A police officer arrives at an apartment building to investigate a domestic violence report. When he gets to the apartment on the 17th floor, a woman answers the door and reports that her husband is crazy and has a gun. Bullets begin to fly. A gun battle involving the lone officer ensues. He returns fire, emptying the clip in his gun. Fortunately, he carries two extra clips on his belt. He grabs one, reloads on the run and ends the gun battle and the threat to his life.

On the other side of town, an engine company arrives at a structure fire and finds flames blowing out of an open garage door. An attack crew quickly advances a line and gets in position to extinguish the rapidly escalating fire. The pump operator, not forced to wait until his hydrant line is connected, charges the line from his engine’s supply tank and gives the crew the water they need.

Two miles to the east, an EMS crew arrives on the scene of a reported “man down” on the 11th green of a golf course. They load themselves, their monitor, suction unit, medical bag, mechanical CPR device, oxygen and backboard onto two golf carts and drive over to the patient. Four minutes later, they arrive at the side of a 52-year-old golfer in cardiac arrest, with his friends performing CPR on him.

It was a witnessed arrest with CPR started immediately on a patient with no reported past medical history. This encourages the providers because they sense the opportunity to resuscitate a “fresh” arrest.

They place monitor/defibrillator pads on the patient while an engine crew simultaneously positions and activates the mechanical CPR device. But, when they turn on their monitor, they discover its battery is dead.

Sadly, for months, they’ve been requesting that a spare battery be stored in each monitor case, but their service administrators have been hesitant to buy extras, insisting the spare carried in a charger in each patient compartment is sufficient.

It took them four minutes to cart across the course and reach the patient, and they know sending a crew member to retrieve the spare battery will take at least eight minutes. So, they elect to rapidly move the patient to the ambulance. They keep the mechanical CPR device on the patient, continuing to deliver high-quality, uninterrupted CPR, and an EMT bags and oxygenates the patient. It’s a smart move because they also know CPR would be ineffective with a crew attempting to perform compressions in the back of a cramped golf cart bouncing across the uneven turf of the golf course.

They arrive back at their ambulance just as the battery on the mechanical CPR device indicates it’s at a low level. Fortunately, they’re able to replace it with a spare, and the device continues its critical mission. They retrieve the spare monitor battery from its charger and fire up their monitor/defibrillator. The patient is found to be in ventricular fibrillation. They shock him and get a return of spontaneous circulation.

The dead battery in their monitor could have been clinically disastrous to their patient and legally disastrous to their service. They were fortunate to have a mechanical CPR device available to save the day. They were also fortunate to have reached their unit before the power was completely drained from the device’s battery.

Power is an essential component of almost everything EMS does. The word “power” really has multiple meanings. Power is a source of energy that allows our equipment to function.1 Power is also a measure of an entity’s ability to control the environment around itself—meaning the ability of our crews to accomplish defined tasks.

In a physical sense, portable radios, suction units, cardiac monitors and mechanical CPR devices are useless without power. In an operational sense, the loss of an energy source also leaves us “powerless” to meet health, safety and patient care objectives.

Plenty of expert witnesses would be willing to point out in court that your service should have known the importance of carrying backup batteries for your radios, monitors and mechanical CPR devices because the inability to use them can result in negative effects for patients or the crew.

Providers should carry spare batteries to the patient’s side, particularly for devices that have a lifesaving role for the patient. And, crews should carry spare radio batteries fully charged and readily available to them while in the field.

They can’t call for assistance when they are being attacked, need important resources or are tasked with running a mass casualty incident if their radio batteries die and the only spares are in a charger back at their base.

I believe the failure of an EMS service to “arm” its crews with spare batteries is as dangerous (and perhaps as negligent) as sending a police officer into a gun battle without spare ammunition clips, or an engine company to a fire with an empty water tank.

Don’t leave your crews powerless. JEMS

1. wordnetweb.princeton.edu/perl/webwn

This article originally appeared in October 2010 JEMS as “Power: Staying Charged When it Matters.”

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