The Doctor’s Bag - the unexpurgated story

1. The Doctor’s Bag- the unexpurgated story Dr Gerard Murphy Woodbrooke Medical Practice January 1999

2. TheEarly Treatment Centre - The End of the Doctor’s Bag

3. Introduction • Other Equipment • The Bag • Medical Equipment • Official Documentation • Personal Documentation • Technology Growth Areas • Stock

4. Other Equipment • Volumatic / Nebuhaler • Aerochambre • Nebuliser • Ambu bag • i.v. fluids • Tackle box • needles • syringes • abc ampoules

5. The Bag • Price • Size • Weight • Materials • Layout • Security Locks • Space inside for charts • Storage (4 - 25C)

6. Medical Equipment • Diagnostic Set • Digital Thermometer • Pinard / Ordinary • Spatulas • Patella Hammer • Hand Lens • Tape Measure • Tourniquet • Plastic gloves / KYJ • Venflons / Butterflies / Tape • N-Labstix

7. Official Documents • BNF • Scripts • Out Of Hours Consults Pad • Referral forms / envelopes • Form 3 / Form 1 for Psyche Compulsory Admission + way of contacting “Approved SW” • Proforma / Death Certificates • Emergency Rx Forms • FP1001 / Med Certs • Take-in rotas / Emergency Obs

8. Personal Documents • Meningitis Rx doses / routes • Meningitis prophylaxis regimes and mean wts (<16yrs / adults) • An Easy Guide To Taking Your Medications • Maps • Phone numbers - especially pharmacies (on a laminated A4 page e.g. photocopy of yellow pages entry • Practice notepaper • Rx Room forms

9. Technology • Mobile phone • Psion Series 3a / 5 • Nokia 9000 / 9000i / 9110 • Ordnance Survey Maps 255769 • Notebook PC / EMIS • Digital Network + Palmtop + Internet / NHS Network Access - the true information age??

10. Stock • Keep list of all stock • record Batch Numbers & Expiry Dates of all stock • Check Stock every 6 mths - replace expired stock • Observe EC Regulations for dispensing on home visits to pass on liability to drug companies • use envelope / container labelled with date, drug name, dose, frequency, amount & patient’s name + record same + batch no / expiry date in patient’s notes

11. DDA’s - mandatory recording • Vitally important to be able to account for DDA’s • Legal requirement to keep a DDA book • Record dates / drug names / drug amounts / pharmacist name both on receipt and on disposal of DDA’s

12. DDA’s - optionalextra recording • Record date, time / name, address, dob of patient / drug name, dose and site of administration for each DDA administered • You will always be able to account for your DDA’s in any event

13. Prescribing DDA’s for patient • Oral MST, Sevredol etc - prescribe on computer to keep track of amounts, intervals to ensure use only for patient • BUT write out script on ordinary script pad with total amount in numbers and in words • Same for Diamorphine for syringe drivers - any left over will be destroyed by nurse with relatives as witnesses

14. Stock Lists (1) • Pain • narcotics / narcan • rectal / deep im voltarol • Vomiting • buccastem / valoid • Asthma • prednesol / deltacortril / HC • Antibiotics • oral / parenteral • Hepsal

15. Stock Lists (2) • Myocardial Infarction • Soluble aspirin 300mg • Atropine • Infections • Crystapen • LVF • Frusemide • Diazemuls / Stesolid • Syntocinon • Glucose / Glucagon • Imigran

16. Stock Lists (3) • j