I remember seeing the picture on Twitter of an anesthesia resident with a bandolier of prefilled syringes, presumably of anesthesia emergency drugs. I hoped that it was a joke, a costume, but feel like it’s more likely to be the truth.
— Robert McCusker (@VPIMedic) October 23, 2014
Although I am guilty of being an “EDC” / bougie-scalpel carrying anesthestist, I think parading your emergency drugs around is foolish and potentially unsafe. When we are called to a code or resuscitation, there is usually a team assembled with individuals dedicated to drawing up medications. There is a usually a code team leader, separate from the action and in charge of dictating which medications and doses to give. However, anesthesia is used to giving their own meds in the OR while also managing the airway, but we must be able to work within a different team and dynamic. I think it’s fair to carry tools that might not be available when you arrive to a ward code, like a scalpel or bougie (which is not routinely on crash carts).
Carrying controlled substances like narcotics/benzos/ketamine around while running to a code is unsafe and unprofessional. It’s easy enough to have your pen or phone drop out of your pocket, what about syringes being held with elastic? If you lose a syringe of ketamine by accident, are you going to be honest and report it to your staff and pharmacy?
The sterility of syringes is actually not great. Drawing up the drugs and carrying them around on-call, who knows what kind of bugs you’ll pick up and be present on the inside of the plunger. That’s why you should never re-draw with syringes, the barrel will be exposed to environment and then you’re refilling it. What impression would you give to a patient or their family when they see you pull a syringe from your utility belt and inject it? They have no idea where you’ve been, how long it’s been drawn up for.
Finally, we are more than just technicians. Our contribution to a code or resus is not the drugs that we carry with us, but our experience and expertise. The drugs should take less importance to making sure there is working suction and airway is patent or clear. Maybe our image should be the ones carrying the POCUS around.
Every time I see the image on Twitter, it makes me cringe a bit.