I will post as many of these as Concerned American at WRSA will put up. We started with this post the other day. Good stuff.
Grid Down Hospital: Part III – Tools
Certain basic tools are needed to perform medicine. While all are not needed on every patient, some are and are needed to properly perform an exam and diagnose patients.
Stethoscope – A cheap stethoscope is good for taking blood pressures in a quiet room and not much more. A good stethoscope can cost several hundred dollars, without getting into electronic ‘scopes. Good brands include 3-M Littman, Welch-Allyn and Hewlett-Packard, ADC is a mid-range brand. It is possible to find good stethoscopes at reasonable prices. Be careful with “Sprague-Rappaport” (a style and not a brand) dual tube scopes, if the tubes rub against each other you get noise. If that’s all you have, tape the two tubes together. Sources include Amazon, Ebay, and Allheart.com, among others.
BP Cuff set – Actually called an aneroid sphygmomanometer, these are the common things that get wrapped around your arm and pumped up. You should have a kit with different sized cuffs, a cuff that is too small for the arm will read high, and too large for the arm will read low. Automated home BP units are nearly worthless – they are expensive, use power, and are frequently quite inaccurate. If you should happen on a mercury sphygmomanometer that is still intact, great – they are fairly accurate over the long haul, and as long as the glass doesn’t break, safe enough.
Headlamp – Preferably a bright and adjustable output LED version. Actually, you should have several. This can be one you use for camping, it doesn’t have to be a medical version. I keep one in my locker at work and occasionally use it in day to day work in my ED.
LED lights have pretty well changed flashlights in the last few years. LED’s are typically whiter, can be brighter and certainly uses less battery power. A headlamp can be used to perform minor or major surgical procedures, work on patients at night, and just is a handy thing to have. They can be purchased almost anywhere, including Amazon or even Wal-Mart for $10-15 or less. Combined with a small solar battery charger and rechargeable batteries, you should be able to have light for quite some time.
Thermometer, normal range, oral – Get a digital version and a bunch of the plastic sleeves for it, and just replace it yearly (it’s cheaper than trying to find the battery and replacing it). Wal-Mart, your local drug store, or Amazon.
For when you can’t replace the digital battery, get (several) glass medical thermometers – oral and rectal, (the only real difference is the taste) and a small dish or tray to disinfect them in. You will also need a program or policy to clean them between different patients: I suggest having one for each admitted patient and do a thorough sterilization between patients, don’t use them across patients. You can use the same sleeves as for the digital thermometers on them to make hygiene a bit easier.
Thermometer, hypothermia – This is a lower than normal reading thermometer. Most of the same comments for regular thermometers apply, with the exception of finding them at Wal-Mart, and they are a bit more expensive. Handy when treating a suspected hypothermia patient.
Tuning fork, 128 Hz and 256 Hz – Refer tohttp://griddownmed.com/2015/02/13/tuning-fork-and-a-stethoscope-poor-mans-xray/ for reasons. (Accessed 1 Oct 2016)
Oto-Ophthalmoscope – This is the tool that doctors use to look at your eyes, and in your ears. While it is two different tools, they are usually combined with a common handle/battery pack. Of the two, the otoscope is probably the most useful, and the least expensive: You can get them at Wal-mart for less than $10, while a professional tool is several hundreds. They require batteries.
Pulse Oximeter – A small device that usually clips onto a fingertip and provides a reading on the amount of oxygen in the blood (showing how well oxygen is getting to the rest of the body) and usually the pulse. These can be purchased from Amazon and the usual sources for around $25 and up, and require battery power.
Watch with second hand, wind-up – This can be a simple and inexpensive watch, if you don’t already have a wind-up look for an old Timex at a swap meet, pawn broker or online. You should have a wind-up for when you can’t get a replacement battery, and the sweep second hand makes it easier to time things like respirations.
Patient Charts -There’s a saying in medicine – if you didn’t write it down, you didn’t do it. So, some sort of charting for your patients is in order. The government, of course, has all sorts of forms for this, some of which are actually useful. You can download government forms from http://www.gsa.gov/portal/forms/type/SF
(Accessed 1 October 2016).
Some of the more useful ones include SF 88, SF 93, and some of the 500-series forms. You can download and print them out if they will be useful for you. You could also make your own if you want, on plain paper. You will need clip boards, pens, 3-ring binders, large envelopes and file folders. Some post-it notes might be useful as well as 3×5 and 4×6 index cards, all of which are commonly available. Don’t forget pens and pencils.
Tool and Supply Sources
As mentioned, many tools are commonly available at Wal-Mart, your local drug store, online at Amazon, Ebay, etc.
Other sources include some of the following online stores – I’ve purchased from them all. (All accessed on 16 May 2015).
Sometimes, if you know what you’re looking for you can buy US Government surplus. Generally the government isn’t getting rid of equipment that works well, that is complete, or is even safe to use so extreme caution is necessary.
The website is http://www.govliquidation.com/
Refer to the upcoming “Grid Down Hospital: Central Supply” for more tools and storage.
We will talk about what to do with this stuff in another article.
American by BIRTH, Infidel by CHOICE