[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.

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.

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.

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.

Desarrollo del botiquín individual de combate en las Fuerzas Armadas españolas / Development of individual combat first aid kit in Spanish Armed Forces

Introducción: El botiquín individual de combate es el material sanitario específico con el que se dota a cada uno de los militares para que, en caso de resultar herido, se puedan realizar los primeros auxilios aunque carezca de formación sanitaria. Objetivo: Diseñar el nuevo botiquín individual de combate para el ejército español determinando su contenido y requisitos técnicos. Material y método: Se han realizado entrevistas a responsables sanitarios de las unidades militares más operativas del Ejército de Tierra Español. Estudio físico de cada uno de los elementos componentes del actual BIC y comparación de los botiquines existentes en los ejércitos de los países de nuestro entorno. Se ha realizado una revisión bibliográfica con metodología sistemática en las principales bases de datos científicas. Para verificar la validez de los textos seleccionados se aplicaron programas de lectura crítica. Resultados y conclusión: Realización de una propuesta de nuevo botiquín de combate así como de su contenedor, con adición y eliminación de elementos

Introduction: The individual combat kit is the specific sanitary material with which each one of the soldiers is provided so that, in case of being injured, the first aid can be carried out even if it lacks health training. Objectives: The objective is to design the new individual combat kit for the Spanish Army and the specific one to determine its content and technical requirements. Material and method: Interviews were carried out to health officials of the most operational military units of the Spanish Army. Physical study of each of the component elements of the current BIC and comparison of the medicine kits existing in the armies of the countries of our environment. A bibliographic review with a systematic methodology was carried out in the main scientific databases. In order to verify the validity of the selected texts, critical reading programs were applied. Results and conclusion: Proposal of addition and elimination of elements in the possible new combat kit as well as the container

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.

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.

¿Mejora el torniquete la supervivencia del combatiente en zonas en conflicto? / Does the tourniquet improve the survival of the fighter in conflict zones?

ANTECEDENTES: El uso de los torniquetes ha estado presente en los conflictos bélicos como elemento terapéutico para el control de la hemorragia externa en miembros, no obstante, su empleo ha estado rodeado de controversias y supersticiones, a pesar de su probada utilidad. La presente revisión evalúa los beneficios que aporta el torniquete en la atención a los heridos en los modernos conflictos bélicos. El uso pre-hospitalario del torniquete es una medida generalizada y protocolizada en el contexto militar, y está fundamentada en estudios científicos y en una experiencia clínica correspondiente al uso de estos dispositivos en ZO. OBJETIVOS: Analizar mediante la revisión de las referencias encontradas los beneficios y los inconvenientes que ofertan estos dispositivos y si realmente mejoran la supervivencia del combatiente con hemorragia externa en miembros. MATERIAL Y MÉTODOS: Revisión bibliográfica de diversos estudios clínicos efectuados en diversas Zonas de Operaciones (ZO) de los últimos once años. RESULTADOS: el análisis de diversos estudios han demostrado que el uso precoz del torniquete en el campo de batalla, supone una mejora en los ratios de supervivencia y una disminución de la morbimortalidad, del consumo de hemoderivados y por lo tanto, de los costes económicos en el tratamiento de este tipo de heridos. Esta revisión bibliográfica pretende demostrar que el empleo precoz del torniquete en ZO aumenta la supervivencia de los heridos que presentan hemorragia externa en combate

BACKGROUND: The use of tourniquets has been in the wars as a therapeutic element to control the external bleeding, however, their use has been surrounded by controversy and superstitions, despite its proven utility. This review assesses the benefits of the tourniquet in care of the wounded soldiers in modern warfare. Pre-hospital use of the tourniquet is widespread and notarized as in the military context, and is based on scientific studies and clinical experience for the use of these devices in ZO. OBJECTIVES: To analyze by reviewing the references found the benefits and drawbacks that offer these devices and whether it improves survival fighterwith external bleeding members. Material and METHOD: Literature review of several clinical studies in various combat areas of the last eleven years. RESULTS: The analysis of several studies have shown that early use of the tourniquet on the battlefield, an improvementin survival rates and decreased morbidity and mortality, consumption of blood and therefore the economic costs treatment of such injuries. This literature review aims to demonstrate that early use of tourniquet ZO increases the survival of the casualty who have external bleeding in combat

[Haemovigilance and blood safety in overseas military]. / Hémovigilance et sécurité transfusionnelle en opération extérieure.

The French military blood institute (FMBI) is the only military blood supplier in France. FMBI operates independently and autonomously under the Ministry of Defense's supervision, and accordingly, to the French, European and NATO technical and safety guidelines. FMBI is in charge of the collection, preparation and distribution of blood products to supply transfusion support to armed forces, especially during overseas operations. In overseas military, a primary physician is responsible for haemovigilance in permanent relation with an expert in the FMBI to manage any adverse reaction. Additionally, traceability of delivered or collected blood products during overseas operation represents a priority, allowing an appropriate management of transfusion inquiries and assessment of practices aiming to improve and update procedures and training. Transfusion safety in overseas operation is based on regular and specific training of people concerned by blood supply chain in exceptional situation.

A simple solution for improving reliability of cardiac arrest equipment provision in hospital.

INTRODUCTION: Effective and safe cardiac arrest care in the hospital setting is reliant on the immediate availability of emergency equipment. The patient safety literature highlights deficiencies in current approaches to resuscitation equipment provision, highlighting the need for innovative solutions to this problem. METHODS: We conducted a before-after study at a large NHS trust to evaluate the effect of a sealed tray system and database on resuscitation equipment provision. The system was evaluated by a series of unannounced inspections to assess resuscitation trolley compliance with local policy prior to and following system implementation. The time taken to check trolleys was assessed by timing clinicians checking both types of trolley in a simulation setting. RESULTS: The sealed tray system was implemented in 2010, and led to a significant increase in the number of resuscitation trolleys without missing, surplus, or expired items (2009: n=1 (4.76%) vs 2011: n=37 (100%), p<0.001). It also significantly reduced the time required to check each resuscitation trolley in the simulation setting (12.86 (95% CI: 10.02-15.71) vs 3.15 (95% CI: 1.19-4.51)min, p<0.001), but had no effect on the number of resuscitation trolleys checked every day over the previous month (2009: n=8 (38.10%) vs 2011: n=11 (29.73%), p=0.514). CONCLUSION: The implementation of a sealed tray system led to a significant and sustained improvement in resuscitation equipment provision, but had no effect on resuscitation trolley checking frequency.

Viajar y salud. Generalitat Valenciana

Contiene recomendaciones dirigidas a viajeros con información sobre medidas generales, vacunaciones obligatorias, vacunaciones recomendadas, prevención del paludismo, cuidado con el agua, alteraciones digestivas, cuidado con los baños, contenido del botiquín, prevención de accidentes, medidas generales al regreso, viajeros en situaciones especiales, enlaces importantes e informacion para descargar.

Consejos para el viajero internacional. Generalitat Valenciana

Contiene recomendaciones para antes del viaje, durante el viaje, al regreso, llevar un botiquín y centros de vacunación.

[Studies on Yakushi Buddha and its medicinal container].

In Japan, there are about 250 Yakushi Buddha (i.e., Buddha of Healing) statues in Buddhist temples. They are listed as Important Cultural Properties and 14 of them are National Treasures. Belief in Yakushi Buddha was especially prevalent from the 7th to the 13th centuries in Japan. The oldest wooden Yakushi Buddha statue is in Horin-ji Temple in Nara. Among the approximately 250 Yakushi Buddha statues, about 200 have medicinal containers-or rarely, a bowl-in the palm of the left hand. However, these medicinal containers are wooden blocks. Very recently, it was found that the Yakushi Buddha statue in the Suho-Kokubun-ji Temple in Yamaguchi Prefecture, Japan has a medicinal container in the palm of his left hand, in which an offering (i.e., 220 g of materials) was found. The date on the reverse side of the lid places the offering at October 12, 1699. The offering is composed of five cereals (rice, barley, wheat, soybean and azuki bean), five medicinal plants (Acori graminei, Acori calami, Ginseng, Flos caryophylli and Lignum santali albi) and six minerals (rock crystals, purple and blue lead glass, CaCO3 particles, and silver and golden foils). Recently, the pharmacy educational program was extended from four to six years in order to meet clinical pharmacy requirements for patients. From studying the Buddha of Healing and its medicinal container described above, the author suggests that, in addition to pharmaceutical bioscience, philosophical concept be studied as part of the history of pharmacy in the future.