The physician’s bag
In alignment with the order needed for a well resolved physician a competent and feasible preparation of the physician’s bag should be realized. This process entails a thorough understanding and mastering of the commonest medical problems that may be a matter of urgency or emergency. Here are some of these cases arranged according to their relative frequency rather than their emergency level:
- Fainting or syncope: – let the person feel that he/she is attended, e.g. hold the arm and ask about how he/she is now, while feeling the radial pulse. – apply the ABC scheme (air way, breathing, and circulation). – notice the colors, odors, sweating, tremors or special positions, if any. And – take the vital data (pulse, blood pressure and temperature). Manage accordingly.
- Anxiety bouts (attacks): – reassure the person that he/she is attended, i.e. appropriate care can be available. – notice pulse rate, hand sweating and temperature. – try to encourage the person to talk about some topics like the type of food, sports, books he/she likes and if he/she have certain fears or current personal problems. – discuss the possibility of immediate treatment, e.g. with a beta blocker (nonselective), and outline a management plan that can multidimensional, e.g. physical, dietary and/or medical.
- Hammering headaches: – reassure the person that the case is not serious. – take the vital data (pulse, blood pressure and temperature). – ask the person if he/she is taking any medications or if there is (are) some chronic illness (es). – encourage the patient to drink normal water after making sure there would be no risks (e.g. the person can swallow normally, no intoxication by a corrosive substance for example, no water restriction, etc.). Manage accordingly.
- Fever: – reassure the person that the case is not serious. – ask about specific pain or other complaints, e.g. diarrhea or colic. – if this would seem conservative and neutral, encourage the person to drink normal water, fresh juice like lemonade and orange that have the same temperature as that of the environment. – take the vital data and notice the colors, odors, sweating, tremors or special positions, if any. Manage accordingly.
- Renal colic: – reassure the person. – the typical renal colic follows the course of the renal system on either right or left side, i.e. the loin region, the ureter and the urethra. – ask for a precipitating factor, e.g. drinking water problem, unbalanced food intake, exposure to cold, or stress. – take the vital data and notice the colors, odors, sweating, tremors or special positions, if any. Manage accordingly.
- Chemical intoxication: – reassure the person. – take the vital data and notice the colors, odors, sweating, tremors or special positions, if any. – after withdrawal or avoidance of the intoxicating agent the condition resolves gradually and steadily over time. Manage accordingly.
- Difficult breathing (asthma): – reassure the person. – ensure good ventilation of the room, e.g. open the windows. – notice the colors, odors, sweating, tremors or special positions, if any. – assess for ABC. – notice lower limb edema, abdominal enlargement and or tenderness, neck vein pulsations. – auscultate the chest for abnormal inspiratory or expiratory sounds. – consider possible heart and or lung diseases. Manage accordingly.
- Bleeding nose (epistaxis): – reassure the person. – let the person breath by his/her mouth and then compress the nasal cartilages against the nasal septum from outside. – ask the person to raise his/her head little up while still closing the nose. – after the condition has stabilized, the person is advised to avoid the precipitating factors, e.g. avoiding sun burns. – notice the colors, odors, sweating, tremors or special positions, if any. And – take the vital data (pulse, blood pressure and temperature). Manage accordingly.
- Cut wound: – control the bleeding site by compression with clean and sterile gauze. – special wound healing plaster and or surgical stitching may be used as required.
- Chest pain: – reassure the patient. – risk factors include family history of coronary heart disease, hypertension, diabetes and smoking. – under medical supervision , e.g. by an ambulance, and while explaining it as being absolutely precautionary, refer the person to the nearest hospital or an intensive care unit for best medical care.
The physician’s bag contents include:
- Physician’s guide.
- Physician’s stationary: a prescription or note-block, pen, plastic ruler (about 10 cm length).
- Medical disposables: 3- 5 plastic examination gloves, 2-5 sterile scalpels, 2-5 sterile plastic syringes (1, 3, and 5 ml), 1-3 i.v. canulas (small and medium), medical cotton and gauze, and 2-5 tongue depressors and sterile surgical needle.
- Medicines and medical stuffs: ampoules and tablets (atropine, theophylline, antihistamine, NSAID, corticosteroid, hyoscine, nonselective beta blocker), and surgical betadine.
- Apparatuses and instruments: stethoscope, sphygmomanometer, torch, thermometer, needle holder and arm tourniquet.