Paramedic everyday carry - 3: Pens

I could nerd out about pens for a while. In fact, I might do so right now.

Some EMS providers don’t care about the pen they carry. They grab the closest thing at hand, probably a clear blue bic with a flimsy plastic cap that promptly gets lost. Who cares, right? There’s a hundred more pens just like it, back at the firehouse. If they forget one, they just ask to borrow yours.

We call these people “monsters.”

When you really pay attention to the tools you use, even the most mundane ones, you start to see how every preference is shaped by your environment and how you chose to interact with it. I want a pen that:

  • Clicks on. I want to jot notes without needing two hands to remove a cap, which I would lose anyway. If I’m getting my gloves dirty/bloody, I tend to try to keep one clean as long as I can, and that’s the pen hand. (I also change gloves frequently on gross calls. Medics: change your gloves. Seriously. Don’t be out there doing your best Hawkeye Pierce impression on a trauma call. And if you don’t know who Hawkweye Pierce is, it’s not because I’m old, it’s because you don’t know your history. Change your gloves. That is all.)

  • Can write almost anywhere: the back of my glove, or on ECG paper, or fabric tape. I don’t do the notes-on-glove thing very often, because of the way we divide roles on a call. The lead medic runs patient care, while the driver gathers history and enters it into a tablet. That will eventually become the report we transmit to the hospital, as well as our permanent record of care. My driver, it she’s any good at her job, should be capturing info as we gather it. So, the rookie doing a blood sugar test knows to call out the result and make sure the driver acknowledges it. The driver also summarizes info for the lead medic, in case I didn’t hear a particularly salient piece of medical history (“patient is a diabetic” or “patient is taking blood thinners” or “the last time I ran this patient, they coded and we resuscitated them”). But every now and then, something comes up while the driver is busy, and I have to scribble a bit of info on my gloves. Then I have to keep that shriveled up glove somewhere handy as a reference, because I change my gloves on calls, as you should. In those situations, I want a pen that can write anywhere.

  • Has a thin tip, but not so delicate that it isn’t easily legible. Personal preference.

  • Is cheap enough to be bought by the pack and tossed out at any sign of contamination. Or can be easily replaced when, on a day when I had more faith in my fellow medics than they deserve, I loaned it to someone, who then kept it and sent a shitty bic pen through departmental mail to taunt me. I’m looking at you, Paul.

Anyway, I use Uni-Ball Jetstream Retractable Ball Point Pens with a 0.7mm tip. Bought in a 3-pack, each one runs under $4, and usually lasts me a couple months. You can also buy them in a 12 pack, which is a much better deal. It writes smoothly, doesn’t bleed, and, well… that’s it. It’s just a pen, after all.

I once bought myself a nicer pen, with a metal housing that looked very slick, and I really liked it… until it got lost. It only set me back about $12, but when it came time to replace it after less than a year of use, I balked. This is why, as they say, we can’t have nice things.

I also highly recommend carrying a Sharpie marker of some type. I use a Sharpie Twin Tip, which has both a traditional fat marker on one end, and a thin nib on the other. Why do you need a sharpie? Because, in a mass-casualty event, when you apply a tourniquet, you’re supposed to write the time of application on the victim’s forehead.

Seriously. Have I ever done this? No. I’ve applied lots of tourniquets, in non-mass casualty events, and I just write the time of application directly on the tourniquet, where the manufacturer has helpfully provided a space for me to do so. (In case you’re interested, most of the tourniquets we use are the Combat Application Tourniquet type, in bright orange. They seem less fussy to apply than others I’ve tried, particularly with blood slicking things up, and they seem to do a good job at stopping arterial bleeds. I’m not an expert, just an enthusiastic user.) Not that I wouldn’t do the forehead thing if the necessity arose. As it happens, I write on our tourniquets with a sharpie.

I also use if for a million other tasks, like scribbling expiration dates on packages, because medication manufacturers delight in shrinking the text of their expiration dates to the point where you need an electron microscope to verify them. And other Sharpie things.

Don’t be a monster. Carry your own pen. And do I need to mention the gloves again? Good.

Next episode: eye & face protection