|
|
||
|
|
|
| ROYAL FLYING DOCTOR SERVICE (RFDS WESTERN OPERATIONS) |
|
|
|
|
|
|
|
|
|
|
SECTION I - INTRODUCTION SECTION II - INSTRUCTIONS FOR NEW CHEST HOLDERS SECTION III - USE OF THE CHEST CONTENTS Seeking Medical Advice by Radio Seeking Medical Advice by Telephone Recording of Patient Details in a Register Medications not requiring a doctor's authorization SECTION IV - CHEST MAINTENANCE Expired Items - Pharmaceuticals SECTION V - OBTAINING MEDICAL ADVICE Making up antibiotic injections
|
The Royal Flying Doctor Service Medical Chest has evolved over many years to cover a number of medical conditions, not just emergencies, which it would be difficult for people living and working in remote areas to treat. As such it contains a large number of "prescription only" pharmaceutical items. It is a condition of the provision of the Chest that these drugs be used only on the advice of a registered RFDS Medical Practitioner. The drugs provided are coded using a simple numbering system since the chemical names and brand names may vary from time to time. These item numbers are known by RFDS Medical Officers, who are familiar with the contents of the Chest and its use. The following notes outline administration and usage of the Medical Chest. SECTION II - INSTRUCTIONS FOR NEW CHEST HOLDERS Each Medical Chest is accompanied by a list of contents which is designed to fit inside the lid. On receipt of the new chest you should check that all the items listed on the chest list are present in the quantities indicated. You should notify the RFDS of any items that are missing or different. The Medical Chest can only be relied on if it is fully stocked with all items in date. It is therefore essential that the chest be checked on a regular basis to ensure that all the contents are present (in accordance with the lid list) and no items have expired. We suggest this is done monthly. Expiry dates can be found on all drugs and some other items. Expiry dates are not applicable to "non-consumables" such as kidney dishes, scissors, medicine measures and the like. However these can be replaced if they deteriorate. Every Chest in Australia is identified by a unique code number which will be given to you with the chest. If this is a label, you should ensure that it is affixed to the front of the Chest. Alternatively you should paint or mark your chest number clearly on the Chest. When properties change hands or, when approved, chests are moved to different locations, the chest registration number is the means by which we can identify the medical chest. You should use the chest number on all orders and any correspondence and inquiries relating to the medical chest. On receipt of a new chest or when taking over control of a chest from a previous user, you will be required to provide a specimen signature on a signature card. This should be returned to the RFDS promptly. The specimen signature is the means by which we can confirm the authenticity of orders received for the chest. We will only fill orders which are signed by persons whose details and signature we have on record. The Medical Chest contents list should be secured to the inside of the lid of the Medical Chest. Every few years a new list will be issued and the old list should be replaced. The contents of the Medical Chest are changed on a national basis in accordance with currently accepted methods of medical treatment. You should ensure that you have an up to date lid list. We welcome any suggestions on the chest contents. When items are freighted to you, they will be accompanied by a packing slip. This red coloured form must be returned to the RFDS to confirm that you have received the requested chest items in good order and condition. We need the slip to claim a rebate on the cost of chest items from the Australian Council of the RFDS. If the pink slip is not returned to us we are unable to claim this rebate and will be required to charge you for the cost of items. If any items are not received, you should clearly mark this on the packing slip when you return it. You should also reorder these items the next time you make an order. The chest should be kept locked at all times. The registered chest holder is responsible for ensuring the safe storage and proper usage of all chest items. Where any theft occurs or misuse is suspected, the RFDS and local police should be informed immediately. Items that are stolen, lost or damaged are to be replaced at chest holder expense and a claim submitted to your insurers for the loss. SECTION III - USE OF THE CHEST CONTENTS St John Ambulance Australian First Aid Manuals are included in the Medical Chest. You are strongly recommended to read these and also to complete a formal First Aid course. This will assist you in providing basic first aid as well as giving you training in bandaging and splinting. Contents of the chest are continually upgraded. Some older chests may contain older versions of the First Aid text. The most current edition of the First Aid manuals can be ordered on the chest order forms along with other items. Whilst you are welcome to seek advice from our medical staff on managing minor injuries, it is not essential to seek such advice just to use the bandages and dressings in the Medical Chest. Seeking Medical Advice by Radio It is preferred if you use the established schedules (time slots) which are specifically set aside for medical consultations at each base. However, in the case of an urgent medical problem, you should not hesitate to call at any time, or to use the emergency button on your radio after-hours. Details of radio frequencies, hours of operations and time schedules for medical consultations can be provided for your area. Guidance on what information will be helpful to the doctor can be found in Section V. Seeking Medical Advice by Telephone It is preferred if you call between 8am and 5pm for these consultations, as for radio medicals. At these times we have the most staff available to help you. However, for an urgent problem, please do not hesitate to telephone at any time for advice. Those items marked on the Medical Chest list as "* doctor's orders only", must be authorized by a registered medical practitioner. It is preferable that this practitioner is an RFDS doctor who is most familiar with your regional circumstances and the drugs available in the Medical Chest. They will provide you with an authorization code if drugs are prescribed. The RFDS will accept authorization by non-RFDS doctors at the present time, provided a record is kept of who authorized treatment. However, we require you to replace at your own expense, any items not authorized by RFDS doctors. Nurses are not permitted to prescribe those drugs from the Chest which require a doctor's authorization. Recording of Patient Details in a Register You are required to maintain a notebook in which you should record any drugs which have been used. This should include the:
It is important that this is completed for all drugs requiring a doctor's authorization. For Items 96 and 137 it is essential that this information be recorded and countersigned by a witness. You should use this register to record the destruction of expired quantities of items 96 and 137 also. A sample layout is shown in Section VI. The Medical Chest contains preparations scheduled S8 under the Poisons Act. It is essential that a doctor's authorization is received prior to using these items (96, 137). The quantities of these S8 items should be checked on a regular basis. As outlined earlier, their destruction should be witnessed and noted in your drug register by a responsible person. You may wish to keep a separate register for the use of these drugs. Medications not requiring a doctor's authorization The medical chest list indicates which medications in the Chest may only be used on a doctor's orders. The remaining agents may be used at your discretion without authorization. Although the Medical Chest contains items to cover most situations, it cannot be a complete supply of all household remedies. You may therefore find it necessary to purchase additional household remedies from a pharmacy. SECTION IV - CHEST MAINTENANCE Expired Items - Pharmaceuticals It is important that these items be reordered and replaced once the expiry dates have passed. In the event that a patient requires treatment but the drug required has expired, it will be up to the prescribing doctor to decide whether it is possible to still use the expired medication. In many cases this will probably be safe, however the drug may be less effective than it should be. Some items such as dressings have expiry dates, after which sterility cannot be guaranteed. Depending on the condition of the packaging it may still be possible to use these items for treatment. Rubber items should be replaced when they expire as they may have perished. Drugs may be disposed of by breaking open the containers and burning or burying. Narcotics (S8) can be disposed of in a similar manner although this must be witnessed and signed in the drug register. Chest holders who are unhappy about disposing of their own drugs can forward them to their nearest RFDS base or pharmacy for destruction. Drugs should be re-ordered using the order forms provided with the chest. It is important to note on the form the reason items are being ordered. The consultation code must be supplied if you wish to have items replaced by the RFDS. It is particularly important to note the name of doctor prescribing the S8 items. Order forms should be forwarded to the address listed on the inside cover. Your order will be recorded, approved and then forwarded to our pharmaceutical supplier (currently Fauldings). The drugs will then be delivered direct from the supplier in accordance with the delivery instructions you have provided. Medical Chest items are delivered direct from the supplier. Please advise us of any special delivery instructions relating to dispatching of orders. A useful method for keeping track of expiry dates is to use a stock card. The stock card lists all the chest item numbers with columns in which to write their expiry dates. When items are used their expiry dates are crossed off the list. When new items are received their expiry dates are added to the card. Items should still be checked individually at regular intervals but a stock card makes the job easier. SECTION V - OBTAINING MEDICAL ADVICE Before calling for medical advice, it is helpful to the doctor if you have checked and recorded the following details for each patient. Wherever possible have the patient nearby to answer further questions. Also have the medical chest nearby.
Making up antibiotic injections
A sample format for a drug register is provided on the following page. This can be made up using any exercise, ledger or similar note book. The register will become a permanent log of people treated by the chest and items used. It can be particularly helpful in keeping track of items where more than one person has access to the chest.
©2001-2006 RFDS Western Operations. (This is a temporary website for clinical staff) |
||||||||||||||||||||||||||||||||||||||||||||||||||||||
