List of Annexures. Annexure - 1 List of Equipment, Drugs Furniture etc for the Primary Level Facilities. 63

Transcription

1 List of Annexures Annexure - 1 List of Equipment, Drugs Furniture etc for the Primary Level Facilities. 63 Annexure 2 Guidelines on Using the OPD / Emergency Ticket 79 Annexure 3 Suggested OPD / Emergency Ticket for adoption 80 Annexure 4 Contents of Emergency Health Kit 81 Annexure 5 Contents of Delivery Kit 82 Annexure 6 Contents of Emergency Injection Tray 83 Annexure 7 Contents of Neonatal Resuscitation Kit 85 Annexure 8 Mercury containment kit 86 Annexure 9 WHO Guidelines on Prescription Audit 87 Annexure 10 Questionnaire on Prescription 88 Annexure 11 IUD Insertion Kit 89 Annexure 12 Suturing Kit 90 Annexure 13 Guideline on Standard Surgical Set 91 Annexure 14 Contents of Standard Surgical Set for Iaparotomy 92 Annexure 15 Contents of Dilatation and Evacuation Instrument Set 93 Annexure 16 No Scalpel Vasectomy Instrument Set 94 Annexure 17 Contents of Trained Birth Attendant Kit 94 Annexure 18 Laboratory reagents list (Pathology) 95 Annexure 19 Laboratory reagents list (Microbiology) 96 Annexure 20 Laboratory reagents list (Biochemistry) 97 Annexure 21 Guidelines on infection control in the primary health care facilities 98 Annexure 22 Guidelines on prescription quality assessment 103 Annexure 23 Information on Establishing Diagnostic Services in Primary Level Health Facilities through PPP 103

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3 Annexure: IList of Equipment, Drugs. Furniture etc for the Primary Level Facilities SN CSN Category Sub category Item RH BPHC PHC_B PHC_NB SC 1 1 Furniture Almirah [Metal] 2 2 Furniture Bed, plain 3 3 Furniture Bed, with backrest section (Semi-Fowler type) 4 4 Furniture Bed, pediatric (Railed cot type) 5 5 Furniture Baby cradle 6 6 Furniture Bedside locker table [Metal] 7 7 Furniture Bedside screen, 4 panel 8 8 Furniture Bench [Wood] 9 9 Furniture Chair [Wood / Metal / Plastic] Furniture Examination table, with backrest section Furniture Footstep [Wood] Furniture Instrument cabinet [Metal and Glass] Furniture Instrument trolley, with 3 shelves Furniture Laboratory reagent rack Furniture Lockers [Metal] Furniture Medicine trolley, with drawers Furniture Obstetric (Delivery) table, with stirrups Furniture OT ceiling lamp Furniture OT lamp on stand [Shadow less lamp] Furniture OT table Furniture Patient Trolley, with Stretcher [Stretcher] Furniture Rack [Metal] Furniture Revolving stool [Metal] Furniture Shoe rack for OT slippers Furniture Stool [Wood / Metal / Plastic] Furniture Stretcher [Canvas on metal frame] Furniture Table [Wood / Metal] Furniture Wheelchair Bedside bowl [Metal] 29 1 disposal Bedpan, with cover [Metal] 30 2 disposal Urinal - Male [Metal] 31 3 disposal Urinal - Female [Metal] 32 4 disposal disposal bins [Plastic, color coded] 33 5 disposal disposal bags [Plastic, color coded] 34 6 disposal Broom 35 7 disposal Mop 36 8 disposal Gumboot 37 9 disposal Utility gloves (heavy duty, for waste disposal) disposal Apron [Plastic] disposal Mask [Disposable] disposal Trolley [for waste bins] disposal Needle hub cutter [manually operated] disposal Puncture proof sharps disposal container disposal Mercury containment kit disposal Bed sheet Mattress

4 Pillow 47 3 Bucket & Mug [Plastic] 48 4 Bucket [Metal] 49 5 Curtain cloth (also usable for screens) 50 6 Drinking water filter / dispenser [Non-electrical] 51 7 Water storage tank [plastic] 52 8 Jerry can (kerosene storage) [plastic] 53 9 paper bin [Plastic] Weighing machine - adult Weighing machine - baby (with height scale) Spring balance - color coded Height measure Measuring tape BP instrument - stand mounted [Mercury type] BP instrument [Mercury type] BP instrument [Dial type] Stethoscope - single tube Clinical thermometer - mercury Clinical thermometer - digital Instrument tray with lid - medium size [SS] Instrument tray with lid - large size [SS] Enamel tray - medium size Enamel tray - large size Saucepan with lid [SS] Steam sterilizer, electrically operated Autoclave - Portable (Table top type) Autoclave - Vertical, high pressure type for OT instruments Kerosene stove Kidney dish - medium size [SS] Kidney dish - large size [SS] Dressing drum [SS] Emergency light [Rechargable] Torch [Heavy duty] Batteries for torch / ophthalmoscope / otoscope X-ray view box [SS] IV stand Wall mirror Ice lined refrigerator [for vaccines] Refrigerator [Domestic type for medicines] Nebulizer - compressed air type Glucometer

5 Lancing device for glucometer Oxygen cylinder Oxygen cylinder trolley Oxygen cylinder accessories (opener, humidifier, pressure gauge, tubing) Sucker machine, electrically operated ECG machine [3-channel solid state type] with accessories Enema set Gastric lavage (stomach) tube Vaccine carrier Ice pack containers for vaccine carrier Baby holding tray Baby phototherapy unit with baby bassinet Baby (newborn) resuscitation set (containing Ambu bag, face mask, Mucus sucker, Endotracheal tube) Proctoscope Vaginal speculum (Cusco) - multiple size set Vaginal speculum (Sims) - multiple size set Percussion hammer McGill's forceps Tongue depressor - multiple sizes set Bottle opener cum ampule cutter Instrument sterilizer, electrically operated Autoclave, tabletop (portable) Autoclave, vertical, high pressure [for OT items] Aerosol disinfector for OT / room fumigation Instrument tray (with lid & handle) [SS] - multiple sizes Lotion / Sponge bowls [SS] - multiple sizes Kidney dish [SS] - medium size Sponge holding forceps [SS] - medium size Bandage cutting (Lister's) scissors [SS] - medium size Stitch cutting (Littauer's) scissors [SS] - medium size Scissors, dissecting, straight, blunt points [SS] - medium size Scissors, dissecting, straight, sharp points [SS] - medium size Scissors, dissecting, straight, fine [SS] - medium size Standard surgical set for laparotomy Standard surgical set for cesarean section IUD insertion instrument set No scalpel vasectomy instrument set D&E instrument set Episiotomy scissors Vacuum extractor set - complete with vacuum pump

6 Long curved (e.g. Simpson's or Das's) obstetric forceps Wrigley's obstetric forceps Otoscope [self-illuminated type] Bull's eye lamp Head mirror Head lamp unit Aural scoop Aural speculum set Hartman's forceps Jobson Horn's probe Laryngeal mirror [Size 4 and 5] set Lignocaine sprayer Nasal foreign body hook set Nasopharyngeal mirror set Tilley's forceps Thudicum's nasal speculum set 40G metal syringe Ophthalmoscope Distant vision chart set Near vision chart set Refraction trial lens set (box) Occluding frame Schiotz tonometer Lacrimal cannula Punctum dilator Eye speculum Lid retractor Consumables Polythene envelope, self-sealing type, 15 cm X 10 cm Consumables Glucose (glucometer specific) test strips Consumables Urine test strips for glucose Urine test strips for glucose, protein, ketone Consumables bodies, etc Consumables Condoms Consumables Pregnancy test card / strip Consumables ECG jelly Consumables ECG paper Consumables Syringe, for vaccination, autodisable ml Consumables Syringe, for vaccination, autodisable ml Consumables Syringe, disposable with needle - 1 ml Consumables Syringe, disposable with needle - 2 ml Consumables Syringe, disposable with needle - 5 ml Consumables Syringe, disposable - 10 ml Consumables Syringe, disposable - 20 ml Consumables Syringe, disposable - 50 ml Consumables IV cannula - 3-way, adult Consumables IV cannula - 3-way, child

7 Consumables IV cannula - 3-way, newborn Consumables Scalp vein set - adult Consumables Scalp vein set - child Consumables Nasal catheter [for oxygen administration] Consumables Nasal prong [for oxygen administration] Consumables Ryles's tube - adult Consumables Ryles's tube - child Consumables Rubber catheter - plain Consumables Foley's catheter - adult Consumables Foley's catheter - child Consumables Urine collection bag - 2 L capacity Consumables IV fluid administration set Consumables Blood transfusion set Consumables Scalpel blades - for No. 3 handle Consumables Scalpel blades - for No. 4 handle Consumables Gloves, latex, sterile - sizes 6.5, Consumables Gloves, latex, sterilizable - sizes 6, 6.5, Consumables Gloves, polythene (for examination) Surgical suture - Silk, black braided, without Consumables needle Consumables Surgical suture - Catgut, chromic, without needle Surgical suture - Catgut, chromic, with needle Consumables (atraumatic( Consumables Needle for lancing device Consumables Mucus sucker, disposable Consumables Umbilical cord clamp, disposable Consumables Adhesive plaster (tape) - fabric type Consumables Adhesive plaster (tape) - micropore type Consumables Bandage - Roller Consumables Bandage - Than Consumables Bandage - Cotton crepe Consumables Surgical gauze - Sterile and non-sterile Consumables Surgical gauze - Non-sterile Consumables Cotton wool - Sterile Consumables Cotton wool - Non-sterile Consumables Disposable eye pad Consumables Sanitary napkin Consumables Surgical cap Consumables Surgical mask Consumables Surgical apron (plastic) Consumables Surgical attire (gown and trouser set) Consumables OT slippers Consumables Liquid soap for handwashing Consumables Paper towel / napkin for hand drying Laboratory Equipment Auto pipette, variable volume type Laboratory Equipment Auto pipette tips [Plastic] Laboratory Equipment Beaker, 100 ml [HRG] Laboratory Equipment Beaker, 50 ml [HRG] Laboratory Equipment Capillary tube, 75 mm X 1 mm [Glass] Centrifuge, 3500 rpm, with 8 X 15 ml angled tube Laboratory Equipment rotor Laboratory Equipment Colorimeter, with accessories Laboratory Equipment Counting chamber cover slip [Glass] Counting chamber, with double Neubauer ruling Laboratory Equipment [Glass] Laboratory Equipment RBC pippette Laboratory Equipment WBC pipette Laboratory Equipment ESR tube Laboratory Equipment ESR tube stand Laboratory Equipment Filter paper discs Laboratory Equipment Hemoglobinometer, Sahli s Measuring cylinder, graduated, with lip, 100 ml Laboratory Equipment [Glass]

8 Laboratory Equipment Laboratory Equipment Measuring cylinder, graduated, with lip, 50 ml [Glass] Microscope [Binocular, with lamp attachment & oilimmersion lens] Laboratory Equipment Microscope slide cover slip [Glass] Laboratory Equipment Microscope slide, 75 mm X 25 mm [Glass] Laboratory Equipment Pipette, serological, 0.05 ml X ml [Glass] Laboratory Equipment Pipette, serological, 1 ml X 0.1 ml [Glass] Laboratory Equipment Pipette, volumetric, 1 ml [Glass] Laboratory Equipment Pipette, volumetric, 2 ml [Glass] Laboratory Equipment Pipette, volumetric, 5 ml [Glass] Laboratory Equipment Pipette, volumetric, 10 ml [Glass] Laboratory Equipment Pipette, volumetric, 20 ml [Glass] Laboratory Equipment Rubber bulb for pipetting Laboratory Equipment Slide drying rack, 30 slide capacity Slide staining tray, 450 mm X 350 mm X 25 mm Laboratory Equipment [SS] Laboratory Equipment Slide storage box, 200 slide capacity [Plastic] Laboratory Equipment Specimen container, sputum [Plastic] Laboratory Equipment Specimen container, urine [Plastic] Laboratory Equipment Spirit lamp, with screw cap, 60 ml [Metal] Laboratory Equipment Stop watch, spring wound type Laboratory Equipment Test tube clamp (holder), nickel plated spring wire type Laboratory Equipment Test tube rack, with twelve 22 mm dia holes [Plastic] Laboratory Equipment Test tube, without rim, 100 mm X 13 mm [HRG] Laboratory Equipment Test tube, without rim, 150 mm X 16 mm [HRG] Laboratory Equipment Test tube, without rim, 75 mm X 12 mm [HRG] Laboratory Equipment Tourniquet for blood collection [Rubber] Wash bottle, with angled delivery tube, 250 ml Laboratory Equipment [Plastic] Laboratory Equipment Water bath, serological, with thermostat Laboratory Reagent Acetic acid, glacial, 1% and 5% Laboratory Reagent Barium chloride 10% Laboratory Reagent Benedict's reagent Laboratory Reagent Benzidine powder Laboratory Reagent Blood glucose kit for colorimetry Laboratory Reagent Blood grouping antisera (A, B, D) set Laboratory Reagent Carbol fuchshin Laboratory Reagent Diluting fluid for RBC Laboratory Reagent Diluting fluid for WBC Laboratory Reagent Distilled water Laboratory Reagent Esbach's reagent Laboratory Reagent Fouchet's reagent Laboratory Reagent Hydrochloric acid N/ Laboratory Reagent Hydrogen peroxide 20 vols Laboratory Reagent Leishman's stain Laboratory Reagent Lugol's iodine Laboratory Reagent Methylene blue Laboratory Reagent Oil for oil-immersion microscopy Laboratory Reagent Sodium citrate 3.8% solution Laboratory Reagent Sulfuric acid 20% Laboratory Reagent Xylene Drug Vaccine BCG vaccine Drug Vaccine DPT vaccine Drug Vaccine DT vaccine Hepatitis B vaccine, recombinant [child - 10 mcg Drug Vaccine antigen per dose] Drug Vaccine Measles vaccine Drug Vaccine OPV vaccine Drug Vaccine Tetanus toxoid Drug Vaccine Diluent for BCG vaccine Drug Vaccine Diluent for measles vaccine Drug Vaccine Polyvalent antisnake venom serum Drug Vaccine Antirabies vaccine

9 Drug Acid control Antacid (Al-hydroxide 250 mg + Mg-hydroxide 250 mg) Tab Chewable Drug Acid control Famotidine Tab 40 mg Drug Acid control Omeprazole Cap (EC pellets) 20 mg Drug Acid control Ranitidine Inj 50 mg / 2 ml Drug Analgesic Aspirin Tab 300 mg / 325 mg Chewable Drug Analgesic Diclofenac Tab EC 50 mg Drug Analgesic Diclofenac Inj 75 mg / 3 ml Drug Analgesic Ibuprofen Tab 400 mg Drug Analgesic Ibuprofen Susp 100 mg / 5 ml Drug Analgesic Paracetamol Tab 500 mg Drug Analgesic Paracetamol Susp 125 mg / 5 ml Drug Analgesic Pentazocine Inj 30 mg / ml Drug Anesthetic Lignocaine Inj 2% without Adrenaline Drug Anesthetic Lignocaine Inj 2% with Adrenaline 1: Drug Anesthetic Lignocaine Gel 2% Drug Anesthetic Succinylcholine Inj 50 mg / ml 10 ml vial Drug Anesthetic Vecuronium Inj 2 mg / ml Drug Anesthetic Neostigmine Inj 0.5 mg / ml Drug Anesthetic Thiopental sodium Inj 500 mg Vial Drug Anesthetic Halothane Drug Anesthetic Nitrous oxide Drug Antiallergic Cetirizine Tab 10 mg Drug Antiallergic Promethazine hydrochloride Inj 25 mg / ml Drug Antiasthmatic Salbutamol Tab 4 mg Drug Antiasthmatic Salbutamol Syr 2 mg / 5 ml Drug Antiasthmatic Salbutamol Nebulizing solution 5 mg / ml (for use with nebulizer) Drug Antiasthmatic Theophylline + Etophylline Inj 25.3 mg mg / ml Drug Antidiabetic Glipizide Tab 5 mg Drug Antidiabetic Metformin Tab 500 mg Drug Antiemetic Domperidone Tab 10 mg Drug Antiemetic Ondansetron Inj 2 mg / ml Drug Cardiovascular Amlodipine Tab 5 mg Drug Cardiovascular Atenolol Tab 50 mg Drug Cardiovascular Frusemide Tab 40 mg Drug Cardiovascular Isosorbide dinitrate Tab 5 mg Sublingual Drug Cardiovascular Nifedipine Cap 10 mg Soft gelatin type Drug Antimicrobial Azithromycin Susp 200 mg / 5 ml Drug Antimicrobial Azithromycin Tab 500 mg Drug Antimicrobial Cefalexin Tab 250 mg Dispersible Drug Antimicrobial Cefixime Tab 200 mg Drug Antimicrobial Cefotaxime Inj 250 mg Drug Antimicrobial Cefotaxime Inj 500 mg Drug Antimicrobial Ceftriaxone Inj 250 mg Drug Antimicrobial Ceftriaxone Inj 1 g Drug Antimicrobial Ciprofloxacin Tab 500 mg Drug Antimicrobial Co-trimoxazole Susp 240 mg / 5 ml Drug Antimicrobial Co-trimoxazole Tab 960 mg Drug Antimicrobial Doxycycline Tab 100 mg Drug Antimicrobial Erythromycin Tab 500 mg (as stearate) Drug Antimicrobial Gentamicin Inj 80 mg / 2 ml Drug Antimicrobial Ivermectin Tab 3 mg Drug Antimicrobial Metronidazole Susp 200 mg / 5 ml Drug Antimicrobial Metronidazole Tab 400 mg Drug Antimicrobial Norfloxacin Tab 400 mg Drug Antimicrobial Fluconazole Tab 150 mg Drug Antimicrobial Miconazole Cream 2% (as nitrate) Drug Antimicrobial Chloroquine phosphate Tab 250 mg

10 Drug Antimicrobial Primaquine phosphate Tab 7.5 mg base Drug Antimicrobial Artemether Inj 150 mg / 2 ml Drug Antimicrobial Artemether + Lumefantrine Tab 40 mg mg Drug Antimicrobial Albendazole Tab 400 mg Chewable Drug Drug Drug Drug Drug Drug Antiseptic / Disin Antiseptic / Disin Antiseptic / Disin Antiseptic / Disin Antiseptic / Disin Antiseptic / Disin Glutaraldehyde Liquid 2% Povidone iodine Oint 5% Povidone iodine Lotion 5% Soapy solution of cresol [Lysol] Sodium hypochlorite Solution 5% [Bleach] Surgical spirit [Rectified spirit] Drug Drug Drug Drug Fluid / Electrolyte Fluid / Electrolyte Fluid / Electrolyte Fluid / Electrolyte IV fluid Sodium chloride 0.9% [Normal saline] IV fluid Dextrose 5% IV fluid Compound sodium lactate [Ringer lactate] Oral rehydration salts Powder [for reconstitution of low osmolality ORS] Drug Obstetric Levonorgestrel Tab 750 mcg Drug Obstetric Magnesium sulphate Inj 15%, 10 ml Drug Obstetric Methylergometrine maleate Inj 200 mcg / ml Drug Obstetric Oxytocin Inj 10 U / ml Drug Vitamin Ferrous sulfate + Folic acid Tab 200 mg mcg Drug Vitamin Vitamin A Liquid [Oral oil] 1,00,000 U / ml Vitamin B Compound Tab for adult therapeutic Drug Vitamin use Drug Others Adrenaline Inj 1 mg / ml [1 in 1000] Drug Others Alprazolam Tab 0.5 mg Drug Others Atropine sulfate Inj 600 mcg / ml Drug Others Ciprofloxacin Eye drop 0.3% Dexamethasone Inj 4 mg / ml [as sodium Drug Others phosphate] Drug Others Diazepam Inj 5 mg / ml Drug Others Dicyclomine Tab 20 mg Drug Others Hydrocortisone Inj 100 mg (as sodium succinate) Drug Others Prednisolone Tab 20 mg Drug Others Water for injection 5 ml (plastic vial) Drug Others Zinc acetate Susp (20 mg elemental zinc / 5 ml) Drug Others Gamma Benzene Hexachloride 1% Drug Others Permethrin 5% Drug Others Acetyl Salicylic Acid (White) Paediatric drugs Drug Paed Inj Frusemide Drug Paed Inj Sodium bicarbonate Drug Paed Inj Calcium gluconate Drug Paed Inj Phenobarbitone Drug Paed Inj Phenytoin sodium Drug Paed Inj Di-cyclomine Drug Paed Inj Quinine sulphate Drug Paed Inj Vitamine A Drug Paed Inj Ampicillin Drug Paed Inj Chloramphenicol Drug Paed Amoxycillin oral suspension Drug Paed Chloramphenicol oral suspension Drug Paed Tab Diazepam Drug Paed Tab Phenytoin

11 Guidelines on Using the OPD / Emergency Ticket Annexure II A prescription, by definition, is a written order from a registered medical practitioner to a pharmacist instructing the latter to compound and dispense medicines as per the instructions provided and explain their use to the patient. In our out-patient department (OPD) set-up, the OPD / Emergency ticket, in addition to fulfilling the defined role of a prescription, also serves as a medium of communication between the physician and patient, and provides a summary record of the patient s clinical condition since there is little scope of generating an additional case record document. Due care should be taken in writing on this ticket so that both these roles are fulfilled. One must also bear in mind that, being a prescription, it automatically becomes a medicolegal document. Name and particulars of the Health Facility This helps in identifying the source of the ticket for both patient and prescriber. A rubber stamp can enable this information (with pin code) to be entered readily. The nature of the facility (i.e. PHC / BPHC / RH) is important as it has a bearing on judging the appropriateness of the prescription by subsequent prescribers and evaluators. Patient identification particulars The importance of this is obvious. The registration, demographic and contact details noted here must tally with those on the OPD / Emergency Register. Complete details will help in contact tracing if needed. Prescriber s identity The prescriber s identity must be clear for any prescription. The most convenient way to record this is to use a rubber stamp specifying the prescriber s name and designation. Clinical notes These should be entered in brief as the patient s chief complaints and/or important symptoms and signs along with their duration. It is very helpful if a provisional diagnosis can be stated as well. Again, the appropriateness / rationality of the prescription cannot be judged by subsequent prescribers and evaluators without this information. Other important clinical information (e.g. known drug allergies, addictions, past surgery) can be entered here. Advice / Investigations / Medicines The maximum amount of space has been provided for noting down investigations to be done, lifestyle modifications and other non-pharmacological measures that may be adopted and the medicines that are to be used. If multiple medicines are being prescribed, these should be noted in a logical sequence. Consider the possibility of adverse drug-drug interactions in such a case. As far as possible prescribe medicines in generic name the advantages of this practice outweigh the disadvantages. ONLY GENERIC NAME should be used if the medicines are dispensed from the health facility itself. Brand names may be used if medicines are to be procured from outside (in this case the generic name may be followed by the preferred brand name in BLOCK letters; avoid a brand if you are not certain about its composition and remember that brand switching may adversely affect therapeutic result) or if medicines with multiple active ingredients are being prescribed (the scope for using such medicines is very limited). Dosing regimen should be complete for every medicine prescribed. Complete dosing regimen includes the dosage form (or route of administration), individual dose, frequency of dosing and duration of treatment. Specify timing in relation to meals where relevant. Avoid Latin abbreviations. Issue dose titration instructions carefully. Potentially confusing instructions like continue, repeat all should be used sparingly, if at all. Avoid impractical advice (e.g. ¾ tablet) and decimal points as far as possible in dosing. If a decimal point is used it should have a leading zero (e.g. 0.5 mg rather than.5 mg). Signature and date A prescription is not valid without a signature and date. The medical officer signing must note his / her name clearly if it is different from that specified by the rubber stamp. Finally, do not forget that legibility of the prescription is important and can prevent many mistakes and medication errors. Prescription in local language can be of great help.

12 Annexure III DEPARTMENT OF HEALTH & FAMILY WELFARE GOVERNMENT OF WEST BENGAL OPD / EMERGEY TREATMENT CARD Name of the Health Facility PHC/BPHC/RH Address.Tel. No. PATIENT DETAILS Registration Number - Date - Name Age Sex.. Address..Vill-.. P.O.-.PS.. Visiting Date.. Doctor s Name. Clinical notes ADVICE / Investigations History/Complaints Date Signs & Symptoms Clinical Examination Injury Notes Provisional diagnosis Signature Name of the Doctor/Stamp Follow Standard Treatment Guidelines and ensure Rational Use of Medicine

13 Clinical Notes with date ADVICE / Investigation Signature Name of the Doctor/Stamp

14 Follow Standard Treatment Guidelines and ensure rational use of Medicine Annexure IV Emergency Health Kit The contents of the Emergency Health Kit is modeled on the World Health Organization Emergency Health Kit 1998 Basic Unit. This is sufficient to meet the emergency requirements of 1000 persons for 3 months. To prepare for a natural calamity or some other disaster, sufficient number of kits should be procured, keeping in mind the size of the population intended to be covered. Item Quantity Drug items 1. Albendazole tablet 400 mg Antacid tablet, chewable Azithromycin tablet 500 mg* Cetirizine tablet 10 mg* Chloramphenicol eye ointment 0.5% 5 g X Chloroquine phosphate tablet 250 mg Co-trimoxazole tablet 480 mg Domperidone tablet 10 mg* Ferrous sulfate + Folic acid tablet 200 mg mcg Ibuprofen tablet 400 mg Metronidazole tablet 400 mg Miconazole cream 2%* 15 g X Oral rehydration salts powder (WHO revised formula) for 1 L 200 sachets 14. Paracetamol tablet 500 g Povidone iodine liquid 5% 1 L Non-drug items 16. Adhesive tape 2.5 cm X 5 m 30 rolls 17. Back ball point pen Clinical thermometer Cotton wool, non-sterile 100 g pack 10 rolls 20. Disinfectant soap (e.g. Chloroxylenol soap) 10 bars 21. Elastic (crepe) bandage 7.5 cm X 5 m 20 units 22. Eye pad, sterile* Gauze pad, sterile 500 pcs 24. Gloves, disposable surgical, latex, sterile, size 7 50 pairs 25. Gloves, disposable examination, polythene, non-sterile* 50 pairs 26. Notebook (hardcover) Notepad Plastic bags for disposal of non-contaminated waste* Roller bandage 10 cm* 20 rolls 30. Roller bandage 7.5 cm 200 rolls 31. Sharps container for disposal of sharp item* Triangular bandage* Wooden splints, assorted* 5 sets 34. Bucket, plastic, approximately 12 L Mug, plastic Kidney dish, stainless steel, size about 26 cm X 14 cm Dressing set (as specified in the footnote) 2 sets 38. Dressing tray, stainless steel, size about 30 cm X 15 cm Forceps, non-toothed, Kocher's type, size cm Scissors, straight, stainless steel, blunt point, size cm 2 pairs 41. Syringe, disposable, 10 ml Plastic bottle, 1000 ml Plastic bottle, 125 ml Storing drum, stainless steel, 15 cm diameter X at least 10 cm height 2 Items with an asterisk are optional and not included in the WHO Emergency Health Kit. The dressing set comprises the following 4 items a) 1 stainless steel box with cover, approximately 17 cm X 7 cm X 3 cm b) 1 Scissors, straight, stainless steel, blunt point, size cm c) 1 Kocher's forceps, non-toothed, straight, size cm and d) 1 Dissecting forceps, non-toothed, size cm. 14

15 Delivery Kit Annexure V The Reproductive and Child Health Programme currently in operation in our country lays due emphasis on simple yet evidence based interventions to make the goal of safe motherhood a reality. One of the measures advocated is use of a standard delivery kit equipped with simple provisions to enable a safe vaginal delivery when no complications are anticipated. Such a kit will help in ensuring the '5 cleans' during delivery clean hands, clean surface, clean cut, clean cord tie and clean stump. The contents of a delivery kit should be as follows: Contents of Delivery Kit Item 1. Container box, plastic hard-case type, preferably with handle * Quantity 2. Toilet soap (preferably antiseptic containing) 1 cake (small) 3. Plastic apron, stitched edges, boilable, stain-resistant, size approximately 40 X Surgical gloves, non-sterile, disposable, size 7 1 pair 5. Examination gloves, polythene, medium size ** 6. Plastic sheet, able to withstand hot water, size approximately 5' X 3' 7. Cord clamping forceps (Kocher s artery forceps) 2 8. Scalpel blade, sterile, size No Cord tie (woven cotton ligature), strong, length 15 cm 3 pcs 10. Umbilical cord clamp (disposable) ** Cotton wool, sterile 25 g pack Cotton wool, non-sterile 100 g pack Gauze swab, sterile, size approximately 8 cm X 8 cm Packet of Towel for wrapping newborn, soft, hand towel size Mucus sucker for newborn, sterile, disposable, capacity 20 ml ** 16. Plastic bag, polythene, self-sealing or zip-lock type, size 25 cm X 16 cm, thickness 80 micron ** * An enamel or stainless steel tray with lid, size about 30 cm X 22 cm X 7 cm, can substitute for the carry case if the kit need not be carried over a distance. ** These items are optional. Current practice does not require application of any disinfectant to the umbilical cord stump

16 Annexure VI Emergency Injection Tray In any healthcare setting, where emergency patients may present, it is of vital importance to keep emergency injections organized in a cabinet or tray. This can be a life saving measure. The contents of a model emergency injection tray for small and mid-level health facilities have been listed below. The tray contains a few nonparenteral drugs. Before using any injection from the tray it is vital to read the label carefully to ensure that the right injection has been selected (often labels appear very similar) and it is not past the expiry date. Contents of Emergency Injection Tray Item Quantity 1. Tray, stainless steel, with lid and recessed cross-bar handle, size 12 X 8 X Surgical spirit Bottle (100 ml) X 1 3. Cotton wool, non-sterile Pack (100 g) X 2 4. Adrenaline Inj 1 mg / ml [1 in 1000] Ampoule (1 ml) X 4 5. Aspirin Tab 300 mg / 325 mg Chewable or Soluble Atropine sulfate Inj 600 mcg / ml Ampoule (1 ml) X 8 7. Diazepam Inj 5 mg / ml Ampoule (2 ml) X 5 8. Dexamethasone Inj 4 mg / ml [as sodium phosphate] Vial (2 ml) X 5 9. Diclofenac sodium Inj 25 mg / ml Ampoule (3 ml) X 5 10.Hydrocortisone Inj 100 mg (as sodium succinate) Vial (powder) X Isosorbide dinitrate Tab 5 mg Sublingual/Tab Glycerol trinatrate Lignocaine Inj 2% (without adrenaline) Vial (30 ml) X 1 13.Nifedipine Cap 10 mg Soft gelatin type Ondansetron Inj 2 mg / ml/ Metoclopramide Inj. Ampoule (2 ml) X 5 15.Ranitidine Inj 25 mg / ml Ampoule (2 ml) X 5 16.Pentazocine Inj 30 mg / ml Ampoule (2 ml) X 5 17.Promethazine hydrochloride Inj 25 mg / ml Ampoule (2 ml) X 5 18.Salbutamol Nebulizing solution 5 mg / ml (for use with nebulizer) Vial (15 ml) X 3 16

17 19.Theophylline + Etophylline Inj 25.3 mg mg / ml 20.Water for injection 21.25% Dextrose ampoule 22.Inj Frusemide 23.Inj Diclomine Ampoule (2 ml) X 5 Ampoule (5 ml) X 5 20ml(amp)-2am p 20mg/ml-2ml amp:5amp 10mg/ml-2ml amp-5 amp * This corresponds to the preparation available under the brand name DERIPHYLLIN. Inj Terbutaline 0.5 mg / ml may be an alternative. However, the latter will require caution if the patient is liable to have hypertension, hyperthyroidism or heart disease. It is important to entrust one individual, such as a nurse or pharmacist, with the responsibility of maintaining the tray. He or she must replenish the contents daily or periodically and check for expiry of the items once a month. 17

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