Transcript Ursulas_presentation_on_the_doctors_bag

Medical Bag
Ursula Treadgold
August 2008
Why important?
Home visits
 During day as routine
 During day as emergency
 Out of hours
 Change due to contract changes
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Safety precautions
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Inform people where you are going
Mobile phone
Torch
Lock car
Limited drugs and prescriptions
Ask family member to meet you/ have towel/
blanket somewhere obvious
Ask police to meet you if violence a possibility
Consider rape alarm
Visits in day
House bound
 Nursing homes
 Post natal visits
 Acute unwell and unable to get to surgery
 Psychiatric assessments
 Terminal illness
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Before you go
Why are you going?
 Do you need any equipment e.g.
nebuliser?
 Confirm address
 Directions ( sat nav, map)
 Urgency of visit so you can go in correct
order
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When you get there
– Introduce yourself
– Make friends with the dog
– Ask for tv/ radio to be turned off
– Good light
– In bedroom for examination
– Wash hands after
No answer at door
Make lots of noise
 Stick nose through letter box ( be careful
of dogs)
 Find another entrance, you may not have
been told the back door is open
 Phone from mobile phone
 High level of concern, phone police
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Your bag
It’s yours!
 It will evolve with time
 Your responsibility
 Keep drugs in date
 Drugs should be in a lockable container
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Equipment
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Stethoscope
Pen
Phone
Patient records
Sphyg
Opthalmoscope/ auriscope
Thermometer
Peak flow meter
Tape measure ( DVTs)
Paperwork
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Headed notepaper
Envelopes
BNF
Phone number list
Prescriptions
Reference chart of emergency drug doses
Map book
Controlled drugs record book
Pathology forms
Peak flow chart/ obstetric wheel
Clinical
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Tongue depressors
Urine pots
Urinalysis sticks
Gloves
KY jelly
BM test
Venesection equipment and blood bottles
Venflons/ butterflies
Mini sharps box
Fluorescein strips
Emergency Drugs
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What conditions are you going to see?
Anaphylaxis
Asthma
MI
LVF
Diabetic hypo
Epileptic fit
Meningitis
Analgesic cases e.g. renal colic
Anaphylaxis
Adrenaline 1ml in 1000
 Chlorpheniramine 10mg/ml
 Hydrocortisone injection 100mg
 Water for reconstitution
 Card for doses!!!
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Asthma
Salbutamol nebules (N.B. once packet
opened it has only few weeks before it has
to be thrown away, put date on)
 Salbutamol inhaler
 Prednisolone soluble tablets
 Hydrocortisone (as before)
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MI
Aspirin 300mg
 GTN spray
 Diamorphine injection (N.B. this needs to
be stored in locked compartment and
book kept in bag to ensure batch numbers
correspond with CD book in surgery)
 Metoclopramide 10mg
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LVF
Furosmide 20mg ampoules
 Diamorphine injection
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Bradycardia- atropine 600 mcg
Diabetic hypo
Hypostop
 Glucagon injection
 Glucose i.v. solution
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Epileptic fit
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Rectal diazepam
Meningitis
Benzylpenicillin 600mg x2 ampoules
 Data sheet for doses
 Water to reconstitute
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?? Penicillin allergy
 Cefotaxime or chloramphenicol
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Analgesics
Diclofenac injection 75 mg
 Pethidine injection
 Diamorphine
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Oral preparations
Depends on where you are
 Generally now I only carry the following
 Aspirin
 Prochlorperazine (labyrinthitis)
 Chlorpheniramine
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What you need to ensure
Check drugs regularly ( every 3 months)
 In date
 Book of injections with their expiry dates
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Dispensing drugs
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Into bottle or envelope you can seal
Clearly label
Patient name
Drug
Date
Dose
How to take
How many tablets given
Warnings e.g. keep away from children
Your documentation
Drug given
 Batch number
 Expiry date
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Ordering supplies
– Dispensing practice, easy it comes from your
dispensary!
– The practice may order in small stock of
injectables
– Local pharmacy, NHS prescription written in
patients name
Other equipment
Nebuliser
 Oxygen
 Emergency box: Airways, pulse oximeter, ECG, defibrillator,
urinary catheterisation set, Laerdel mask
 Torch
 Dressing pack, suture equipment
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