This is Zambia: What’s in my mobile nursing kit?

March 26, 2013 § Leave a comment

I first visited Africa in 2006 with World Outreach Mission Fellowship in Uganda. I assisted with a few medical bush camps and had my first exposure to nursing outside of the US.

After another medical mission trip to Uganda and working as a nurse in Zambia for a year and half, I have gotten good use of my mobile nursing kit. Like many nurses, I often get calls to come look at a sick or injured person day or night and so I always keep the kit available to me. For those that are curious, I thought I would share what I keep in my nursing kit.

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Medical kit and water/sharps bottle

The most important equipment I have is for assessments. In particular, my stethoscope (doubles as a reflex hammer) and thermometer. I particularly like having a thermometer because of the common complaints of fever.

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Stethoscope, blood pressure cuff, measuring tape, hand gel and wipes, thermometer and disposable covers, and pen light

After assessing a patient, I will decide and/or advise how to move forward. Some I send on to the local clinic or hospital. Others I have taken myself if I think their condition is severe enough. If the person has any signs of malaria (including flu-like symptoms, fever, GI symptoms) I will test for malaria with an instant kit test. Many people will often claim to have malaria and will even treat themselves for it but few get a test and/or a positive result. I always carry the medicine to treat malaria (Coartem) with me but I have never had a positive malaria test in the 18 months I’ve been here.

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Gloves and instant malaria test kits

Most drugs, except for narcotics and benzodiazepines, do not require a prescription over the counter in Zambia. Even many of the anaesthetic drugs (including propofol, a strong sedative, and rocuronium, a paralytic drug) may be bought without a prescription. That being said, I carry a number of drugs with me including antibiotics and mild pain killers (acetominophen and ibuprofen). My old boss always said that one dose of ciprofloxacin is usually enough to stop and kill most GI bugs, which I have found true anecdotally. I always have MicroMedex available as an app on my phone in order check medications and proper dosages as well. Best. Nursing App. Ever.

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Drugs: most important and/or commonly used are acetominophen, ibuprofen, ciprofloxacin, hydrocortisone cream, and coartem (for malaria treatment).

If a person is feverish, they are often so clamped down that I can get blood through one finger poke for a malaria test. Often I will do a venous blood draw in order to be quicker and more efficient. I have also given bags of IV fluid at home for a severely dehydrated patient. I keep one bag of lactated ringers with me for this purpose. My phlebotomy skills have improved a bit after these challenges. I carry a plastic disposable water bottle to double as a sharps container.

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IV/Blood draw: IV catheters, syringes, tourniquets, alcohol pads, cotton, etc.

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First Aid: band aids, ace bandage, cold pack, scissors, razor blades, gauze, cotton wool, etc.

And of course, I also have general first aid supplies for the variety of injuries that could occur.

What do other nurses carry with them, either in the developed or undeveloped world?

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