Sunday, April 30, 2006

The ULTIMATE Doctor's Bag

I've decided to construct the ultimate doctor's bag, so as to never be short the materials necessary to perform the diagnostic physical exam. I have some of these materials but I thought I'd show the whole shopping list:
I really like my Classic II S.E. from 3M Littman Stethoscope. It's resilient but I've been able to perform decent auscultation of the abdominal, breath, and heart sounds. The decent is probably more a failing on my part then this fine instrument. Plus it makes me look "doctorly".

Pulse Oximeter
The O2 saturation has become part of standard vital signs. Pulse oximeters have become smaller and more compact, providing both the heart rate and O2 sat. The Invacare Digit Finger Pulse Oximeter is one of those available.

Blood pressure measurement requires a stethoscope and sphygmomanometer (blood pressure cuff and gauge). There are many types of sphygmomanometers available at AllHeart.

Peak Flow Meter
There is a new hand held Peak Flow Meter for Spirometry with FEV1 from MicroLife which enables both measurement of peak expiratory flow (PEF) and forced expiratory volume in 1-second (FEV1), allowing a quick bedside evaluation of pulmonary function.

Two years ago I purchased a Welch Allyn 3.5v Diagnostic Set due to the size constraints and needs of a medical student. However, in a doctor's bag the 5x magnification and ease of a PanOptic opthalmoscope might well be worth it.

Neurological Instruments
A Baseline Taylor Hammer with Tuning Fork has all the tools necessary to test fine touch, pain, vibration, and deep tendon reflexes. Auditory testing including Weber and Rhinne test requires a 512 Hz tuning fork. Two-point discrimination can be done with a Baseline Aesthesiometer. Finally a pen light would also be necessary. A Snellen eye chart would also fall in this category.

With the increasing prevalence of diabetes this makes a valuable addition to a doctor's bag. Glucometers are available at Diabetes Store.

EKG Calipers and Ruler
Make use of a drug rep, usually the ones in cardiology will have some.

CPR Mask
Cardiopumonary resuscitation can be performed more efficiently and safely with a CPR mask. Checkout The Lunatick's Fire and EMS Store.

Trauma Shears
Its amazing how handy trauma shears can be, try The Lunatick's Fire and EMS Store.

Tape Measure
I have not included disposal items such as hand sanitizer, gloves, Hemoccult cards, lubricants, etc. This British article also has some excellent suggestions, with the addition of medications.

Monday, April 24, 2006

Fear the Joker

Not a bad imitation of a certain Detective Comics villainThis weekend I went on a bar crawl with the nominal "theme" of pirates versus clowns. As girls and pretty boys generally pull off the sexy pirate routine (a lot) better than me, I went with the clown motif. Since I'm already menacing and creepy I decided I might as well maximize this by going as my nicknamesake, the Joker. Therefore, I appropriately arrayed myself with green hair and eyebrows, white face paint, and red lipstick. Little did I realize what a study in fears this would be.
First, on a personal level. I had to drive several miles during the daylight hours to make the bar crawl. Thus my fellow motorists had ample time to gawk and stare. Fortunately the circus was in town so maybe they thought I was a refuge from there. But as I drove it dawned on me that their attention shouldn't bother me. I wasn't hurting anyone and their judgment was entirely irrelevant. If they thought I was weird, creepy, "light in the loafers", or whatever I was doing something fun, legal, and they could all largely bite me if they didn't like it. Although as I was entering the bar I hoped wholeheartedly that other people would be dressed up, otherwise it would make for a long night, I certainly wasn't going to backdown if they weren't, but clown reinforcements were appreciated. I did spend part of the evening alone in my regalia at one bar and had to walk the length of campus town to get my wheels. Although I provoked quite a few stares I received a bunch of compliments ranging from, "great job" to "you look fantastic" to my favorite "holee...". Apparently you can't mess with a classic and a little bit of theatrical balls is appreciated.
My appearance must have been terrifying. People from a poor guy with a phobia of clowns to several shocked young ladies gave me wide berth. I made one of our party scream when I snuck into her field of view. I defeated a whole table of attractive pirate-ettes when I brandished a plastic scimitar and cackled maniacally, their weapons hit the table with a concerted polymer clatter. It was interesting to see them not only shy away but to avoid eye contact as if the ostrich defense would work. In their minds not seeing me, I would not see them and hence wouldn't do anything. What this says about people not facing their everyday or global fears is probably illuminating. Do we as a species hide or avoid that which scares us? Definitely and its self-destructive. Rather than seeing me as a silly guy with a bad paint job they saw something else which played on fears inlaid by popular culture.
It was interesting to see how much "bravery" my grease paint skin afforded me. I climbed on furniture and stole a tray from a waitress without anyone saying anything. My normally low level of self-control eroded with the safety of my disguise. I would talk to anyone just to see the reaction I could provoke, especially folks trying their desperate to appear cool as a gaunt, menacing clown invaded their libations. Although normally sociable this is extreme even for me.
I might just have to get some more make-up.