Chapter 129: The doctor’s bag and other emergency equipment

INTRODUCTION

GPs who perform home visits and nursing home visits require the traditional doctor’s bag that includes the basic tools of trade: drugs (including those for emergency use), stationery and various miscellaneous items. Country doctors will by necessity use their bag for more emergency home and roadside calls. These recommended contents are simply a guide for cross-checking.

ESSENTIAL REQUIREMENTS FOR THE BAG

• Sturdiness

• Lockable (e.g. combination lock)

• Ready interior access

• Uncluttered

• Disposable single-use items

• Light, portable equipment

• Regular checks to ensure non-expired drugs

• Storage in a cool place (not boot of car)

Traditionalists may prefer the Gladstone bag, whose style confers a sense of time-honoured assurance. Pragmatists may opt for a fishing tackle box: far from elegant, but the sight of those organised compartments emerging during a crisis can calm the nerves.

Stationery (checklist)

• Practice letterhead and envelopes

• Prescription pads

• Sickness/off-work certificates

• X-ray, pathology referral forms

• Accounting and Medicare forms

• Dangerous drugs record books

• Continuation notes

• Tie-on labels for emergencies

• Recommendation forms (to psychiatric/mental hospitals)

• Pens

Many of these items will increasingly be replaceable by a portable computer connected to a virtual ‘paperless’ office.

Miscellaneous items

• Quick reference cards:

  • – the doctor’s bag checklist¹

  • – dosage details of drugs, all age groups

• Handbook of emergency medicine

Many details can be stored on a smartphone, including drug dosage apps, local maps and local emergency phone numbers.

Equipment

• Sphygmomanometer (aneroid)

• Stethoscope

• Pulse oximeter

• Diagnostic set (auriscope + ophthalmoscope)

• Tongue depressors

• Tourniquet

• Small needle disposal bottle

• Scissors

• Syringes 2, 5, 10 mL

• Needles 19, 21, 23, 25 gauge

• Scalp veins (butterfly) needles

• IV cannulae 16, 18, 20 gauge

• Alcohol swabs

• Micropore tape

• Thermometer

• Spacer (e.g. Volumatic, for asthma)

• Artery forceps

• Urine testing sticks

• Pathology specimen bottles

• Skin swabs, throat swabs

• Torch

• Patellar hammer

• Oral airway (e.g. Revivatube, Resuscitube—FIG. 129.1, Guedel)

• Laerdal pocket mask (FIG. 129.2)

• Scalpel (disposable)

• Examination gloves

Drugs

Drugs (oral)

• Samples of commonly used:

  • – analgesics

  • – antibiotics

  • – antidiarrhoeal agents

  • – anti-emetics

  • – antihistamines

  • – sedatives

• Glyceryl trinitrate (although sublingual tablets deteriorate after opening)

• Soluble aspirin (for myocardial infarction)

• Sumatriptan

Drugs (sprays)

• Glyceryl trinitrate

• Salbutamol aerosol

Drugs (topical)