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Medical 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. Safety precautions. Inform people where you are going Mobile phone Torch Lock car Limited drugs and prescriptions

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Medical Bag

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  1. Medical Bag Ursula Treadgold August 2008

  2. Why important? • Home visits • During day as routine • During day as emergency • Out of hours • Change due to contract changes

  3. Safety precautions • 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

  4. Visits in day • House bound • Nursing homes • Post natal visits • Acute unwell and unable to get to surgery • Psychiatric assessments • Terminal illness

  5. 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

  6. 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

  7. 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

  8. Your bag • It’s yours! • It will evolve with time • Your responsibility • Keep drugs in date • Drugs should be in a lockable container

  9. Equipment • Stethoscope • Pen • Phone • Patient records • Sphyg • Opthalmoscope/ auriscope • Thermometer • Peak flow meter • Tape measure ( DVTs)

  10. Paperwork • 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

  11. Clinical • Tongue depressors • Urine pots • Urinalysis sticks • Gloves • KY jelly • BM test • Venesection equipment and blood bottles • Venflons/ butterflies • Mini sharps box • Fluorescein strips

  12. Emergency Drugs • What conditions are you going to see? • Anaphylaxis • Asthma • MI • LVF • Diabetic hypo • Epileptic fit • Meningitis • Analgesic cases e.g. renal colic

  13. Anaphylaxis • Adrenaline 1ml in 1000 • Chlorpheniramine 10mg/ml • Hydrocortisone injection 100mg • Water for reconstitution • Card for doses!!!

  14. 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)

  15. 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

  16. LVF • Furosmide 20mg ampoules • Diamorphine injection • Bradycardia- atropine 600 mcg

  17. Diabetic hypo • Hypostop • Glucagon injection • Glucose i.v. solution

  18. Epileptic fit • Rectal diazepam

  19. Meningitis • Benzylpenicillin 600mg x2 ampoules • Data sheet for doses • Water to reconstitute • ?? Penicillin allergy • Cefotaxime or chloramphenicol

  20. Analgesics • Diclofenac injection 75 mg • Pethidine injection • Diamorphine

  21. Oral preparations • Depends on where you are • Generally now I only carry the following • Aspirin • Prochlorperazine (labyrinthitis) • Chlorpheniramine

  22. What you need to ensure • Check drugs regularly ( every 3 months) • In date • Book of injections with their expiry dates

  23. Dispensing drugs • 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

  24. Your documentation • Drug given • Batch number • Expiry date

  25. 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

  26. 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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