[ Pobierz całość w formacie PDF ]
senior khakis to spot check the equipment (particularly first aid boxes) to ensure
accuracy of the inventories.
Also in your travels about the ship, it is a good idea to inspect the first aid boxes
specifically looking for tampering, to see if they need replacement or re-inventory. The
NSN (stock number) on the AMMAL list must match the NSN on the item in the
emergency equipment. If the NSNs do not match, but they are descriptively the same
e.g., both 7 ¼ inch bandage scissors then write in the correct NSN for the item and put
a star next to the NSN on the AMMAL list.
CONTINGENCY SUPPLIES
A number of storerooms located in various parts of the ship are designated for your
medical supplies and equipment. Some of these will be readily accessible from your
medical spaces; others will be so out of the way they require a navigational chart and
sextant to find. One of the first things you should definitely do during the turnover time
with your predecessor is to get a tour of all the Medical Department spaces, including
the storerooms. This will not only better acquaint you with the ship in general but will
allow you to find supplies later. The first time you venture out on your own, leave a trail
of breadcrumbs.
Another good reason for touring the storerooms is to get a visual idea of the material for
which your department is responsible. You will be pleasantly surprised by the
abundance of supplies at your disposal. Some of it will be unavailable for every day Sick
Call. There should be gynecological instruments and empty bottles (by the thousands).
Most of this equipment is earmarked for disaster relief or evacuation of civilians during
wartime operations. You will also find some miscellaneous items you ve never heard of
and others you thought you would never see.
It is a good idea to inspect the storerooms throughout the year to see that spaces are
kept neat and clean, properly stocked, and in good condition. You will occasionally find
surprises: personal gear belonging to corpsmen, bicycles, radios, tapes, woodcarvings
and various other souvenirs purchased at foreign ports. Make sure non-medical items
are removed.
One important supply function is stocking the Medical Officer Response Kit, which is
normally kept in the designated trauma area. These are often overlooked by the
corpsmen who update medicinals and during preventive maintenance of equipment.
This bag should hold most medications necessary for advanced cardiac life support and
trauma situations. At least once a month you should inspect the kit, checking the dates
of all medications and replacing those that have expired. If your chief and LPO are on
their toes, this will be done for you automatically, but don t assume that it will be. You
don t want to get caught short in a true emergency.
Other than AMMAL items and supplies, ordering any additional medical supplies will be
up to your personal preferences. Keep in mind that the AMMALs cover almost
everything that you will need to supply your Medical Department. They contain all the
103
basic materials, including a wide variety of cold medications, anti-inflammatories,
antibiotics (both PO and IV), some plaster for rolling casts, metal splints for fingers, and
a variety of suture material and needles. The department AMMAL also includes
professional books. The TYCOMs have a list of required books, publications and
instructions you must maintain on board. Anything else you want is up to you.
When you get on board, look over the AMMALs and talk to the person you are relieving
about what may be missing. You can then decide what medications and items you
simply cannot live without and order appropriately. While you can order anything that
you have money for, be cautious with ordering non-AMMAL items.
The AMMALs are intended to be standard minimal types of supplies that you will need
as a GMO on a ship. AMMALs were developed as consensus standards by panels of
Medical Officers, are intended to cover the types of contingencies you can expect to
face, and should supply the needs for what you expect to treat on your type of ship.
They will not and should not replace what is available in the local hospital.
Don t waste your OPTAR on the latest and greatest medications, when the older, more
cost-effective medications work just as well. If you have only one or two patients on a
special non-AMMAL medication, have their doctor at the hospital write prescriptions to
be filled at the hospital pharmacy. The shore-based docs are usually very good about
giving the patient enough medication for a deployment as long as you ask. A penny
saved may save your bacon at the end of the quarter.
A few words on AMMAL limits. The AMMAL levels are conservative, low quantities. For
medications and supplies not often used, they are fine, e.g., antihypertensive
medications, and surgical instruments. But for commonly used medications like
antibiotics, OTC cold medications, non-steroidals, birth control pills, antifungals,
antiemetics, and sunscreen, they can be woefully short. Discuss your ship s dispensing
history with your pharmacy tech and the person you are relieving. Then you will have an
idea what medications you may need in higher quantities.
Keep in mind that you are the corner drugstore for the crew, since the ship s store can t
sell medication. Realize also that some medications are seasonal. You may need to
order more cold medicines during cold and flu season and more antifungals and non-
steroidals during hot weather and sports tournaments. The AMMALs are planned for the
same numbers year round. You have to plan two to three months in advance to ensure
your order makes it through the supply system.
MAINTENANCE AND REPAIR (3M PMS)
The 3M system will initially seem to defy logic and be as exciting as watching paint dry,
but it is important for you to understand and make sure it is properly implemented.
There really is logic and purpose to it, and the 3M system will work. Just give it a
chance; it s not that hard.
Some basic facts about the 3M system (for excruciatingly complete details see
OPNAVINST 4790.4B Ship s Maintenance and Material Management [3M] Manual).
Every piece of equipment on the ship, and most of the equipment in Medical, has
scheduled preventive maintenance that must be performed to keep that equipment at its
104
peak operating standard. This is particularly important for emergency equipment or
equipment that is rarely used. The system forces you to look at your equipment on a
regularly prescribed basis, so it doesn t sit in a storeroom and rust to pieces.
Each work center has a list of the equipment that requires preventive maintenance,
called a List of Effective Pages or LOEP. There are Maintenance Requirement Cards
(MRCs) for each piece of equipment on the LOEP, which state what maintenance is to
be done. This MRC card states:
" how often maintenance is required (weekly, monthly, etc.), [ Pobierz całość w formacie PDF ]
zanotowane.pl doc.pisz.pl pdf.pisz.pl exclamation.htw.pl
senior khakis to spot check the equipment (particularly first aid boxes) to ensure
accuracy of the inventories.
Also in your travels about the ship, it is a good idea to inspect the first aid boxes
specifically looking for tampering, to see if they need replacement or re-inventory. The
NSN (stock number) on the AMMAL list must match the NSN on the item in the
emergency equipment. If the NSNs do not match, but they are descriptively the same
e.g., both 7 ¼ inch bandage scissors then write in the correct NSN for the item and put
a star next to the NSN on the AMMAL list.
CONTINGENCY SUPPLIES
A number of storerooms located in various parts of the ship are designated for your
medical supplies and equipment. Some of these will be readily accessible from your
medical spaces; others will be so out of the way they require a navigational chart and
sextant to find. One of the first things you should definitely do during the turnover time
with your predecessor is to get a tour of all the Medical Department spaces, including
the storerooms. This will not only better acquaint you with the ship in general but will
allow you to find supplies later. The first time you venture out on your own, leave a trail
of breadcrumbs.
Another good reason for touring the storerooms is to get a visual idea of the material for
which your department is responsible. You will be pleasantly surprised by the
abundance of supplies at your disposal. Some of it will be unavailable for every day Sick
Call. There should be gynecological instruments and empty bottles (by the thousands).
Most of this equipment is earmarked for disaster relief or evacuation of civilians during
wartime operations. You will also find some miscellaneous items you ve never heard of
and others you thought you would never see.
It is a good idea to inspect the storerooms throughout the year to see that spaces are
kept neat and clean, properly stocked, and in good condition. You will occasionally find
surprises: personal gear belonging to corpsmen, bicycles, radios, tapes, woodcarvings
and various other souvenirs purchased at foreign ports. Make sure non-medical items
are removed.
One important supply function is stocking the Medical Officer Response Kit, which is
normally kept in the designated trauma area. These are often overlooked by the
corpsmen who update medicinals and during preventive maintenance of equipment.
This bag should hold most medications necessary for advanced cardiac life support and
trauma situations. At least once a month you should inspect the kit, checking the dates
of all medications and replacing those that have expired. If your chief and LPO are on
their toes, this will be done for you automatically, but don t assume that it will be. You
don t want to get caught short in a true emergency.
Other than AMMAL items and supplies, ordering any additional medical supplies will be
up to your personal preferences. Keep in mind that the AMMALs cover almost
everything that you will need to supply your Medical Department. They contain all the
103
basic materials, including a wide variety of cold medications, anti-inflammatories,
antibiotics (both PO and IV), some plaster for rolling casts, metal splints for fingers, and
a variety of suture material and needles. The department AMMAL also includes
professional books. The TYCOMs have a list of required books, publications and
instructions you must maintain on board. Anything else you want is up to you.
When you get on board, look over the AMMALs and talk to the person you are relieving
about what may be missing. You can then decide what medications and items you
simply cannot live without and order appropriately. While you can order anything that
you have money for, be cautious with ordering non-AMMAL items.
The AMMALs are intended to be standard minimal types of supplies that you will need
as a GMO on a ship. AMMALs were developed as consensus standards by panels of
Medical Officers, are intended to cover the types of contingencies you can expect to
face, and should supply the needs for what you expect to treat on your type of ship.
They will not and should not replace what is available in the local hospital.
Don t waste your OPTAR on the latest and greatest medications, when the older, more
cost-effective medications work just as well. If you have only one or two patients on a
special non-AMMAL medication, have their doctor at the hospital write prescriptions to
be filled at the hospital pharmacy. The shore-based docs are usually very good about
giving the patient enough medication for a deployment as long as you ask. A penny
saved may save your bacon at the end of the quarter.
A few words on AMMAL limits. The AMMAL levels are conservative, low quantities. For
medications and supplies not often used, they are fine, e.g., antihypertensive
medications, and surgical instruments. But for commonly used medications like
antibiotics, OTC cold medications, non-steroidals, birth control pills, antifungals,
antiemetics, and sunscreen, they can be woefully short. Discuss your ship s dispensing
history with your pharmacy tech and the person you are relieving. Then you will have an
idea what medications you may need in higher quantities.
Keep in mind that you are the corner drugstore for the crew, since the ship s store can t
sell medication. Realize also that some medications are seasonal. You may need to
order more cold medicines during cold and flu season and more antifungals and non-
steroidals during hot weather and sports tournaments. The AMMALs are planned for the
same numbers year round. You have to plan two to three months in advance to ensure
your order makes it through the supply system.
MAINTENANCE AND REPAIR (3M PMS)
The 3M system will initially seem to defy logic and be as exciting as watching paint dry,
but it is important for you to understand and make sure it is properly implemented.
There really is logic and purpose to it, and the 3M system will work. Just give it a
chance; it s not that hard.
Some basic facts about the 3M system (for excruciatingly complete details see
OPNAVINST 4790.4B Ship s Maintenance and Material Management [3M] Manual).
Every piece of equipment on the ship, and most of the equipment in Medical, has
scheduled preventive maintenance that must be performed to keep that equipment at its
104
peak operating standard. This is particularly important for emergency equipment or
equipment that is rarely used. The system forces you to look at your equipment on a
regularly prescribed basis, so it doesn t sit in a storeroom and rust to pieces.
Each work center has a list of the equipment that requires preventive maintenance,
called a List of Effective Pages or LOEP. There are Maintenance Requirement Cards
(MRCs) for each piece of equipment on the LOEP, which state what maintenance is to
be done. This MRC card states:
" how often maintenance is required (weekly, monthly, etc.), [ Pobierz całość w formacie PDF ]