[The specificity of replenishment of ship's medicine chest on foreign-going vessels].

In the conditions of duration of passages of foreign-going vessels, the issue of procurement of medications needed by individual crew members within the framework of personal prescriptions issued on the territory of the Russian Federation, related to administration of therapeutic treatment. In conditions of coronavirus pandemic, this issue has become particularly acute, since it has become problematic to estimate the exact time of passages because of complicated regime of changing crews in foreign states. The analysis testifies absence of unified system permitting to implement information interaction in electronic mode to apply interaction between pharmacists, physicians, patients and insurance companies. Thus, the formulated recommendations will permit hereinafter international exchange of digital prescriptions without current difficulties that will simplify process of replenishing the ship's medicine chest with individual medications assigned to crew members. Moreover, the information about the need of selling medications of long-term use needed by particular crew member will be quickly displayed on the territory of country of sojourn.

The U.S. medicine chest: Understanding the U.S. pharmaceutical supply chain and the role of the pharmacist.

The U.S. capacity to manufacture key essential medications has diminished. The U.S. pharmaceutical supply chain (USPSC) has diversified and now relies on international sources of active pharmaceutical ingredients and finished drug products (FDPs). Despite years of effort raising concerns about the USPSC, pharmacists and pharmacy technicians continue to spend a substantial amount of time and energy responding to, and mitigating the impact of, medication shortages, drug recalls, and the adverse outcomes related to low-quality medications. The extent of U.S. reliance on foreign sources of medications is largely unknown. Pharmacists do not have a reliable way to determine the country of origin (i.e., source), capacity, or geographic location of pharmaceutical manufacturers, limiting our ability to anticipate challenges or mitigate risks to our Nation's drug supply. The U.S. Food and Drug Administration's task of regulating quality and safety is challenging and will likely require additional safeguards and resources. In addition to pharmacists' engagement, solutions will likely need to leverage a mix of policy, economic incentives, and expanded objective surveillance testing. The U.S. pharmaceutical supply chain is complex, global, and goes beyond FDPs. The 2020 American Pharmacists Association House of Delegates has rightly asserted that "The quality and safety of pharmaceutical and other medical products and the global pharmaceutical and medical product supply chain are essential to the United States national security and public health." Pharmacy professionals on the front line engage with patients, identify medication-related issues, and engage in drug-procurement decisions. Pharmacists are essential to our nation's overall health and must be engaged in the development and implementation of strategies to safeguard the USPSC.

Where in the world is Florence Nightingale's medicine chest?

BACKGROUND: In the 121st anniversary year of the birth of Florence Nightingale, and during the COVID-19 pandemic, it is both interesting and salient to be reminded of the foundational work of this famous woman who began modern nursing. Her work in nursing care and nursing, health and public policy has been a continuing strong foundation to practices in societies around the world. METHODS: In this short communication about historical research, various aspects of Florence's life and work are described, as well as the locations, memorials and museum significant to our remembrance of her. RESULTS: A particular focus of this paper is the description of a larger but little-known medicine chest located at the College of Nursing, University of Saskatchewan, in Saskatoon, SK, Canada, and attributed as belonging to Florence. CONCLUSION: Best known to this point in time is a smaller medicine chest at the Florence Nightingale Museum in London.

Portable medicine chests and supply of medicines in Serbia from the 1830s to the mid-20th century: analysis of medicines list.

The first portable medicine chests appeared in Serbia immediately after liberation from Ottoman rule around 1830. The network of portable medicine chests grew very quickly and became the first effective public health method of supplying medicines and medical items to people living in cities without community pharmacies and to the rural population in villages. According to their purposes, three categories of portable medicine chests could be identified: Portable medicine chests owned by physicians or veterinarians in the cities, portable medicine chests established by the Department of Workers Health Insurance, and portable medicine chests of the Health Cooperatives that operated in the villages This paper analyzes all three types of portable medicine chests. We specifically examine the regulations concerning the management of portable medicine chests, their content, and supply chains of medicines from the third decade of the 19 th century through the first half of the 20th century. We conclude that portable medicine chests represent a specific type of pharmacy in the territory of Serbia that provided very effective medical service. The medicines in these pharmacies were handled and dispensed to patients by physicians not by pharmacists. Patent medicines, compounded medicines, sanitary items and bandage materials were dispensed as well. Future research is needed to ascertain if physicians who owned or worked with the portable medicine chests actually prepared and compounded simple preparations as they were specified in the laws.

In-Flight Medical Emergencies: A Review.

IMPORTANCE: In-flight medical emergencies (IMEs) are common and occur in a complex environment with limited medical resources. Health care personnel are often asked to assist affected passengers and the flight team, and many have limited experience in this environment. OBSERVATIONS: In-flight medical emergencies are estimated to occur in approximately 1 per 604 flights, or 24 to 130 IMEs per 1 million passengers. These events happen in a unique environment, with airplane cabin pressurization equivalent to an altitude of 5000 to 8000 ft during flight, exposing patients to a low partial pressure of oxygen and low humidity. Minimum requirements for emergency medical kit equipment in the United States include an automated external defibrillator; equipment to obtain a basic assessment, hemorrhage control, and initiation of an intravenous line; and medications to treat basic conditions. Other countries have different minimum medical kit standards, and individual airlines have expanded the contents of their medical kit. The most common IMEs involve syncope or near-syncope (32.7%) and gastrointestinal (14.8%), respiratory (10.1%), and cardiovascular (7.0%) symptoms. Diversion of the aircraft from landing at the scheduled destination to a different airport because of a medical emergency occurs in an estimated 4.4% (95% CI, 4.3%-4.6%) of IMEs. Protections for medical volunteers who respond to IMEs in the United States include a Good Samaritan provision of the Aviation Medical Assistance Act and components of the Montreal Convention, although the duty to respond and legal protections vary across countries. Medical volunteers should identify their background and skills, perform an assessment, and report findings to ground-based medical support personnel through the flight crew. Ground-based recommendations ultimately guide interventions on board. CONCLUSIONS AND RELEVANCE: In-flight medical emergencies most commonly involve near-syncope and gastrointestinal, respiratory, and cardiovascular symptoms. Health care professionals can assist during these emergencies as part of a collaborative team involving the flight crew and ground-based physicians.

[Mysteries of a medicine chest ].

This article retraces the history of an old medicine chest, used at the beginning of the 19th century, but probably designed earlier. Possibly made in A ustria, with a two-headed eagle lining the bottom of the lid, this first-aid kit belongs to a small group of related chests. It should be noted that these chests were used for a wide variety of different purposes over time. Also named a «droguier¼ in French, this light chest, made of walnut, and, according to family lore, found in Normandy, would have belonged to a doctor, as confirmed by a short invoice found among numerous documents. The identity of the supplier of numerous old medicines is shown on the labels on the flasks (many of which are intact) and other boxes (containing, in particular, herbal drugs) : «Clément, Apothicaire. Rue St Onge N°. 42. près le Bd. du Temple A Paris¼, whose history is recounted here step by step.

[Secure cupboards, an advantage for the medicine use pathway]. / Les armoires sécurisées, un atout pour le circuit du médicament.

At Valenciennes general hospital, for some patients, the medicine use pathway is made secure through the use of computer systems which ensure named-patient daily dispensing. Secure cupboards are a complement to this main pathway.

Medical supplies for the expeditions of the heroic age of Antarctic exploration: introduction.

During the heroic age of Antarctic exploration (1895-1922) there were at least 18 expeditions to the Antarctic lasting between 18 and 30 months. This is an introduction to a series of articles about the drugs taken and used in the Antarctic at this time. Most of the information relates to the expeditions of Robert Scott and Ernest Shackleton and the main supplier of medical equipment was Burroughs Wellcome and Co. This article also describes the medical cases that were taken to the Antarctic.

Be prepared! Drugs and equipment for 'Good Samaritan' acts.

Little evidence or advice exists in the medical literature on 'medical kit' that could be usefully carried by physicians to prepare them for unexpected emergencies. The aim of this study was to establish what, in the opinion of Emergency Physicians, is an appropriate medical kit for doctors to carry to prepare them for 'Good Samaritan' acts. A telephone survey, using a proforma, of United Kingdom Emergency Physicians was conducted. Of the responders to the survey, 10% routinely undertook prehospital work. Seventy-two percent thought it appropriate to carry equipment, but only 43% thought it appropriate to carry medications. Over 80% considered basic airway equipment useful to carry, whereas other items of medical kit were considered appropriate much less commonly. A large proportion of emergency physicians consider it appropriate to carry some medical kit for 'Good Samaritan' acts and, in general, the consensus of opinion as to what medical kit should be carried agreed with the evidence-base for prehospital interventions.

Commercial aviation in-flight emergencies and the physician.

Commercial aviation in-flight emergencies are relatively common, so it is likely that a doctor travelling frequently by air will receive a call for help at some stage in their career. These events are stressful, even for experienced physicians. The present paper reviews what is known about the incidence and types of in-flight emergencies that are likely to be encountered, the international regulations governing medical kits and drugs, and the liability, fitness and indemnity issues facing 'Good Samaritan' medical volunteers. The medical and aviation literature was searched, and information was collated from airlines and other sources regarding medical equipment available on board commercial aircraft. Figures for the incidence of significant in-flight emergencies are approximately 1 per 10-40 000 passengers, with one death occurring per 3-5 million passengers. Medically related diversion of an aircraft following an in-flight emergency may occur in up to 7-13% of cases, but passenger prescreening, online medical advice and on-board medical assistance from volunteers reduce this rate. Medical volunteers may find assisting with an in-flight emergency stressful, but should acknowledge that they play a vital role in successful outcomes. The medico-legal liability risk is extremely small, and various laws and industry indemnity practices offer additional protection to the volunteer. In addition, cabin crew receive training in a number of emergency skills, including automated defibrillation, and are one of several sources of help available to the medical volunteer, who is not expected to work alone.

Review on the importance of an emergency kit for physicians in out-of-hospital emergencies.

The importance of an emergency kit for private use by emergency physicians was evaluated. Self-reporting questionnaires were used to assess the satisfaction of emergency physicians who were given a specially adjusted emergency kit for 3 years. Of 73 emergency physicians, 52.1% used the kit at least once during a 3-year interval. Physicians who already used the emergency kit responded more frequently to the importance of having private emergency equipment than those who did not. The kit's low weight and assortment of equipment including ventilation equipment were given higher ratings by users. The majority of physicians regarded a maintenance interval of 6-12 months as sufficient for the emergency equipment. In conclusion, the private emergency kit was used by more than half of the study participants at least once during a 3-year study period. Emergency physicians who used the emergency kit gave it higher ratings than did non-users.

Emergency Physicians as Good Samaritans: Survey of Frequency, Locations, Supplies and Medications.

INTRODUCTION: Little is known about the frequency and locations in which emergency physicians (EPs) are bystanders to an accident or emergency; equally uncertain is which contents of an "emergency kit" may be useful during such events. The aim of this study was to describe the frequency and locations of Good Samaritan acts by EPs and also determine which emergency kit supplies and medications were most commonly used by Good Samaritans. METHODS: We conducted an electronic survey among a convenience sample of EPs in Colorado. RESULTS: Respondents reported a median frequency of 2.0 Good Samaritan acts per five years of practice, with the most common locations being sports and entertainment events (25%), road traffic accidents (21%), and wilderness settings (19%). Of those who had acted as Good Samaritans, 86% reported that at least one supply would have been useful during the most recent event, and 66% reported at least one medication would have been useful. The most useful supplies were gloves (54%), dressings (34%), and a stethoscope (20%), while the most useful medications were oxygen (19%), intravenous fluids (17%), and epinephrine (14%). CONCLUSION: The majority of EPs can expect to provide Good Samaritan care during their careers and would be better prepared by carrying a kit with common supplies and medications where they are most likely to use them.

Equipment and supplies for sports and event medicine.

There is an art and a science to determining the contents of an appropriate medical bag for sports and event medicine. Sports and event medicine encompass a broad range of activities and venues, and the medical bag's contents must be adapted accordingly. We discuss relevant considerations as well as general principles and recommendations accompanied by a checklist, using coverage of football games as a model.

Wrestling and sports medicine.

The coverage of wrestling events from the perspective of medical personnel is reviewed here. Considerations are made regarding the role of medical personnel, the supplies that are important for wrestling event coverage, and the injuries that are frequently encountered in wrestling. Attention is given to treatment of injuries and conditions that are largely specific to wrestling.