Below is a list of 10 essentials that should accompany every emergency department fanny pack, distilled from peer feedback, personal experiences, and extensive literature review. We tried to include items that serve multiple uses, might run out of stock, or can save an unnecessary walk to the supply room. Some of these items may not be relevant to everyone’s practice. Excluded are trauma shears and stethoscope, as well as key items for niche scenarios.

1. 10 cc Syringe 

One of the most versatile items in the emergency department, this handy syringe can easily be Macgyvered in a wide range of clinical emergencies, including inflating an endotracheal tube cuff during an intubation, performing Valsalva maneuvers for patients presenting with supraventricular tachycardia (SVT), leaving “syringe hickey” landmarks via negative pressure lumbar punctures, bolusing medications from the pump, or facilitating reductions of temporomandibular joint dislocations.^2-4  

2. Three-way Stopcock 

This can be used for bedside bubble studies to evaluate for patent foramen ovale or confirm central line placement, set up for nerve blocks, rapid bolus pushes in pediatric resuscitations, adenosine administration for SVT, push-dose pressors, and push-pull IV fluids.^5-8

3. Lubricating Jelly 

One to three packets of lubricating jelly can be useful for rectal exams, endocavitary exams, or as ultrasound gel in a pinch. It is also helpful for inserting airways, Blakemore tubes, nasogastric tubes.

4. Surgical Pen 

Surgical pens are not just for demarcating cellulitis, but also for marking airways for cricothyroid membrane localization. They also can be used for burrow ink test to rule out scabies (see Sidebar), to draw diagrams on patient bedsheets for discharge instructions, and to sign ECGs.⁹   

5. Tongue Depressor 

These are not just for intraoral evaluations; the tongue depressor can be used to assess for mandibular fractures or rigged to create a makeshift nasal clip for anterior epistaxis.^10,11

6. Tegaderm 

Tegaderm works as an ultrasound probe cover in a pinch; although, this may spark debate. It is also great for peripheral IV placement, to have as part of your suture kit, to use as a bandage, and as a protective eyelid covering for bedside ocular ultrasound exams.^12,13

7. Alcohol Swab 

Not only do alcohol swabs clean your phone, stethoscope, or other wearable equipment, but they also can serve as impromptu packets for nausea relief. They are great for patients who may be maxed out on ondansetron, haloperidol (Haldol)/droperidol, and other multimodal nausea approaches.¹⁴