Microsoft word - appx 2 to section 6 - minimum standards for medical staff facilities allied items_v1 14 06 11.doc

Minimum Standards for Medical Staff, Facilities, Medications,
Medical Equipments & Ambulance for ROO Onshore Operations
Contents
Attachment 1 - Medicines, Disposables & Equipment List Owned by ROO Health Manager (e-mail parkerw@bp.com) 1. Medical Staffing Requirements The following decision matrices reflect the risk activity (for example, seismic versus drilling), personnel numbers and time it takes to provide specialist care. These guidelines indicate the level of expertise appropriate based on the location and risks identified. ROO onshore operations
Activity
Number of personnel
Time from the tertiary referral centre (see 1)
Add one number from each category for the total score.
Recommended medical staffing (see 2)
PLUS - One trained and certified first aider for every 20 POB
with 1 level 1 first aid kit per first aider (see page 8)
'Other medical practitioners' includes physicians, Physician Assistants (PAs), nurses, paramedics or Emergency Medical Technicians (EMTs). 1. Specialised care in a centre that has personnel and facilities for special investigation and treatment. The 'Time from the tertiary referral centre' should include time taken for an ambulance to reach the site. 2. Staffing should be based on the worst-case scenario. For example, if the cardiac centre is two hours away but the burn centre is more than six hours away, staffing is based on the burn centre’s score. Owned by ROO Health Manager (e-mail parkerw@bp.com)
First Aider Level 1 - (minimum of 8 hours training)

Knowledge and skills:
 Scene assessment and prevention of secondary accidents (including self  Contents and use of Level 1 first aid kit (see page 8)  Priorities (“ABC-Airway, Breathing, Circulation)  Emergency call-out procedures  Relevant safety data sheets  Blood-borne pathogens and other associated hazards  Basic hygiene  Application of the recovery position  Cardio-pulmonary resuscitation (CPR) possibly including use of an automatic  Basic control of external bleeding  Application of simple dressings  Application of simple splints  Irrigation of eyes for foreign bodies and chemical splashes  Initial treatment of thermal or chemical injuries  Initial treatment of acute medical conditions/illness  Ability to provide clear details of injury/illness
Advanced First Aid Level 2 - (minimum of 40 hours training)
Knowledge and skills (In addition to Level 1):
 Contents and use of Level 2 first aid kit (appendix 4)  Treatment for shock, hypothermia, heat injury, immersion, burns  Various types of more complex dressings  Transportation of an injured or ill person  Communication and delegation in an emergency  Specific workplace risks  Simple record keeping Other abilities In certain circumstances first aiders may need to drive or operate radio equipment in order to fulfil their first aid responsibilities. Owned by ROO Health Manager (e-mail parkerw@bp.com) Recertification and maintenance of skills First aid and resuscitation skills decline rapidly without practice. Recertification should take place at least every two years. In the interim, skills should be maintained through participation in drills. Records should be kept of each individual’s training. Supervision All first aiders require supervision by competent company approved health professionals. Paramedics are trained to provide the most extensive pre-hospital care. In addition to the skills already listed for advanced first aider, paramedics may administer drugs, interpret electrocardiograms (EKGs), and place a tube into the windpipe to help breathing, and use monitors and other complex equipment. Prerequisite  Holds current registration or license  Registered nursing/paramedic/medic/medical qualification in home country  ATLS observer and ACLS or equivalent training and certification within the last 2  Self reliant with the ability to work independently and as part of a team  Able to communicate clearly and effectively to all levels within an organisation and  Manage multiple acute and trauma events including stabilisation on site for up to 24 hours in collaboration with local medical provider or ‘topside’ medical support  Input into decisions on medical evacuations  Participate in emergency response exercises and major incident plans with emergency response/HSSE team at least quarterly  Maintain in date stock of medical consumables in compliance with legal and professional standards relating to storage, dispensing, administration and disposal of approved medications  Ensure correct maintenance of medical equipment and check function regularly  Maintain the clinic/hospital and triage area  Put clinical processes in place according to professional and legal standards  Maintain a professional profile  Keep up to date with industry and legislative competency standards Nurse (RN) Emergency care nurses are registered general nurses. They possess good clinical skills, emergency care knowledge and experience that are applied in a work setting. Owned by ROO Health Manager (e-mail parkerw@bp.com) Prerequisite  Registered nurse with at least 3 years post basic training experience in emergency  Holds current registration or license qualification in home country  ATLS observer and ACLS or equivalent training and certification within the 2 years  Self reliant with the ability to work independently and as part of a team  Able to communicate clearly and effectively to all levels within an organisation and  Recognise and work within own limitations and professional qualifications  Manage multiple acute and trauma events including stabilisation on site for up to 24 hours in collaboration with local medical provider or ‘topside’ medical support  Provide emergency care – cannulation, intubation, AED use, burns  Maintain ACLS/ATLS/PHTLS/BASICS or equivalent training every 2 years  Input into decisions on medical evacuations  Participate in emergency response exercises and major incident plans with emergency response/HSSE team at least quarterly  Comply with written procedures, standing orders, patient group directions etc.  Maintain in date stock of medical consumables in compliance with legal and professional standards relating to storage, dispensing, administration and disposal of CD, POM, OTC medications  Ensure correct maintenance of medical equipment and check function  Maintain the clinic/hospital and triage area  Put clinical processes in place according to professional and legal standards Physician Assistant is a health professional who has been certified following an accredited Physician Assistant educational program. They practice medicine under the supervision of a licensed physician.  Physician Assistant, who has graduated from an approved program, accredited by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) or equivalent and has successfully completed the National Commission of Certification of Physician Assistants examination or equivalent  Holds current license  At least 5 years post certification experience in emergency medicine in a clinical  ACLS/ATLS/PHTLS or residency trained in Emergency Medicine.  Self reliant with the ability to work independently and as part of a team. Owned by ROO Health Manager (e-mail parkerw@bp.com)  Able to communicate clearly and effectively to all levels within an organisation  Recognise and work within own limitations and professional qualifications  Provide emergency medical response, advanced life support and stabilization for cases involving trauma, cardiac events, acute illnesses and allergic reactions  Competently perform cardio-pulmonary resuscitation including intubation  Proficient in the use of bag and mask for resuscitation  Proficient in the use of a defibrillator and emergency cardiac drugs  Proficient in starting both peripheral and central lines  Proficient at venous cut downs  Insert a chest drain and crico-thyroidotomy cannula  Use a nebuliser  Provide fluid replacement  Give intravenous, intramuscular, subcutaneous or intra-dermal injections  Pass a urinary catheter  Pass a naso-gastric tube  Splint and stabilize fractures  Stabilization and treatment of significant thermal burns  Proficient at fasciotomy /eschar release in burns or trauma cases  Proficient with a slit lamp for treatment of foreign body removal and evaluation of  Proficient in techniques for eye foreign body and rust removal  Evaluate and treat toxic overdoses and/or exposures  Provide adequate pain relief and sedation for emergency procedures (shoulder  Establish cervical spine and backboard immobilization for transport  Provide and co-ordinate medical evacuation and topside support  Refer cases to specialist centres and assist with the transfer  Provide functional leadership for emergency medical delivery systems  Produce and /or follow basic procedures associated with disaster planning and the  Train first aiders and monitor their performance  Ability to recognize and to work within their own limitations - seeking help from  Maintain continuing professional development and license  Maintain clinical competence and current evidence based practice Emergency Physician Emergency physicians have the knowledge and skill to provide acute medical care for a wide variety of common injuries and illnesses, as well as to stabilise and refer individuals for specialised care. Prerequisite  Physician with at least 5 years post-graduate experience in emergency medicine  Holds current registration or license qualification in home country Owned by ROO Health Manager (e-mail parkerw@bp.com)  ACLS/ATLS/PHTLS or Board Certified in Emergency Medicine  Major Incident Medical Management and Support (MIMMS) or equivalent  Self reliant with the ability to work independently and as part of a team.  Able to communicate clearly and effectively to all levels within an organisation  Recognise and work within own limitations and professional qualifications  Provide emergency medical response, advanced life support and stabilisation for cases involving trauma, cardiac events, acute illnesses and allergic reactions  Competently perform cardio-pulmonary resuscitation including intubation  Proficient in the use of bag and mask for resuscitation  Proficient in the use of a defibrillator and emergency cardiac drugs  Proficient in starting both peripheral and central lines  Insert a chest drain and crico-thyroidotomy cannula  Use a nebuliser  Provide fluid replacement  Give intravenous, intramuscular, subcutaneous or intra-dermal injections  Pass a urinary catheter  Pass a naso-gastric tube  Stabilization and treatment of significant thermal burns  Proficient at fasciotomy /eschar release in burns or trauma cases  Proficient with a slit lamp for treatment of foreign body removal and evaluation of  Proficient in techniques for eye foreign body and rust removal  Evaluate and treat toxic overdoses and/or exposures  Provide adequate pain relief and sedation for emergency procedures (shoulder  Establish cervical spine and backboard immobilization for transport  Provide and co-ordinate medical evacuation and ‘topside’ support  Refer cases to specialist centres and assist with the transfer  Provide functional leadership for emergency medical delivery systems  Produce and /or follow basic procedures associated with disaster planning and the delivery of emergency medical services.  Train first aiders and monitor their performance  Recognise and work within own limitations - seeking help from colleagues where  Maintain continuing professional development and licence  Maintain clinical competence and current evidence based practice  Suitably spaced with necessary arrangements to house all necessary medical equipments, medications, disposables and other items.  A toilet and shower  A lockable refrigerator for vaccines and heat-sensitive supplies  Lockable cabinets for storing medical records, medicines and supplies Owned by ROO Health Manager (e-mail parkerw@bp.com)  A supply of hot and cold potable drinking water  Adequate lighting and back-up power  Adequate environmental protection, including climate control (for example, air conditioning, air cooling or heating) and ventilation  Proper insulation and protection from vermin and insects  Telecommunication links, a computer, fax machine access and radio etc.  Patient bed shall have access from all sides.  Sufficient illumination to manage seriously ill patient at night.  Sufficient power sockets and electrical connections for medical equipments There must be enough medications on hand to respond to emergency situations (e.g. snakebite, dog bite and heart related emergencies) which are identified as a potential risk within the workplace. The medications should meet internationally accepted standards and be regularly checked against an inventory. All controlled medication must be stored, dispensed, administered and disposed of to legal and professional standards. Refer to Appendix 1’medications’ for further details 5. Medical Equipment & Other Items  Contents list  Cardiopulmonary resuscitation card  Individually wrapped sterile adhesive dressings  Sterile eye pads  Surgical tape  Triangular bandages  Medium and large sterile unmedicated dressings  Alcohol-free cleaning wipes  Surgical gloves  Scissors  Pocket mask  Burns packet (for example, Watergel or equivalent)  Bag for clinical waste First-aid kit – level 2 (includes level 1)  Guidance leaflet  Butterfly closures  Crepe bandages  Splints (inflatable or vacuum)  Thermometer (digital)  Forceps  Pocket light  Saline solution  Burn blanket (space blanket)  Tourniquet Owned by ROO Health Manager (e-mail parkerw@bp.com) Medical kit bag – (includes level 1 and 2) used by paramedics, nurses, physician assistants and emergency doctors)  Suture set  Sphygmomanometer (blood pressure meter)  Stethoscope  Oropharyngeal airway  Laryngeal mask  Pulse oximeter  Bag, mask and valve set (Ambubag)  Oxygen, tubing and manometer  Foot-operated suction unit with catheters  Laryngoscope with blades, bulbs and batteries  Endotracheal tubes  Intravenous giving sets  Intravenous cannulas  Intravenous fluids  Intramuscular injection needles and syringes  Medication as approved by the supervising health professional (with manufacturer’s prescribing information)  Rehydration sachets  Patient identity tags  Injury and treatment summary charts and report forms  Large torch with batteries  Container for contaminated needles and sharps The equipment inventory should at least include equipment supporting ACLS and ATLS. This includes, but is not limited to, the following.  AED (automatic external defibrillator) with spare set of defibrillation pads  ECG Machine (Portable)  Pulse Oximeter  Oxygen (medical) cylinders - ensure enough capacity to last transport  Patient Stretchers (Hard) for Trauma Patients  Hard Cervical Collars  Glucometer  Sphygmomanometer (blood pressure meter)  Stethoscope  Oropharyngeal airway  Bag, mask and valve set (Ambubag)  Oxygen (medical) cylinders with tubing and manometer  Suction unit with catheters  Laryngoscope with blades, bulbs and batteries  Endotracheal tubes Owned by ROO Health Manager (e-mail parkerw@bp.com)  Autoscope  Ophthalmoscope  Crepe bandages  Splints (inflatable or vacuum)  Thermometer (digital)  Forceps  Burn blanket / Water Jel Burn Kits  Tourniquet  Suture set  Intravenous giving sets  Intravenous cannulas  Intravenous fluids  Intramuscular injection needles and syringes  Necessary medications as (with manufacturer’s prescribing information)  Rehydration sachets (ORS)  Large torch with batteries  Container for contaminated needles and sharps  Other items as appropriate (based on risks) Refer to Appendix 1 6. Road Ambulance (For patients/ transport)  Should be suitable for the terrain, meet local laws and safety regulations and  Should be suitable for stretcher recovery work, with easy access for the stretcher as well as for equipment and the patient escort.  Should have secure storage space for the necessary equipment and material.  Seating should be available at the patient’s head for the patient escort  Should have a suitable and approved power supply for medical equipment.  Should have climate control systems (air conditioning and heating) and  The patient escort (medical personnel) should be able to communicate with the driver, either directly or by a headset link.  The patient escort or the driver (or both) should be able to communicate with outside support such as the worksite, hospital etc. The patient escort should have enough space to provide care and resuscitation. The driver should be appropriately trained in transporting patients.  The stretcher should be securely fastened and have a patient-restraining  Patient compartment shall have appropriate illumination to effectively manage  All other necessary equipments such as oxygen cylinder/s, suction unit etc. shall be safely fixed and within easy reach of the patient escort (medical personnel).  All electrical medical equipment should have a self-contained power supply.  Should have suitable provision for safe disposal of hazardous wastes and  Level 3 medical kit bag as detailed in page 9 Owned by ROO Health Manager (e-mail parkerw@bp.com) Attachment 1 - Medicines, Disposables & Equipment List Owned by ROO Health Manager (e-mail parkerw@bp.com) Attachment 1 - Medicines, Disposables Equipment List
Brand Name
Indicated Use
Pack Size
No Packs for
100 + persons
Gastro-Intestinal
Anusol ointment
Sodium Chloride + Dextrose Rehydration Salts Cardiac
Adenosine Injection - 3mg/ml (2ml vial)
Amiodarone Hydrochloride Injection - 300mg/10ml Glyceryl Trinitrate (Buccal) Tablets - 2mg Actilyse OR
100mgs
Metalyse
Respiratory Tract
Salbutamol injection 0.5 ml 100mcg
Analgesia
Paracetamol tablets BP 500 mg
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GP Clinic Medications
Attachment 1 - Medicines, Disposables Equipment List
Brand Name
Indicated Use
Pack Size
No Packs for
100 + persons
Tramadol Injection - 50mg/ml (if diamorphine and pethidine unavailable) CNS
Metoclopramide HCL injection (10mg in 2ml)
Chlorpromazine Hydrochloride Tablets - 25mg Dicycloverine Hydrochloride Tablets - 20mg Anti allergenics
Cetirizine HCl Tablets - 10mg
Antibiotics
Amoxycillin 250mg capsules
Benzylpenicillin (Pencillin G) - 600mg vial Anti-viral
Acyclovir tablets 800 mg
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GP Clinic Medications
Attachment 1 - Medicines, Disposables Equipment List
Brand Name
Indicated Use
Pack Size
No Packs for
100 + persons
Endocrine
Hydrocortisone injection powder - 100 mg vial
Fluids
Dextrose 50% - 50 ml
Compound sodium lactate compound sodium lactate Each Anti-inflammatories
Diclofenac Sodium Injection - 75mg/3ml
Eye preparations
Acyclovir Eye Ointment 3%
4500 Milligram 1
Pilocarpine Nitrate Eye Drops (Minims) - 4% ENT
Bonjela oral gel 10 g
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GP Clinic Medications
Attachment 1 - Medicines, Disposables Equipment List
Brand Name
Indicated Use
Pack Size
No Packs for
100 + persons
Skin
Aciclovir 5% Cream - 2g
parisitacide for scabies and lice 200 Millilitre Iraq - Medical Facilities Site Inventory
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GP Clinic Medications
Attachment 1 - Medicines, Disposables Equipment List
Brand Name
Indicated Use
Pack Size
No Packs for
100 + persons
Immunisation
Tetanus Toxoid ampoules 0.5 ml
Anaesthetic
Lignccaine 1% 1 mg/ml (5ml)
Antidotes
Naloxone Hydrochloride Injection - 400mcg
Miscellaneous
Betadine Antiseptic Solution
NOTES: Suggest a combination
Difficulty obtaining opiates in many countries therapy of midazolam
Consider conscious sedation for intubation. Conscious sedation such as
diazepam as listed should also have a reversal agent- Flumazenil 100mcgs and sublimaze (Fentanyl in the states) . Ketamine Iraq - Medical Facilities Site Inventory
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GP Clinic Medications
Attachment 1 - Medicines, Disposables Equipment List
Preferred Suppliers
Quantity
Comments
Required 25 - 100 +
1 00 persons
AIRWAY MANAGEMENT
Pocket masks O2 inlet and strap oxygen Laerdal Iraq - Medical Facilities Site Inventory
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Disposables
Attachment 1 - Medicines, Disposables Equipment List
Urinary catheter, self filling 10ml ballon ADHESIVE DRESSINGS
Bioclusive / Opsite dressing, 10cm x 12cm DRESSINGS GENERAL and BURNS
Field / Ambulance Dressing, Large, (Burn Iraq - Medical Facilities Site Inventory
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Disposables
Attachment 1 - Medicines, Disposables Equipment List
BLADES/GLOVES
REAGENTS/PAPER
SYRINGE/NEEDLES
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Disposables
Attachment 1 - Medicines, Disposables Equipment List
SPECIMEN COLLECTION
SUNDRY ITEMS
SUPPORT BANDAGES
SPECIMEN CONTAINERS
MISCELLANEOUS
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Disposables
Attachment 1 - Medicines, Disposables Equipment List
Disposable suture and minor instrument kits preferred rather than autoclaving non- disposable instruments Iraq - Medical Facilities Site Inventory
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Disposables
Attachment 1 - Medicines, Disposables Equipment List
Specifications (preferred
Comments
Qty per Qty Req 25-Quantity required
suppliers)
100+ persons
GENERAL ITEMS
Examination couch, three section, adjustable Pillows, non flammabale with plastic covers DEFIBRILLATOR, ECG, PULSE OXIMETER
Defribillator with ECG (12 lead simultaneous acquisition interpretative portable, 3 channel,) battery with mains backup, Pulse Oxymeter and preferably Dynamap AIRWAY MANAGEMENT
OXYGEN AND ANALGESIC GAS
Spindle key for "F" size O2 Cylinders Iraq - Medical Facilities Site Inventory
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Equipment
Attachment 1 - Medicines, Disposables Equipment List
Oxygen cylinder Trolley (for "F" size cyn) DIAGNOSTICS
INSTRUMENTS
Forceps artery spencer wells (straight) , 7" 1 Forceps needle holding, 6", (Gillies) Tubular gauze applicator metal ( Cylindrical ), 1 Size 01 - for fingers, sizes D-FSpirit lamp TRANSPORTING, SPLINTS
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Equipment
Attachment 1 - Medicines, Disposables Equipment List
SUNDRY ITEMS
Emergency response tabard, with the legend Emergency response tabard, with the legend 'FIRST AID' on the back .
Emergency response tabard, with the legend 1xRed 1x Green 1x Yellow 'TRIAGE' on the back .
SMART commander triage system OPHTHALMIC INSTRUMENTS
EAR, NOSE AND THROAT INSTRUMENTS
E0701
Nasal Speculum ( St.Clair Thompson), 2" Offshore - add bath, low reading thermometer and foil survival sheets Iraq - Medical Facilities Site Inventory
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Equipment
Appendix 1 - Medicines, Disposables Equipment List
No. Referencematerials
required
HSE - Offshore Installations and Pipeworks of Fitness for Offshore Work, October 2003 Accident and Emergency (ABC Major Trauma) Oxford handbook of Clinical Specialitiies British National Formulary, latest edition ACLS Protocols on A3 and laminated full set Subtotal Referencematerials
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References

Source: http://underpop.online.fr/b/britam-defence/iraq/contracts/bp/section-4.6-minimum-standards-for-medical-staff-facilities-allied-items.pdf