my state, ambulances are obliged to carry a minimum set of equipment, supplies and medications.
Patient expectations should be considered, as well. Every EMT or medic I have ever met has said the patient is the top reason they do the job. Patients don’t just want us to get there fast, they also expect us to have the tools we need to be able to do our job and care for them when we arrive.
2. Shift checks guarantee supplies
We sometimes hear ambulances referred to as “mobile emergency departments.” If something is missing or broken on scene, you won’t be able to get another one right away. It’s important to check and make sure it is on the rig and functional before you need it. You can’t just stop off at the pharmacy and pick up a specific size of a non-visualized airway that is missing from the kit. If you are in a larger system with multiple ambulances, dispatch may be able to send you another unit, but this is impractical and takes those ambulances out of service for other calls. If you work in rural areas, you are more than likely on your own; there won’t be another dose of albuterol for miles.
3. Rig checks help educate crews
Doing a rig check is the best way to learn the location of every supply and each piece of equipment in your ambulance. There is no worse feeling when your patient is crashing than having to claw through every cabinet looking for that one-of-a-kind adapter. Regular, hands-on inspection of each kit, compartment and cabinet in the ambulance will build a form of muscle memory. Not only will you be able to reach for an item without even thinking about it when time is of the essence, but you will also find that you notice more quickly when something is missing.
Hands-on checks are also a great way to refresh your memory on how a piece of equipment works. Even if you don’t test every feature, the simple act of handling the device, powering it up if appropriate and visually inspecting it will remind you how it works and the steps needed to prepare it for patient use.
4. Checking the rig keeps supplies in working order
Thorough shift sign-offs are an important opportunity to make sure that things are still in the shape we think they are. It is no secret that the pre-hospital environment is tough on equipment and supplies. Not only is our gear exposed to hot, cold, drops, puddles and occasional kicks, we routinely load 10 pounds of supplies into five-pound sacks. Supplies packaged to sit nicely on hospital shelves are stuffed into tiny pockets and then rolled, folded and crammed into tight compartments. Sterile dressings are inadvertently torn open, IV catheters end up bent, syringes are shattered and stethoscope diaphragms punctured.
As you flip through your dressings, medications and airways, make sure they have not expired. Many of our disposable supplies have expiration dates on them, especially if they contain a medication, fluid, cream, adhesive or paste. Others have expirations intended to assure sterility.
5. Rig checks ensure everything is where it should be
As I mentioned in my opening, the possibility exists that the previous crew did not do a thorough check before beginning their shift. Maybe they had an early call, or one partner thought the other checked a certain area of the rig for supplies when they hadn’t. Often, crews do a good check at the beginning of their swing, but are less detailed later in the week. They hear what types of calls the previous shift did and then base their checks off of that.
Often, supplies are used on a call and not replaced before the next shift. It’s common for an ambulance to be destroyed on the inside running a code, and then crewmembers missing one or two items putting it all back together. We are human; it happens, especially when dispatch has other plans for us or we are rushing to get the paperwork done before the end of a shift.
Take an opportunity to review your department’s shift check policy and make a commitment to do it right each and every time. Your patient’s life may depend on it.
Read next: How to set yourself up for shift success
This article was originally posted May 23, 2018. It has been updated.
