Picture this: You’re working a cardiac arrest at 5:30 in the morning. The family is panicking. Your partner is ready to work. And then someone trying to help opens your jump kit and dumps everything on the floor. Sound familiar?
This article explores why the design and organization of your EMS equipment matters just as much as your clinical knowledge. If you’re an early-career paramedic who’s ever struggled to find critical equipment in a high-stress moment, or if you’ve wondered why your bag seems to work against you instead of with you, this article is for you.
The big idea: Your equipment design is a cognitive aid, just like checklists and protocols. When designed well, it can shave minutes off critical procedures and reduce errors. When designed poorly, it adds friction to every call you run.
Why Equipment Design Affects Patient Outcomes
Most paramedics don’t think about equipment design until something goes wrong. Your bag fits everything neatly on the shelf, so it seems fine—until you’re on scene and can’t find what you need.
The truth is that design improves performance, and performance affects outcomes. EMS is unique because you bring your entire workspace to the patient. Unlike hospital settings where equipment is stationary and organized the same way every shift, you’re carrying your tools, creating your workspace on scene, and adapting to whatever environment you encounter.
Key Insights and Tips:
- Think of your bag as a cognitive aid, not just storage. Just like checklists help you remember steps in a procedure, well-designed equipment helps you execute faster and with fewer errors. When everything has a designated place that makes sense for the clinical workflow, you spend less time searching and more time treating.
- Design reduces cognitive load during high-stress calls. In a true emergency, your brain is already managing scene safety, patient assessment, family dynamics, and treatment decisions. If you also have to remember where you stuffed that piece of equipment last shift, you’re adding unnecessary mental burden when you can least afford it.
- The “one percent better” philosophy compounds quickly. If better design saves you 10 seconds here and reduces one potential error there, those marginal gains add up. Research on structured airway kits showed a nine-minute reduction in time from decision to successful intubation—that’s not a small improvement.
- Without your equipment, you’re not a paramedic. One of my mentors put it bluntly to me when I was training: “You’re not a paramedic without your paramedic shit.” Your knowledge means nothing if you can’t efficiently access and deploy the tools you need. Design bridges the gap between what you know and what you can actually accomplish on scene.
Common Mistakes to Avoid:
- Starting with the bag instead of the equipment. Most systems buy a bag and then try to make their equipment fit. This leads to compromises, wasted space, and awkward organization. Instead, start by identifying exactly what equipment you need for your most common and most critical calls, then design storage around that.
- You don’t realize the problem until it’s too late. Poor bag design doesn’t reveal itself during the calm moments. It shows up when you’re managing a critical patient and suddenly can’t find something. Use simulation to identify these problems before they cost you time on a real call.
The Quality Principle: Your Gear Takes a Beating
EMS is hard on equipment. You’re carrying bags in and out of houses, up and down stairs, through rain and snow. Your gear gets dropped, kicked, stuffed in compartments, and generally abused. This is why quality matters.
Key Insights and Tips:
- Durability must balance with usability. Yes, a Pelican case is incredibly robust, but it’s also heavy and uncomfortable to carry. Quality design means the bag can withstand the punishment of EMS work while still being practical for daily use. You’re more likely to grab the right equipment if the bag isn’t a hassle to transport.
- EMS providers are masters of adaptation—sometimes too much. The industry has trained medics to accept whatever equipment they’re given and figure it out. While that ingenuity is admirable, it shouldn’t be necessary. You deserve equipment that’s designed for your actual workflow, not equipment that requires duct tape and workarounds.
- Backup systems matter when equipment fails. In EMS, if something breaks during a critical call, lives are on the line. Quality design means having redundancy built in and knowing your backup equipment is just as accessible as your primary tools.
Reducing Friction: The Norman Door Problem
Ever tried to push a door that you’re supposed to pull? That frustrating moment represents a design failure called a “Norman door”—something designed in a way that works against your natural instincts.
EMS is full of Norman doors. Zippers that don’t unzip the direction you pull. Equipment that requires awkward maneuvers to extract. Bags where you have to dig through three layers to reach something you need immediately.
Key Insights and Tips:
- Design for the grab-and-go items. A tourniquet needs to be on the outside of your bag, accessible within one second. Your blood pressure cuff and pulse oximeter—tools you need on almost every call—should be in the first compartment you open. Critical, time-sensitive equipment shouldn’t require unzipping multiple pockets or unbuckling multiple straps.
- Everything should pull toward you. This seems simple, but many bags require you to reach around or angle your hand awkwardly to grab equipment. When designing or evaluating a bag, physically test the retrieval motion. Can you grab what you need with a natural movement, or are you fighting the bag’s design?
- Friction shows up in the sounds you hear. Listen to a high-performing team running a cardiac arrest. The volume is low. You don’t hear a lot of zipper noise because everyone knows exactly where everything is and can access it immediately. If your cardiac arrest sounds like a symphony of zippers, your bag design is adding friction.
- Match the bag to the most likely scenario. Most calls only require basic assessment equipment—blood pressure cuff, pulse ox, glucometer. Design your primary access around these items. Then ensure that when you do need to escalate (cardiac arrest, difficult airway), you can open the bag completely and have everything visible and accessible without digging through compartments.
Common Mistakes to Avoid:
- Creating too many compartments. More pockets seem like better organization, but they often create a scavenger hunt. If you have to remember which of six pockets contains a specific piece of equipment, you’re adding mental work. Fewer, larger, well-organized compartments often work better.
- Duplicating equipment in multiple locations. When medics can’t consistently find equipment, they start stashing duplicates in different spots “just in case.” This leads to excess weight, wasted inventory, and confusion about which item is the “real” one you should grab.
The Iteration Principle: Your First Design Won’t Be Perfect
Even with the best planning, your first attempt at redesigning your equipment organization probably won’t be perfect. Your first attempt isn’t your final attempt—it’s the start of the improvement process.
Key Insights and Tips:
- Test your design with someone who hasn’t been trained on it. Hand your newly organized bag to a medic who’s been off for six months and watch them try to use it. If they can intuitively find what they need, your design is good. If they’re confused or searching, you need to iterate.
- New equipment requires new design. Ten years ago, many systems weren’t carrying CPAP devices or mechanical CPR devices. As your equipment list evolves, your storage design must evolve with it. Don’t try to force new tools into old organizational schemes.
- Visual layout reveals problems that mental planning misses. You can imagine how something will work, but until you physically lay out all your equipment and arrange it, you won’t see the real problems. Take time to dump out your entire kit and experiment with different arrangements.
- One bag for one procedure should be the goal. If you need three separate bags to perform an advanced airway (intubation kit, backup airway kit, surgical airway kit), you’re going to waste time and create noise. The goal should be one bag that contains your primary approach, backup approaches, and rescue approach all in logical, sequential order.
Common Mistakes to Avoid:
- Filling empty space just because it’s there. Just because your bag has room for three more rolls of gauze doesn’t mean you should add them. Stick to the equipment you actually need for your mission. Extra weight and visual clutter slow you down.
- Making system-wide changes without adequate testing. Before ordering 50 new bags for your agency, test the design extensively. Run it through simulations. Use it on actual calls. Get feedback from multiple providers with different experience levels. Small design flaws become major frustrations when multiplied across an entire system.
Practical Steps You Can Take Today
You might be thinking, “This all sounds great, but I don’t control what equipment my service buys.” That’s valid, but you still have options.
Even without budget for new bags, you can apply these principles to your current setup. Start by understanding your mission—what calls do you run most often? What are your most critical procedures? Then audit your equipment against that mission.
Key Insights and Tips:
- Conduct a “role-based” equipment review. For a cardiac arrest, identify what the airway person needs, what the IV/IO person needs, what the medication person needs. Can you pull these items into separate, logical groupings even within your current bag? Sometimes simple reorganization makes a huge difference.
- Physically lay out equipment for specific procedures. Take out everything you’d need for an IO placement: the drill, the needle, the start kit, the flush. Lay them out in the order you’d use them. Now think about how that could be stored as a single, accessible unit rather than scattered across three pockets.
- Identify your “must grab immediately” items. Every system has equipment that absolutely must be accessible within seconds—tourniquets for trauma systems, CPAP for CHF-heavy urban areas. Make sure these items are on the outside of your bag or in the first compartment that opens. No digging allowed.
- Don’t confuse quantity with preparedness. You don’t need to carry supplies for a mass casualty incident in your primary jump bag. Design for the one or two patients you’re most likely to treat. Your ambulance or backup units can handle surge capacity.
The Change Management Challenge
Even perfect design requires buy-in. If your system runs dual-response with fire departments, they need to understand your new organization. If you work for a third-party service where equipment varies between agencies, there’s extra complexity.
Change is hard. People resist it, especially when current systems are “good enough.” But “good enough” shouldn’t be the standard when lives are at stake.
Key Insights and Tips:
- Focus on the “why” behind design changes. Don’t just tell your team “we’re reorganizing the bags.” Explain how better design reduces errors, saves time, and makes their jobs easier. When people understand the clinical reasoning, they’re more likely to embrace change.
- Involve end-users in the design process. The medics who will actually use the equipment should have input on how it’s organized. They know the real-world challenges and workflows. Design imposed from the top down rarely works as well as collaborative design.
- Accept that transition will be awkward at first. Any change in equipment organization means a temporary period where people don’t automatically know where things are. That’s okay. Plan for it. Run extra drills. Give people time to build new muscle memory.
The Bigger Picture: Systems Thinking
Your bag doesn’t exist in isolation. It’s part of a larger system that includes your ambulance, your protocols, your team structure, and your patient population.
High-performing EMS systems don’t just have good clinical protocols—they have good logistics. They’ve thought through how every procedure will actually be executed, not just what procedures should be done.
- Equipment design is about more than convenience—it’s about safety. Poor design doesn’t just slow you down; it creates opportunities for errors. When you’re stressed, rushed, and managing a critical patient, the last thing you need is equipment that works against you.
- Think in terms of workflows, not just equipment lists. Don’t ask “what equipment do I need?” Ask “what procedures will I perform, in what order, and how can my equipment support that workflow?” This shifts your thinking from inventory management to performance optimization.
- Small systems can innovate too. You don’t need a massive budget to improve equipment design. Sometimes it’s as simple as repurposing a bag for a different role or adding a single well-designed pouch. Start small, prove the concept, then expand.
Conclusion
Your equipment is more than a collection of tools—it’s an extension of your clinical capabilities. Every second you spend searching for equipment is a second you’re not spending on patient care. Every unnecessary zipper is friction added to an already stressful situation.
The good news: equipment design is fixable. Unlike some problems in EMS that require policy changes or budget increases, you can start improving your equipment organization today. Even small changes compound over time.
Key Takeaways:
- Design is a cognitive aid. Well-organized equipment reduces mental load and allows you to focus on patient care, not treasure hunting.
- Start with mission, not with bags. Identify what you need to accomplish, then design storage around that, not the other way around.
- Test, iterate, improve. Your first design won’t be perfect. Use simulation and real calls to identify problems, then keep refining.
- Reduce friction at every step. From how you grab your bag to how you access critical equipment, every touchpoint should be smooth and intuitive.
- Quality matters because your gear takes a beating. Invest in equipment that can withstand EMS work without being so bulky it creates new problems.
Your Next Step: This week, pick one procedure you perform regularly—maybe IO placement or airway management. Take out all the equipment you’d need for that procedure and lay it out on a table in the order you’d use it. Then look at how it’s currently stored in your bag. Is there a better way? Start there. One procedure, one improvement. Then move to the next.
Remember: amateurs focus on what needs to be done. Professionals focus on how it will actually get done. Your equipment design is part of the “how.” Make it count.
And if you are interested in designing a bag to meet the needs of your specific mission, check out The Resus Tailor at- https://www.theresustailor.com/. Improving outcomes through better design is their mission.
