Medical Bag

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

• Its 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)

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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

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Emergency Drugs

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

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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)

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

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Epileptic fit

• Rectal diazepam

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Meningitis

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

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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

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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

• 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

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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

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Other equipment

• Nebuliser
• Oxygen
• Emergency box-
• Airways, pulse oximeter, ECG, defibrillator,
  urinary catheterisation set, Laerdel mask
• Torch
• Dressing pack, suture equipment