HOSPITAL PHARMACY PHARM D 4th PROFF.

1. Health supplies/ accessories
The dynamismof healthcaresystemforsearch of improved and new techniquesforbetter patient care
hasalso led advancementin pharmacy practice.Under thisinfluence,theconceptof pharmacy practice
hasevolved fromdrug orientation to patientorientation.
Role of pharmacist:
Nowa pharmacistis notonlyinvolvedmerelyinstockinganddispensingof drugsbut alsoprovidesother
significantservicesforabetterpatientcare.The provisionof health-accessoriesorinformation
regardingthemtothe patientsisone of these specialized services
HEALTH ACCESSORIES ARE THE ITEM THE USE OF WHICH IMPROVES THE PATIENTS" QUALITY OF
LIFE AND PROVIDES THEM MAXIMUM PHYSICAL INDEPENDENCE.
Recognizingthe importance of health-accessoriesinapatientlife,currentlythese are givenaname of
parapharmaceuticals.
In a hospital pharmacy,a separate sectioncanbe established.A comprehensive health-accessory
departmentinalarger hospital maystocka wide varietyof parapharmaceuticals.Stockingof acomplete
line of suchitemsisverycostly
Alternatively,ratherstocking.institutingasystemof orderingof aselecteditemfroma
vendorcan helpreduce inventorycost.
 To provide these servicesthe pharmacistmustacquire new skillsandexpertise whichcan
be obtainedmanufacturer-producedliterature,catalog,throughspecial coursesgivenby
several health-accessorymanufacturers.The studentsatgraduate levelmust be aquatinted
withthisknowledgeconcerninghealthaccessories.
Division:The healthaccessoriesare dividedintoconvalescentaids,orthopedicbraces,home
diagnosticaids,firstaidsuppliesetc
CONVALESCENTAIDS
For discussionpurpose,convalescent aidsincludeambulatoryaid(wheelchairs,walkers andcansand
crutches),hospital beds,patientlifters,andorthopedicbraces.
AMBULATORY AIDS CanesWalkingcanes are verysimple andlight-weigheddevicesthatserve two
importantfunctionssuchas weighttransferandbalance Weighttransfer
CANE:
A cane providesameansto transferweightoff the weaklimbof patient.Toaccomplish
this,weightmustbe puton the cane.Canescan be carriedon weaklimbside oronstrong Hospital
Pharmacy side.Ineithercase itweighoff fromthe weaklimbside Balance Goodbalance inwalkingisno
more than kecpingone'scenterof gravityover the supportinglimbs.Incase of a weaklimb,the centre
of gravitymovesfromside to gravityforward side.The use of walkingcane providesabalance by
providingadjustingthe centre.
Types-
The canes maybe made up of woodenormetallic.

2. Woodencanesmade for males typicallyare heavierthanthose made forfemales,Metal canescome in
adjustable and non-adjustable modelsandmaybe monopodormultipod,Foldingcanesare available
alsowhichfoldintofoursectionsandare made of wood,metal,orplastic.
Fitting:A cane shouldbe neithertoolongnortoo short.Each one mustbe adjustedor cut to fit
the patient.Fittingacane is quite simple Usingacane.Carryingof cane on weaklimbside narrowsthe
base of support(i.e.,distancebetween the cane tipandhisweaklimbissmall) andpatienttransfershis
weightfromside toside, increasingpossibilityof falling.Using cane onside opposite tothe side of weak
limb,the base of supportwill be widerandthe centerof gravitymovesprimarilyforwardrather than
side toside.Unlessspecificallyinstructedbythe patient'sphysicianorphysical therapisttothe contrary,
alwaysinstructthe patienttocarry hiswalkingcane onhis strongside.
Crutches:
o Crutchesare the devicesusedgenerallybythe patientswithtemporarydisabilities(eg.
fractured) or bypatientswhorequire more supportthana cane.
o Sizesof crutches:The size of crutchesrangesfromtoddlertolarge adult.The adultsize crutches
are adjustable.
o material of crutches:Crutchescan be made of woodor aluminum.
o Typesof crutches:Crutchesare of followingvarioustypeseitherof thatcan be fixedor
adjustable.
o Forearmof crutch:The forearmcrutch (alsocalledaCanadianor Lofstrandcrutch) supports
patient'swrists
o and elbows,attachingtothe fleshypartof forearmbya collar or cuff.It isusedby patientswho
needcrutchesonlong-termbasis.The collarorcuff encirclesthe patient's forearm.The cuff
usuallyisopensoas thisopeningeithermayface side orfront.The forearmcuff alsoshouldbe
adjustedsothat the cuff comesto the middle of the patient's forearm, usuallyoverthe fleshiest
part. It isimportantthat the cuff isopenso the crutches may be thrownout of the wayif the
patientfalls.
o Handgripof crutches: The handgripprojectsfromthe mainshaftand, unlessspecifically
instructedbythe physicianorphysical therapist,the patient shouldbe instructedtoholdthe
handgripso that it pointsforwardIf onlyone crutch isused,itshouldbe on the side opposite
the 70Distributionof HealthSupplies weakleg.
o Two crutches:Whentwocrutches are used,the patientshouldbe instructedto stepforward
o withhisrightlegand hisleftcrutch,followedbyhisleftlegandrightcrutchand so on,
o Axillarycrutch:The axillarycrutchisordinarywoodenoraluminumunderarmcommonlyused
crutch
o and providesmore supportthanthe forearmcrutch since it bracesboth wristand
elbow.Adjustable crutcheswithreference tocrutchtip underarm and handgripare preferredas
theyofferbetterandeasierfitting.These mustbe fittedproperlyandthe weightbearing should
be on the hand gripsto avoidthe dangerof injurytothe lymphglands,blood vesselsorradial
nervesinthe armpitsthat can leadto "crutchparalysis."
o Quad crutch: The quad crutch isa forearmcrutch witha quadrangular(four-sided) base
attachedto the
o mainshaftwitha flexible rubbermount.Thisdesignallowsthe quadfeettomaintain constant
contact withthe ground.
o Shepherd'scrookcrutch:The shepherd'scrookcrutch,a type of axillarycrutch,resemblesa
forearmcrunch except thatthe handgrips pointtothe rear andaxillary ratherthanforearm
supportisprovided.

3. o Fitting:A crutchmustbe properlymeasuredtoprevent'crutch paralysis'asmentionedbefore
By followingway
a) The patientshouldstanderect,supportedbythe wall ora chair,for the fitting.
b) The crutch tip (lowerpart) shouldfalls2inchesawayfromand 6 inchesinfrontof
the toes.
c) The top rest shouldfall 2inchesbelow the axilia
d) The handgripsshouldbe setsothat the arms formroughlya 30° angle.
Crutch accessoriesincludearmpads,handgripcushions,andcrutchtips.
Walkers
Walkersare lightweightdevicesthatare made of metal tubing.
Types:
o Non-wheeledwalker:Thenon-wheeledwalkershave fourwidelyplacedlegs.
o Wheeledwalker:Alsocalledarollatorwalkermade upof steel haswheelswithmulti-braking
systemand variable wheelresistantThiswalkerhasadjustabilitytocontrol the ambulatorygait
of the user.Some unitsare available withseatsforintermittentrestingandbasketortray
accessories tocarry itemsfordailylivingneeds.Wheeledwalkerhave beenmade safe by
equippingthemwithbrakingmechanismthatworksdue toan increasedweighton normal hand
hodsdue to trippingof patientsorlosingof balance.Rollatorwalkers generallyare
recommendedforbutare not limitedtoanindividual'sneedformobility outside the home
environmentwhere avarietyof surfacescouldbe anobstacle tothe use of an aluminum-
wheeledwalker
o Forcarm platform-attachedwalkers Thesewalkersare usedforpatientswithadisabilityor
injuryinvolvingthe handorwrist makingitnon weight-bearingThe platformattachmentallows
forearmto bearthe weight insteadof the handorwrist.
Other types
 The other typesinclude:Adultadjustable,nonadjustable,childadjustable,foldingand
hemiplegicwalkers.
 All walkersshouldbe adjustable forindividualuser.A foldingwalkerismuchmore convenientto
transportand to use in confinedareasoron stairs.
Use
Recommendedforthe patientswhoneedmore supportthana cane but have reasonably
goodarm, hand,and wristfunction.Fornon-wheeledwalker,the patientholdsontothe
walkerandtakesa step,thenmovesthe walkerandtakesanotherstep.A walkershould
not to be usedbya walkingpatientandif he were able todothiswithrelative security,a
cane probablywouldsuffice.Intermsof support,awalkercanbestbe comparedto a
simple cane.While awalkerdoesprovideasteadiersupportforthe patient,likethe cane,
it requiresreasonablygoodarms,wristsandhands,
Wheelchairs
o Many differenttypesof wheelchairsare available the use of whichkeepsthe patient mobile.Itis
usedforthe weakandinfirmpatientsandelderpeople havinglessstrength.
o A carefullyselectedchairhasa prolongedanduseful life andpromotesthe patient maximal
physical independence.The patient'sdisabilities,size,weight,activitiesand fittinguser's
physical limitationandlifestyleare the mainconsiderationsinwheelchair selection.The
followingoptionsshouldbe consideredwhenselectingawheelchair.
 Seatsize
 Side-to-sidewidth

4. A measurementimportantforthe goodseatingposture andstability.The wheelchairsare availablein
standardsize butfor a particularpatientto avoidpressure onthe hipsor thighs,itmust 2 incheswider
than the widestpartof the patient'sbody(straightCTOSS the hips).
Knee-to-hip:Knee-to-hipmeasurementisthe actual chair-seatdepthandisapproximately2to3
incheslessthanthismeasurementinordertoprovide adequate support
Seat-to-elbow:Thisisan indicatorforarmrestheight.Dependingonseatingposture,armrestheight
shouldprovide properbodysupport.Anarmrestheight1inchmore than the patient's seat-to-elbow
measurementwill force the patient'selbows slightlyforward,providinga natural supportagainst
forwardbodyfall,especiallyondescendingramps.
Floor-to-knee:Thismeasurementdeterminesthe footrestadjustmentsfromseatlevel.The minimum
footrestadjustmentshouldbe atleast2 inchesless thanthismeasurementinorderto avoidpressure
againstthe underside of the legs.A goodvisual guide forproperfootrest adjustmentistomake sure
that the tops of the patient'sthighsare horizontal andparallel tothe floor
For other measurements a pharmacistcanconsultthe manufacturerproduct literature.
Wheelchairdimensions
Certainwheelchairdimensionsare importantinpreparinganindividualizedprescription
These are some of the componentsandmeasurements,whichshouldbe considered:
Arms:
The arms can be fixed,detachable,tilt-back,half,orfull.The armrestsandpaddingmust alsobe
considered.A more convenientoptionisthe adjustable-heightarmthat is available inthe detachable
styles.
Wheelsandcasters
Tirescan be made upof hard rubberor pneumatic(ie,air-filled)maybe of reinforced
withspokesorcan be composite based.The rearwheel generallyisalignedwiththe back
upright.Insome chairswheelsare setback to provide alargerbase of supportwhichis
neededtopreventtrippingbackwards.The frontwheel,calledcastercanbe of hard
rubberor pneumaticCastersare usuallyswirlingtype foreasyturning.
Leg rests
The legrestscan be of differentsizesadjustable inlengthelevatingornon-elevatingand are available
withpaddingA newconceptthe articulatingelevatinglegrest,extends automaticallyasthe legrestis
raisedto fitthe outstretchedlegcorrectly
Footsupports
The foot supportscan be of differentsizesandare available withorwithoutheelloops adjustablein
length,removable orfixedwithorwithoutheel-and-toeloopsandoversized ornon-skidfootplates.
Seatand side drapery
The seat and side draperycanbe made upof meshor vinyl.
Types based on operation
Manual wheelchair:A wheelchairwidely usedwithspecificationsmentionedabovethe userrunsthis
wheelchairwithhisarms.
Battery operated: A batteroperatedwheelchair,alsocalledanelectricwheelchairiscostlyandusedfor
people cannotmove but needmore mobilityorthe userwithweak arms.
Three-wheeled battery-operated:Anotherwheelchaircategoryisa three-wheeledbattery-operated
scooter.These are often useful forpeoplewithlimitedmobility.A personwhocanwalka short distance
inhome environmentmaybe unable tospend several hoursonhisfeetoutside.Thiswheelchair
may be answerto sucha situation

5. Wheelchairaccessories
Cushions
Many typesof cushionsare available fora varietyof purposes.The mostimportantuse is toprotectthe
patientfrombruises(small abrasions,injuries,andswellings) andprevent the occurrence of pressure
soresdue to a long-termconfinementinawheelchair. Wheelchairsshouldneverbe usedoveran
extendedperiodof time withoutsome kindof seatcushions.The mostfrequentoccurrence of pressure
soresinwheelchairusersisat the ischial tuberosities(below the buttocks).The otherreasonsfor
pressure soresare a too wide ortoo small chair,or whose footrestsare adjustedimproperly.Footrests
that are toolowcause the patient'slegs tohangoff the frontedge of the seatupholstery.Thus,
interruptscirculationtothe lowerlegs,andalsocause some patients'kneestocome together,
increasingthe possibilityof pressure soresbetweenknees.Footrestswhichare toohighforce the
patient'skneesupinthe airand take body weightoff the backof the thighs,resultinginall of the
patient'sbodyweightbeingfocuseddirectlyonthe ischial tuberosities.A pharmacistshouldguideon
such mattersto the patients.
Types ofcushions wide varietyof cushionsisavailable inthe marketthe most
commonlyusedare:
SheepskincushionorPad preparedfromnatural sheepskinisastandardcushionusedin hospitalsfor
decades,inwheelchairsandinthe hospital bed.Itsfluffy,thickhair provides agoodrelief frompressure.
Syntheticsheepskinsare superiortonatural sheepskinbecausetheirpolyesterfiberswill notsupport
bacterial growthandtheirporous back permitsadequate drainage andairflowThe syntheticsheepskin
ishelpful tothe wheelchairuserif placedontopof anothercushionand worksbestwhenindirect
contact withthe skin
Foam cushion isanothertype mostcommonlyused.These are made of polyfoamorlatex foamrubber
and are available inavarietyof sentsizesandthickness
Convolutedfoamcushion consistsof rowsof conesonthe topsurface,givingitan ege crate
appearance.
Coccyx cushion isa modificationof foamcushionswithitscut-outinone side.Itusually comeswitha
board insert,whichprovidesstabilityinaninherentlyunstablecushion
Inflatable ringcushions are availableinwheelchair-size,whicheffectivelyprovidessoft surface tothe
patients
Silicone gel cushion,anothercushiontype intendedtosimulate adipose tissue (bodyfat) andso
perfectly distributesbodyweight.The resin-lilledcushionislighterthansilicone, yetalsoconformsto
the bodycontours.It doesso more slowly,due toitsnature,and maintainsa"memory'enablingthe
patienttojostle andmove a bitwhile inhischair withoutroll typical of the waterandgel cushions.It
doeshave a hard feel tothe touch.
Alternating-pressure pad isanair mattressarrangedinlongitudinaltubesandconnected toanair
pump,whichalternatelyinflatesanddeflatesalternate rowsof tubesevery60to 120 seconds.The
newerconfigurationsinclude small pillowsarrangedlongitudinally,in lieuof straighttubesworksonthe
principle thatcirculationinthe tissuesoccursinthe absence of pressure.The padisveryeffective in
preventingandtreatingpressuresoresin hospital bedsbutislesseffectiveinwheelchairs.
Chair tables
Special foldingtablesandtrayswithcontouredfrontsare available toenablethe userof
wheelchairtogetcomfortablyclose andcontribute tothe non-ambulatorypatient's
comfortand convenience
BED RIDDEN AIDS
Hospital bedsandaccessories
Types

6. Hospital bedsmaybe manuallyorelectricallyoperatedbothwithfixedandvariable heightwith
adjustable headorfootor bothsections.The manuallyoperatedbedscanbe adjustedbya crank On the
otherhand,electricallyoperatedbedscaneasilybe positioned byapatientindependentlywhilehe or
she isin bedusinghand-heldcontrols. Use Hospital bedsare usedbypatientswhoare confinedtobed
for longperiodsof time.Alsousedforthe patients,requiringelevation of the headorfeetaspart of
theirtreatment
Bedaccessories
o Mattresses
o Polyfoammattresses
are excellentforhospital beds.A mattressshouldbe coveredby plasticimpregnatedmattressticking
and itis well toprovide plasticmattresscovers.
Bedside safetyrails
The bed side safetyrailsare the safetydevicesthatpreventthe patientfromfallingoutof bed.These
are made up of aluminumorsteel.Three typesof safetyrailsare available full length,half lengthand
"any bed'type.The formertwohave clamps.are made up of steel oraluminumandare usedfor
hospital beds.The laterismade upof aluminumwith cross-menmbersof steelandmostlyare usedon
the bedsinhome
Trapeze Bars
The trapeze bars are overbedbars usedas an assistinsittingupand gettingintoandout of bed.These
height-adjustable steel-made barsare attachedwiththe helpof clampsto the headboardof a hospital
bed.A trapeze-barfloor-stand,whichenablesthe trapezeto be usedoveranybed,isalso available.
Bed cushions use:
Bedcushionsare usedfor varietyof purposes,eg. To
 Supportthe patientonbedfor eatingandworkinginbedinrelativelycomfort
 Supportthe patient'slegstoachieve muscle flexion.
 Protectthe patientfrombruisesandoccurrence of pressure sores.
 Long-termconfinementinabedcausesoccurrence of pressure sores.Pressure sores resultfrom
pressure atthe thinlycoveredbonyprominencesof the bodyparticularlyon belowthe buttocks,
heels, elbows,shoulderbladesandearsandback of headin children.The bestcure is
preventionandcanbe achievedbyuse of cushions.
Varioustypesof cushionsare available andhave beenmentionedunderaccessoriesforwheelchairs.
Otherbedaccessories
Bed pans
Feces collectingbedpan:Fecescollectingbedpansare made upof plastic,stainlesssteel. orporcelain
usedforcollectionof fecesof bedriddenpatients.A bedpanmaybe round burusuallyitisoval in shape
The plastic,like rubber,tendstobe warmerto the touch and therefore muchmore comfortable than
steel orporcelaininwinterseason
Eracture urne collecting) bedpan: Urine collectingbedpansare smaller,slopingand flartercontainments
usedforcollectionof urine of immobilizedoroverweightpatients. Whenahospital bedisnotavailable
inthe patient'shome.fourorfive pillowsbehindhis backwill make use of abedpanmucheasier
Over-bed tables:Varietyof special tablesandtraysare available forpatientcomfort.Over-bedtables
are available toserve mealstopatientsThesemayof straddle the whole bedorpatient'ships while he s
tn bedSome over-bedtableshave acentersectionthatcan be raisedto a slantedpositionforthe
supportof a bookor magazine
Over-bedtrays are usedforspill-preventingsafetyaid.A solidorinflatable plastic shampootray
faciitatesshampooingforpatientswhocannotleave theirbeds.The tray fitsacross bedmattresswhere
a pillownormallygoes,andisdesignedtocarryshampoo waterto a drainat the side of the bedwhere it

7. may be collectedinaplasticbucket. The patient'sheadrestsinthe shampootray havinga depression
for the back of hisneck.
PatientLifters
The patientliftersare usedtotransfera patientonbed,chair,or to commode.These liftersare either
hydraulicorscrew-type.All liftershave anadjustable boomtowhicha patient-carryingseatisattached.
Lifterbasesare usuallyU-shapedadjustable inwidthto spreadwide andmovedaroundachairor
commode fora patientlift. Slingof seatdesignisanimportantconsiderationwhenchoosingapatient
lifter.Slings maybe one ortwopiece units,withandwithoutheadsupportsormaybe witha
commode opening.Positioningthe slingunderthe patientisachievedbyrollinghimonside sothaton
rollinghimbackhisspine will restonthe middle of the sling.He isrolledbackoverthe foldedportionof
the slingandto his otherside while the foldedpartof the slingis unfolded,thenhe isreturnedtohis
back. The slingishookedupwiththe helpof chainsor straps andthe boomisraisedslowlyand gently
until he isliftedoff the mattresssoas the patientarmsinside the sling.Whenthe patientisreadytobe
loweredintoachair.commode or bed,the attendantshouldrelease the hydraulicvalve carefullyand
slowly,guidingthe patientintopositionbyhisheel.
BATHROOMSAFETY EQUIPMENTS
The bathroomsafetyequipmentsare categorizedintothe equipmentsprimarilyneedat toiletandintub
for the patientsafety. The bedside commodesusedbythe patientswho cannotambulate fromhisbed
to the bathroomare alsoincludedinthe formerclassof safetyproducts
The variousbathroomsafetyequipmentsare asfollows:
Elevated toilet seats
The elevatedtoiletcanbe attachedwiththe usual bathroomcommodestomake it easier fora patient
to sitor stand. Elevatedtoiletseatsare usedbypeople withlimitedmobility, thoseundergoingtherapy
for hipfracture or whocannot standfrom a low sittingposition Toiletguard(safety) rail orhandrails
may be attachedwiththe seat withregulartoilet seatbolts.Some attachingtypesare designedwith
detachable sidespermittingthe use of one side onlyforeasypersonal cleanlinessindependently.Itmay
be adjustable inheight, andispaddedforsoftness
Toilet safety rails The toiletsafetyrailsorhandrailsare attachedeitherwiththe elevatedseatsas
mentionedabove orcanbe affixedinwall tosupportthe patientsforsupportwhile walkingthrough
bathroomor duringgettingonand off the toiletcommodes.
Bathtub safetyaids Safetyaidsforthe bathtubmay include adhesive stripsandspotsforthe tub
bottom,mats preventshipsanda varietyof tub seatsandsafetygrab bars. Tubseatsare eitherbench
openswithlegs orseatsthat straddle the tubsides.The bathseatsare more commonlyusedandare of
followingtypes.
Bench type tubseat A tub benchseatis withor withoutaback and has eitherfixed(standard)or
adjustable-heightlegs.A transferbenchisusedwith twolegsinthe tuband twolegson the floor
outside the tub.The patientcansit downonthat portionof the seatwhichisoutside the tub,swinghis
legsoverthe edge of the tub and slide acrossthe benchuntil the entire bodyis"inside"the tub.Transfer
benchesmayhave a commode openingtofacilitate perineal cleansing
Powered tub bench Thisbath seat,alsocalledbathlift,ispoweredbyeitherwaterpressure ora
hydraulicpumpwhichactuallyraisesorlowersthe heightof the seatfromthe heightof the tubside to
nearthe bottom
Bathtub grabbars The bathtubgrab bars range fromthose,whichattach to the side of the bathtubto
wall-mountedgrabbars.Perhapsthe mostfrequentlyusedtype isone thatextendshigh enoughfora
personstandingoutside the tubtogeta firmsupportbefore steppingintothe tub.
CommodesThe commodesare portable toiletsusedbypeople withlimitedmobilityandare unable to
walkfrombedto the bathroom.Commodescontainasteel- oraluminum-frame (withorwithouta

8. backrest),atoiletseat,anda removable plasticbucketandcover.Some commodesare adjustable
heightdesirabletomeetindividual needs.
Types
Commodeswithdroparmsare available tofacilitatelateral transfertoandfrom the commode Tomake
storage easier,foldingcommodesare alsoavailable.Commodesare availablewithpaddedandnon-
paddedbacks.an upholsteredseatandarmrestsand castersformovingabouteasily.However,the
commodeswithwheelsshouldbe used withcautionAnothercommode type ismade upof woodand
resemble furniture Somecommodesare designedforuse bothinthe bedroomandin the bathroom.
These are eitherbacklessor have a removable back.soas not to interfere withthe toilettank.The
three-in-onecommodesfunctionasacommode or elevatedtoiletseatandhave toilet safetyrails
ORTHOPEDICBRACES ANDSURGICAL FITTINGS
By limitingpatientmovement,orthopedicbracesandsurgical fittingspromoteproper bodyalignment
Pharmacistsmustundergospecial trainingbefore providinganorthopedicdevice. Dependingonthe
policiesof the hospital.apharmacistmaystock orthopedicbracesand surgical fittingsusedtopromote
properbodyalignment
BACK SUPPORTS
These devicesare wornbypatientswithvariousspinal disorders.
CERVICAL COLLARS
Cervical collarsare usedto provide supportorlimitthe range of motionof neck.These maybe soft,or
of foamfora mildsupportandstabilitytoneck.Hard,or rigidcervical collarprovidessemi-rigidsupport
to neckand isusedfor soft-tissuedamage andinjuries, A Philadelphia,(extrication) collarisusedto
immobilize the neckandiscommonlyused inemergencysituations.
SHOULDER IMMOBILIZERS Shoulderimmobilizerskeepshoulderandarmstill.Theyare usedfor
separations, dislocations,andinjuriestothe shoulderarea.
CLAVICLE SUPPORTSThe clavicle supports(alsocalledfigure eightstrapsbecause of theirappearance)
are usedas aidsforthe reductionandstabilizationof claviclefractures.
TENNIS ELBOW Tenniselbowapplies pressure toinflammedforearmmusclestoprovide supportand
cushiontothose withtenniselbow.
WRIST BRACES Wrist bracesare usedto reduce motionandto protectand stabilizewristfromsprains
and strains.
ARM SLINGSThe arms slingsare usedtoprovide comfortandsupportduringrecuperationfrom
fractures.sprainsandsurgery
RIB BELTS Ribbeltsare usedto stabilize ribfractures.Female ribbeltsare shapedtogounderthe
breasts
ABDOMINAL SUPPORTSAbdominal supportsare usedtoprovide abdominalsupportandtohold
surgical dressinplace aftersurgery
KNEE BRACES Knee braces(alsocalledkneecages) are usedforstabilizationandsupportof
may have spiral stays,hinges,andanopenor closedpatellahorseshoe pad.
KNEE IMMOBILIZERS Knee immobilizerspreventanymotionof the knee andare usedfor
fractures
HOME DIAGNOSTIC AIDS
THERMOMETER
A thermometerisaninstrumentforthe measurementof bodytotomedical practice andshouldbe kept
ineveryhome
Types

9. Standard fever thermometer
Thishas sealedglassconstrictionchambercontainingliquidmercury.Inresponse to temperature
changes,the mercuryrisesor failsina columnas itexpandsorcontracts. It will thenremainatthe
maximal temperatureregistereduntil itisshakenbackinto the reservoiratthe bottom.The constriction
chamberalsoacts as a valve check,preventing the mercuryfromflowingbackintothe reservoir.Their
range is fromabout 34,45°C (94°F) to 41.11°C (10697). Graduationsare intwo-tenthsof adegree itmay
be an oral thermometerhavingaslenderreservoirandbulbandisto be placedunderthe tongue and
leftthere for3 minutes.Ininfantsandchildren,itcanalsobe placedunderarmpits.The rectal
thermometerhasablunt,pear-shapedbulbforaddedsafety andretention.Itis insertedintothe
rectumand letthere for4 minutes.A lubricantsuchas petroleumjelly shouldbe usedtoaidinsertion
Rectal temperature isnormallylºhigherthanoral temperature.The Securitythermometerisalsocalled
a stubby thermometer,ashasa short andstubbybulbisusedto take oral or rectal temperature of a
childor non-compliantpatients. The basal temperaturerecordstemperaturesrangingfrom35.50°C
(96°F) to 37.78°C (100°F) andis usedto estimate the time of ovulation.Thisthermometercanbe placed
inthe mouthor rectum. Anelectronicthermometerisbasedonthe heat-ledfluctuationinelectric
currentpassingthrougha resistoranda digital readoutThe accurate and preciselymeasured
temperature isthendisplayedondisplayof the thermometer.Liquidcrystal thermometerstripsare to
be placeddirectlyonthe skin,calculate core bodytemperature frombodysurface.Disposable
thermometersare pre-sterilizedandintendedforsingle-use only.Disposable thermometercoversare
nowalsoavailable whichare thin,sterileplasticsheathsthatcan be placedoveroral thermometersfor
each temperature measurementandthendiscarded.
SELF-CARETEST KITS Self-care testkitsare soldinpharmaciesforhome use.These kits caneasily
but empiricallydetectspecificconditionsormeasure levelsof certainsubstancesfor monitoring
purposes.The responsibilityof hospital pharmacistwhilesupplyingtoany patient,mustadvise that
these kitsare not accurate andare not usedas the substitutionfor laboratorytests The Pharmacists
shouldfamiliarize themselveswiththe testkitstheysell andbe prepared tocounsel patientsontheir
use.
A pharmacist can furnish assistance in the area mentioned as:
 Properuse and interpretationof outcome.
 Referral forappropriate medical follow-upif necessary.
Typesof home diagnosticaidsavailable.
The typesof variousdiagnostickitsare mentionedbelow:
PREGNANCYTEST KIT: Pregnancytestkitdetectsthe presence of humanchorionicgonadotropinhCGin
urine.
The pharmacistmustinstruct the consumersabout the proper instructionscarefully
OVULATIONTEST KIT The ovulationtestkithelpspredictovulationtime andisusedtoincrease the
chance of conception.Thiskitmeasuresthe surge of luteinizinghormone(LH) thatoccurs before
ovulation.The periodof time fortestingisindividualizedandisdependentonthe length andregularity
of the menstrual cycle.
GLUCOSETEST KIT/Bloodglucosetest kit Glucose testkitmonitorsthe glucose levelsof the diabetic
patients.The glucose testkit containsteststriponto whichthe patientsplace adrop of theirblood.To
measure blood glucose levels,these stripschange colororare insertedintoabloodglucose monitor,
whichgivesamore accurate result.

10. Urine glucosetests The urine glucose testkitincludessuchproductsasBenedict'ssolution,tablets,and
usuallyteststrips.These testsare notas accurate as bloodglucose tests andare more appropriate for
stable diabeticswithalowrenal threshold.
KETONE TEST KIT The ketone testkithelpsindetectingthe presence of ketonesindiabeticpatient's
urine as an indicationof glucose control.
BLOOD PRESSURE MONITORS
The patients withthe historiesof borderlineorhighbloodpressure tomonitortheir condition,use the
bloodpressure monitors.A physiciantoassessefficacyof a patient's therapymayuse these readings.
Pharmacistscanplay an importantrole by giving instructions onproper techniqueandinterpretation
of results.
The available bloodpressuremonitorsinclude:
The mercury model:Thismodel isthe mostaccurate and doesnotrequire calibration.Itisgenerally
more expensive andrequiresthe use of a stethoscope, whichcouldbe difficultforpatientswith
impaireddexterityorhearing.
Electronic or digital model These modelsare the easiesttooperate,andtheydonotrequire a
stethoscope.
DRESSINGSANDFIRST AID SUPPLIES
The firstaid suppliesare itemstoprovide afirstaidinhome before amedical advice or bringingthe
patienttothe hospital.The firstaidsuppliesinclude dressings,firstaidkits, scissors,tweezersand
applicators.
pharmacy witha comprehensivehealth-accessoriesdepartmentshould also stockfirstaid supplies.The
pharmacistis a distributorof theseitems and providerof the information on them.A pharmacistmust
adviseforuse of a family medicine cabinet for storageof theseitems and drugs,particularly in homes
wherethere are children to avoid chancesof poisoning.A family medicinecabinet is a place where
medicines arekept in locked or completely outof thereach of children. Pharmacistmustalso instructfor
appropriateand clearlabeling of each bottleor box.Unused orexpired medicationsand empty bottles
should beremoved.Somepharmacistsprovidefolderscontaining information on firstaid,poison
antidotesand simplehomemedication.
COMPONENTSOFFIRST AID BOX
Heat applications
1. Hot-waterbottles.
Hot bottle isan instrumentforapplyingdryheat.Electricheatingpadsisalternate of hot-water
bottles. Made of rubber,hot-waterbottle hasanopeningthroughwhichwarm waterisadded
and a stoppersecurelysealedwithawasher.Pharmacistmustinstructthat bare rubbershould
neverbe allowedtocome incontact withthe skin,orburns may result.Rubberpadsor a towel
wrappedaroundthe hot-waterbottle will give adequate passageof heatandcomfortand
convenience.
2. Electricheatingpads
The advantagesof the electricheatingpadoverthe hot-waterbottle include'nopossibility of
leakingandpreciselycontrol overtemperature.
3. Moist-HeatPacks
Variouscommercial moist-heatpacksare now incommonuse inhospitalsandnursing homes,
and are alsoavailable foruse at home.These steampacksappearas compartmented,clothbags
whenare newand filledwithtinybeads.Whenboiledin water,however,the beadsbecome
hydratedandcombine intoa gelatinoussubstance whichhasthe unique propertyof holdingits
temperature farlongerthananyotherpack -about30 to 40 minutes.Moist-heatpacksshouldnever
be useddirectlyincontactwith the skin

11. ColdApplication
In deepinflammationthe effectsof externalapplicationof eitherheatorcoldare essentiallysimilar,due
to reflexesarisingfromstimulationof nervesconducting temperature sensation.However,thereare
some conditions(suchasappendicitis)where the applicationof cold isthe more desirable.The cold
applicationinclude:
o Ice cap The ice cap is a reusable instrumentof applicationof cold.Itisusuallyacircular rubber
or rubberizedmackintoshclothbag,circularinshape,witha large openingtoadmit crackedice.
It usuallyrequiresacoverof some type suchas thinrubberor cloth to protectthe skin
o Tonsillectomyice bag Anadaptationof the ice cap isusedfor throatinflammation.Itisthe
collar-shapedrubberbagand itfitssnuglyaroundthe neck,holdingthe ice onthe parts
o Redi-Freeze ice pack These are also calledcoldpacks,whichare insteadof usingice,filledwith
glycerinoran isopropyl alcohol-watermixture.Theseare refrigerateduntil neededandare
exchanged forbags whichhave become warminuse.Thus,coldpacks are immediatelyavailable
at all times,andthe liquidcontentsconform mare readilytothe contoursof the body.
o Instanthot/coldpacks Instanthot or cold packscontaininganinnerpacketfilledwithan
activatingfluid. Whenthesepacksare struck firmlyonskin,innerpacketisbrokenandthe
activatingfluid comesintocontactwiththe base chemical toinitiate areaction.Thischemical
reactionis eitherendothermicproducingcold,orexothermicproducingheat.Theymaintain
heator cold forabout 30 minutes,andthenmustbe discarded.Thismodalityprovidesheatand
coldtherapyinstantaneouslyinsituationswhere refrigerationorheatingunitsare not accessible