Health accessories

HOSPITAL PHARMACY PHARM D 4th PROFF.

1. Health supplies/ accessories
The dynamism of healthcare system for search of improved and new techniques for better patient care
has also led advancement in pharmacy practice. Under this influence, the concept of pharmacy practice
has evolved from drug orientation to patient orientation.
Role of pharmacist:
Now a pharmacist is not only involved merely in stocking and dispensing of drugs but also provides other
significant services for a better patient care. The provision of health-accessories or information
regarding them to the patients is one 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.
Recognizing the importance of health-accessories in a patient life, currently these are given a name of
parapharmaceuticals.
In a hospital pharmacy, a separate section can be established. A comprehensive health-accessory
department in a larger hospital may stock a wide variety of parapharmaceuticals. Stocking of a complete
line of such items is very costly
Alternatively, rather stocking. instituting a system of ordering of a selected item from a
vendor can help reduce inventory cost.
 To provide these services the pharmacist must acquire new skills and expertise which can
be obtained manufacturer-produced literature, catalog, through special courses given by
several health-accessory manufacturers. The students at graduate level must be aquatinted
with this knowledge concerning health accessories.

Division:The health accessories are divided into convalescent aids, orthopedic braces, home
diagnostic aids, first aid supplies etc
CONVALESCENT AIDS
For discussion purpose, convalescent aids include ambulatory aid (wheelchairs, walkers and cans and
crutches), hospital beds, patient lifters, and orthopedic braces.
AMBULATORY AIDS Canes Walking canes are very simple and light-weighed devices that serve two
important functions such as weight transfer and balance Weight transfer
CANE:
A cane provides a means to transfer weight off the weak limb of patient. To accomplish
this, weight must be put on the cane. Canes can be carried on weak limb side or on strong Hospital
Pharmacy side. In either case it weigh off from the weak limb side Balance Good balance in walking is no
more than kecping one's center of gravity over the supporting limbs. In case of a weak limb, the centre
of gravity moves from side to gravity forward side. The use of walking cane provides a balance by
providing adjusting the centre.
Types-
The canes may be made up of wooden or metallic.

2. Wooden canes made for males typically are heavier than those made for females, Metal canes come in
adjustable and non-adjustable models and may be monopod or multipod, Folding canes are available
also which fold into four sections and are made of wood, metal, or plastic.
Fitting: A cane should be neither too long nor too short. Each one must be adjusted or cut to fit
the patient. Fitting a cane is quite simple Using a cane. Carrying of cane on weak limb side narrows the
base of support (i.e., distance between the cane tip and his weak limb is small) and patient transfers his
weight from side to side, increasing possibility of falling. Using cane on side opposite to the side of weak
limb, the base of support will be wider and the center of gravity moves primarily forward rather than
side to side. Unless specifically instructed by the patient's physician or physical therapist to the contrary,
always instruct the patient to carry his walking cane on his strong side.
Crutches:
o Crutches are the devices used generally by the patients with temporary disabilities (eg.
fractured) or by patients who require more support than a cane.
o Sizes of crutches:The size of crutches ranges from toddler to large adult. The adult size crutches
are adjustable.
o material of crutches: Crutches can be made of wood or aluminum.
o Types of crutches:Crutches are of following various types either of that can be fixed or
adjustable.
o Forearm of crutch:The forearm crutch (also called a Canadian or Lofstrand crutch) supports
patient's wrists
o and elbows, attaching to the fleshy part of forearm by a collar or cuff. It is used by patients who
need crutches on long-term basis. The collar or cuff encircles the patient's forearm. The cuff
usually is open so as this opening either may face side or front. The forearm cuff also should be
adjusted so that the cuff comes to the middle of the patient's forearm, usually over the fleshiest
part. It is important that the cuff is open so the crutches may be thrown out of the way if the
patient falls.
o Handgrip of crutches: The handgrip projects from the main shaft and, unless specifically
instructed by the physician or physical therapist, the patient should be instructed to hold the
handgrip so that it points forward If only one crutch is used, it should be on the side opposite
the 70Distribution of Health Supplies weak leg.
o Two crutches: When two crutches are used, the patient should be instructed to step forward
o with his right leg and his left crutch, followed by his left leg and right crutch and so on,
o Axillary crutch: The axillary crutch is ordinary wooden or aluminum under arm commonly used
crutch
o and provides more support than the forearm crutch since it braces both wrist and
elbow.Adjustable crutches with reference to crutch tip under arm and handgrip are preferred as
they offer better and easier fitting. These must be fitted properly and the weight bearing should
be on the hand grips to avoid the danger of injury to the lymph glands, blood vessels or radial
nerves in the armpits that can lead to "crutch paralysis."
o Quad crutch: The quad crutch is a forearm crutch with a quadrangular (four-sided) base
attached to the
o main shaft with a flexible rubber mount. This design allows the quad feet to maintain constant
contact with the ground.
o Shepherd's crook crutch: The shepherd's crook crutch, a type of axillary crutch, resembles a
forearm crunch except that the hand grips point to the rear and axillary rather than forearm
support is provided.

3. o Fitting:A crutch must be properly measured to prevent 'crutch paralysis' as mentioned before
By following way
a) The patient should stand erect, supported by the wall or a chair, for the fitting.
b) The crutch tip (lower part) should falls 2 inches away from and 6 inches in front of
the toes.
c) The top rest should fall 2 inches below the axilia
d) The handgrips should be set so that the arms form roughly a 30° angle.
Crutch accessories include arm pads, handgrip cushions, and crutch tips.
Walkers
Walkers are lightweight devices that are made of metal tubing.
Types:
o Non-wheeled walker:The non-wheeled walkers have four widely placed legs.
o Wheeled walker : Also called a rollator walker made up of steel has wheels with multi-braking
system and variable wheel resistant This walker has adjustability to control the ambulatory gait
of the user. Some units are available with seats for intermittent resting and basket or tray
accessories to carry items for daily living needs. Wheeled walker have been made safe by
equipping them with braking mechanism that works due to an increased weight on normal hand
hods due to tripping of patients or losing of balance. Rollator walkers generally are
recommended for but are not limited to an individual's need for mobility outside the home
environment where a variety of surfaces could be an obstacle to the use of an aluminum-
wheeled walker
o Forcarm platform-attached walkers These walkers are used for patients with a disability or
injury involving the hand or wrist making it non weight-bearing The platform attachment allows
forearm to bear the weight instead of the hand or wrist.
Other types
 The other types include: Adult adjustable, nonadjustable, child adjustable, folding and
hemiplegic walkers.
 All walkers should be adjustable for individual user. A folding walker is much more convenient to
transport and to use in confined areas or on stairs.
Use
Recommended for the patients who need more support than a cane but have reasonably
good arm, hand, and wrist function. For non-wheeled walker, the patient holds onto the
walker and takes a step, then moves the walker and takes another step. A walker should
not to be used by a walking patient and if he were able to do this with relative security, a
cane probably would suffice. In terms of support, a walker can best be compared to a
simple cane. While a walker does provide a steadier support for the patient, like the cane,
it requires reasonably good arms, wrists and hands,
Wheelchairs
o Many different types of wheelchairs are available the use of which keeps the patient mobile. It is
used for the weak and infirm patients and elder people having less strength.
o A carefully selected chair has a prolonged and useful life and promotes the patient maximal
physical independence. The patient's disabilities, size, weight, activities and fitting user's
physical limitation and lifestyle are the main considerations in wheelchair selection. The
following options should be considered when selecting a wheelchair.
 Seat size
 Side-to-side width

4. A measurement important for the good seating posture and stability. The wheelchairs are available in
standard size but for a particular patient to avoid pressure on the hips or thighs, it must 2 inches wider
than the widest part of the patient's body (straight CTOSS the hips).
Knee-to-hip: Knee-to-hip measurement is the actual chair-seat depth and is approximately 2 to 3
inches less than this measurement in order to provide adequate support
Seat-to-elbow: This is an indicator for armrest height. Depending on seating posture, armrest height
should provide proper body support. An armrest height 1 inch more than the patient's seat-to-elbow
measurement will force the patient's elbows slightly forward, providing a natural support against
forward body fall, especially on descending ramps.
Floor-to-knee: This measurement determines the footrest adjustments from seat level. The minimum
footrest adjustment should be at least 2 inches less than this measurement in order to avoid pressure
against the underside of the legs. A good visual guide for proper footrest adjustment is to make sure
that the tops of the patient's thighs are horizontal and parallel to the floor
For other measurements a pharmacist can consult the manufacturer product literature.
Wheelchair dimensions
Certain wheelchair dimensions are important in preparing an individualized prescription
These are some of the components and measurements, which should be considered:
Arms:
The arms can be fixed, detachable, tilt-back, half, or full. The armrests and padding must also be
considered. A more convenient option is the adjustable-height arm that is available in the detachable
styles.
Wheels and casters
Tires can be made up of hard rubber or pneumatic (ie, air-filled) may be of reinforced
with spokes or can be composite based. The rear wheel generally is aligned with the back
upright. In some chairs wheels are set back to provide a larger base of support which is
needed to prevent tripping backwards. The front wheel, called caster can be of hard
rubber or pneumatic Casters are usually swirling type for easy turning.
Leg rests
The leg rests can be of different sizes adjustable in length elevating or non-elevating and are available
with padding A new concept the articulating elevating leg rest, extends automatically as the leg rest is
raised to fit the outstretched leg correctly
Foot supports
The foot supports can be of different sizes and are available with or without heel loops adjustable in
length, removable or fixed with or without heel-and-toe loops and oversized or non-skid foot plates.
Seat and side drapery
The seat and side drapery can be made up of mesh or vinyl.
Types based on operation
Manual wheelchair: A wheelchair widely used with specifications mentioned above the user runs this
wheelchair with his arms.
Battery operated: A batter operated wheelchair, also called an electric wheelchair is costly and used for
people can not move but need more mobility or the user with weak arms.
Three-wheeled battery-operated: Another wheelchair category is a three-wheeled battery-operated
scooter. These are often useful for people with limited mobility. A person who can walk a short distance
in home environment may be unable to spend several hours on his feet outside. This wheelchair
may be answer to such a situation

5. Wheelchair accessories
Cushions
Many types of cushions are available for a variety of purposes. The most important use is to protect the
patient from bruises (small abrasions, injuries, and swellings) and prevent the occurrence of pressure
sores due to a long-term confinement in a wheelchair. Wheelchairs should never be used over an
extended period of time without some kind of seat cushions. The most frequent occurrence of pressure
sores in wheelchair users is at the ischial tuberosities (below the buttocks). The other reasons for
pressure sores are a too wide or too small chair, or whose footrests are adjusted improperly. Footrests
that are too low cause the patient's legs to hang off the front edge of the seat upholstery. Thus,
interrupts circulation to the lower legs, and also cause some patients' knees to come together,
increasing the possibility of pressure sores between knees. Footrests which are too high force the
patient's knees up in the air and take body weight off the back of the thighs, resulting in all of the
patient's body weight being focused directly on the ischial tuberosities. A pharmacist should guide on
such matters to the patients.
Types of cushions wide variety of cushions is available in the market the most
commonly used are:
Sheepskin cushion or Pad prepared from natural sheepskin is a standard cushion used in hospitals for
decades, in wheelchairs and in the hospital bed. Its fluffy, thick hair provides a good relief from pressure.
Synthetic sheepskins are superior to natural sheepskin because their polyester fibers will not support
bacterial growth and their porous back permits adequate drainage and airflow The synthetic sheepskin
is helpful to the wheelchair user if placed on top of another cushion and works best when in direct
contact with the skin
Foam cushion is another type most commonly used. These are made of polyfoam or latex foam rubber
and are available in a variety of sent sizes and thickness
Convoluted foam cushion consists of rows of cones on the top surface, giving it an ege crate
appearance.
Coccyx cushion is a modification of foam cushions with its cut-out in one side. It usually comes with a
board insert, which provides stability in an inherently unstable cushion
Inflatable ring cushions are available in wheelchair-size, which effectively provides soft surface to the
patients
Silicone gel cushion, another cushion type intended to simulate adipose tissue (body fat) and so
perfectly distributes body weight. The resin-lilled cushion is lighter than silicone, yet also conforms to
the body contours. It does so more slowly, due to its nature, and maintains a "memory' enabling the
patient to jostle and move a bit while in his chair without roll typical of the water and gel cushions. It
does have a hard feel to the touch.
Alternating-pressure pad is an air mattress arranged in longitudinal tubes and connected to an air
pump, which alternately inflates and deflates alternate rows of tubes every 60 to 120 seconds. The
newer configurations include small pillows arranged longitudinally, in lieu of straight tubes works on the
principle that circulation in the tissues occurs in the absence of pressure. The pad is very effective in
preventing and treating pressure sores in hospital beds but is less effective in wheelchairs.
Chair tables
Special folding tables and trays with contoured fronts are available to enable the user of
wheelchair to get comfortably close and contribute to the non-ambulatory patient's
comfort and convenience
BED RIDDEN AIDS
Hospital beds and accessories
Types

6. Hospital beds may be manually or electrically operated both with fixed and variable height with
adjustable head or foot or both sections. The manually operated beds can be adjusted by a crank On the
other hand, electrically operated beds can easily be positioned by a patient independently while he or
she is in bed using hand-held controls. Use Hospital beds are used by patients who are confined to bed
for long periods of time. Also used for the patients, requiring elevation of the head or feet as part of
their treatment
Bed accessories
o Mattresses
o Polyfoam mattresses
are excellent for hospital beds. A mattress should be covered by plastic impregnated mattress ticking
and it is well to provide plastic mattress covers.
Bedside safety rails
The bed side safety rails are the safety devices that prevent the patient from falling out of bed. These
are made up of aluminum or steel. Three types of safety rails are available full length, half length and
"any bed' type. The former two have clamps. are made up of steel or aluminum and are used for
hospital beds. The later is made up of aluminum with cross-menmbers of steel and mostly are used on
the beds in home
Trapeze Bars
The trapeze bars are over bed bars used as an assist in sitting up and getting into and out of bed. These
height-adjustable steel-made bars are attached with the help of clamps to the headboard of a hospital
bed. A trapeze-bar floor-stand, which enables the trapeze to be used over any bed, is also available.
Bed cushions use:
Bed cushions are used for variety of purposes, eg. To
 Support the patient on bed for eating and working in bed in relatively comfort
 Support the patient's legs to achieve muscle flexion.
 Protect the patient from bruises and occurrence of pressure sores.
 Long-term confinement in a bed causes occurrence of pressure sores. Pressure sores result from
pressure at the thinly covered bony prominences of the body particularly on below the buttocks,
heels, elbows, shoulder blades and ears and back of head in children. The best cure is
prevention and can be achieved by use of cushions.
Various types of cushions are available and have been mentioned under accessories for wheelchairs.
Other bed accessories
Bed pans
Feces collecting bedpan: Feces collecting bedpans are made up of plastic, stainless steel. or porcelain
used for collection of feces of bedridden patients. A bedpan may be round bur usually it is oval in shape
The plastic, like rubber, tends to be warmer to the touch and therefore much more comfortable than
steel or porcelain in winter season
Eracture urne collecting) bedpan: Urine collecting bedpans are smaller, sloping and flarter containments
used for collection of urine of immobilized or overweight patients. When a hospital bed is not available
in the patient's home. four or five pillows behind his back will make use of a bedpan much easier
Over-bed tables: Variety of special tables and trays are available for patient comfort. Over-bed tables
are available to serve meals to patients These may of straddle the whole bed or patient's hips while he s
tn bed Some over-bed tables have a center section that can be raised to a slanted position for the
support of a book or magazine
Over-bed trays are used for spill-preventing safety aid. A solid or inflatable plastic shampoo tray
faciitates shampooing for patients who cannot leave their beds. The tray fits across bed mattress where
a pillow normally goes, and is designed to carry shampoo water to a drain at the side of the bed where it

7. may be collected in a plastic bucket. The patient's head rests in the shampoo tray having a depression
for the back of his neck.
Patient Lifters
The patient lifters are used to transfer a patient on bed, chair, or to commode. These lifters are either
hydraulic or screw-type. All lifters have an adjustable boom to which a patient-carrying seat is attached.
Lifter bases are usually U-shaped adjustable in width to spread wide and moved around a chair or
commode for a patient lift. Sling of seat design is an important consideration when choosing a patient
lifter. Slings may be one or two piece units, with and without head supports or may be with a
commode opening. Positioning the sling under the patient is achieved by rolling him on side so that on
rolling him back his spine will rest on the middle of the sling. He is rolled back over the folded portion of
the sling and to his other side while the folded part of the sling is unfolded, then he is returned to his
back. The sling is hooked up with the help of chains or straps and the boom is raised slowly and gently
until he is lifted off the mattress so as the patient arms inside the sling. When the patient is ready to be
lowered into a chair. commode or bed, the attendant should release the hydraulic valve carefully and
slowly, guiding the patient into position by his heel.
BATHROOM SAFETY EQUIPMENTS
The bathroom safety equipments are categorized into the equipments primarily need at toilet and in tub
for the patient safety. The bedside commodes used by the patients who cannot ambulate from his bed
to the bathroom are also included in the former class of safety products
The various bathroom safety equipments are as follows:
Elevated toilet seats
The elevated toilet can be attached with the usual bathroom commodes to make it easier for a patient
to sit or stand. Elevated toilet seats are used by people with limited mobility, those undergoing therapy
for hip fracture or who cannot stand from a low sitting position Toilet guard (safety) rail or hand rails
may be attached with the seat with regular toilet seat bolts. Some attaching types are designed with
detachable sides permitting the use of one side only for easy personal cleanliness independently. It may
be adjustable in height, and is padded for softness
Toilet safety rails The toilet safety rails or hand rails are attached either with the elevated seats as
mentioned above or can be affixed in wall to support the patients for support while walking through
bathroom or during getting on and off the toilet commodes.
Bathtub safety aids Safety aids for the bathtub may include adhesive strips and spots for the tub
bottom, mats prevent ships and a variety of tub seats and safety grab bars. Tub seats are either bench
opens with legs or seats that straddle the tub sides. The bath seats are more commonly used and are of
following types.
Bench type tub seat A tub bench seat is with or without a back and has either fixed (standard) or
adjustable-height legs. A transfer bench is used with two legs in the tub and two legs on the floor
outside the tub. The patient can sit down on that portion of the seat which is outside the tub, swing his
legs over the edge of the tub and slide across the bench until the entire body is "inside" the tub. Transfer
benches may have a commode opening to facilitate perineal cleansing
Powered tub bench This bath seat, also called bath lift, is powered by either water pressure or a
hydraulic pump which actually raises or lowers the height of the seat from the height of the tub side to
near the bottom
Bathtub grab bars The bathtub grab bars range from those, which attach to the side of the bathtub to
wall-mounted grab bars. Perhaps the most frequently used type is one that extends high enough for a
person standing outside the tub to get a firm support before stepping into the tub.
Commodes The commodes are portable toilets used by people with limited mobility and are unable to
walk from bed to the bathroom. Commodes contain a steel- or aluminum-frame (with or without a

8. backrest), a toilet seat, and a removable plastic bucket and cover. Some commodes are adjustable
height desirable to meet individual needs.
Types
Commodes with drop arms are available to facilitate lateral transfer to and from the commode To make
storage easier, folding commodes are also available. Commodes are available with padded and non-
padded backs. an upholstered seat and armrests and casters for moving about easily. However, the
commodes with wheels should be used with caution Another commode type is made up of wood and
resemble furniture Some commodes are designed for use both in the bedroom and in the bathroom.
These are either back less or have a removable back. so as not to interfere with the toilet tank. The
three-in-one commodes function as a commode or elevated toilet seat and have toilet safety rails
ORTHOPEDIC BRACES AND SURGICAL FITTINGS
By limiting patient movement, orthopedic braces and surgical fittings promote proper body alignment
Pharmacists must undergo special training before providing an orthopedic device. Depending on the
policies of the hospital. a pharmacist may stock orthopedic braces and surgical fittings used to promote
proper body alignment
BACK SUPPORTS
These devices are worn by patients with various spinal disorders.
CERVICAL COLLARS
Cervical collars are used to provide support or limit the range of motion of neck. These may be soft, or
of foam for a mild support and stability to neck. Hard, or rigid cervical collar provides semi-rigid support
to neck and is used for soft-tissue damage and injuries, A Philadelphia, (extrication) collar is used to
immobilize the neck and is commonly used in emergency situations.
SHOULDER IMMOBILIZERS Shoulder immobilizers keep shoulder and arm still. They are used for
separations, dislocations, and injuries to the shoulder area.
CLAVICLE SUPPORTS The clavicle supports (also called figure eight straps because of their appearance)
are used as aids for the reduction and stabilization of clavicle fractures.
TENNIS ELBOW Tennis elbow applies pressure to inflammed forearm muscles to provide support and
cushion to those with tennis elbow.
WRIST BRACES Wrist braces are used to reduce motion and to protect and stabilize wrist from sprains
and strains.
ARM SLINGS The arms slings are used to provide comfort and support during recuperation from
fractures. sprains and surgery
RIB BELTS Rib belts are used to stabilize rib fractures. Female rib belts are shaped to go under the
breasts
ABDOMINAL SUPPORTS Abdominal supports are used to provide abdominal support and to hold
surgical dress in place after surgery
KNEE BRACES Knee braces (also called knee cages) are used for stabilization and support of
may have spiral stays, hinges, and an open or closed patella horseshoe pad.
KNEE IMMOBILIZERS Knee immobilizers prevent any motion of the knee and are used for
fractures
HOME DIAGNOSTIC AIDS
THERMOMETER
A thermometer is an instrument for the measurement of body to to medical practice and should be kept
in every home
Types

9. Standard fever thermometer
This has sealed glass constriction chamber containing liquid mercury. In response to temperature
changes, the mercury rises or fails in a column as it expands or contracts. It will then remain at the
maximal temperature registered until it is shaken back into the reservoir at the bottom. The constriction
chamber also acts as a valve check, preventing the mercury from flowing back into the reservoir. Their
range is from about 34,45°C (94°F) to 41.11°C (10697). Graduations are in two-tenths of a degree it may
be an oral thermometer having a slender reservoir and bulb and is to be placed under the tongue and
left there for 3 minutes. In infants and children, it can also be placed under armpits. The rectal
thermometer has a blunt, pear-shaped bulb for added safety and retention. It is inserted into the
rectum and let there for 4 minutes. A lubricant such as petroleum jelly should be used to aid insertion
Rectal temperature is normally lº higher than oral temperature. The Security thermometer is also called
a stubby thermometer, as has a short and stubby bulb is used to take oral or rectal temperature of a
child or non-compliant patients. The basal temperature records temperatures ranging from 35.50°C
(96°F) to 37.78°C (100°F) and is used to estimate the time of ovulation. This thermometer can be placed
in the mouth or rectum. An electronic thermometer is based on the heat-led fluctuation in electric
current passing through a resistor and a digital readout The accurate and precisely measured
temperature is then displayed on display of the thermometer.Liquid crystal thermometer strips are to
be placed directly on the skin, calculate core body temperature from body surface. Disposable
thermometers are pre-sterilized and intended for single-use only. Disposable thermometer covers are
now also available which are thin, sterile plastic sheaths that can be placed over oral thermometers for
each temperature measurement and then discarded.
SELF-CARE TEST KITS Self-care test kits are sold in pharmacies for home use. These kits can easily
but empirically detect specific conditions or measure levels of certain substances for monitoring
purposes. The responsibility of hospital pharmacist while supplying to any patient, must advise that
these kits are not accurate and are not used as the substitution for laboratory tests The Pharmacists
should familiarize themselves with the test kits they sell and be prepared to counsel patients on their
use.
A pharmacist can furnish assistance in the area mentioned as:
 Proper use and interpretation of outcome.
 Referral for appropriate medical follow-up if necessary.
Types of home diagnostic aids available.

The types of various diagnostic kits are mentioned below:
PREGNANCY TEST KIT: Pregnancy test kit detects the presence of human chorionic gonadotropin hCG in
urine.
The pharmacist must instruct the consumers about the proper instructions carefully
OVULATION TEST KIT The ovulation test kit helps predict ovulation time and is used to increase the
chance of conception. This kit measures the surge of luteinizing hormone (LH) that occurs before
ovulation. The period of time for testing is individualized and is dependent on the length and regularity
of the menstrual cycle.
GLUCOSE TEST KIT/Blood glucose test kit Glucose test kit monitors the glucose levels of the diabetic
patients. The glucose test kit contains test strip on to which the patients place a drop of their blood. To
measure blood glucose levels, these strips change color or are inserted into a blood glucose monitor,
which gives a more accurate result.

10. Urine glucose tests The urine glucose test kit includes such products as Benedict's solution, tablets, and
usually test strips. These tests are not as accurate as blood glucose tests and are more appropriate for
stable diabetics with a low renal threshold.
KETONE TEST KIT The ketone test kit helps in detecting the presence of ketones in diabetic patient's
urine as an indication of glucose control.
BLOOD PRESSURE MONITORS
The patients with the histories of borderline or high blood pressure to monitor their condition, use the
blood pressure monitors. A physician to assess efficacy of a patient's therapy may use these readings.
Pharmacists can play an important role by giving instructions on proper technique and interpretation
of results.
The available blood pressure monitors include:
The mercury model:This model is the most accurate and does not require calibration. It is generally
more expensive and requires the use of a stethoscope, which could be difficult for patients with
impaired dexterity or hearing.
Electronic or digital model These models are the easiest to operate, and they do not require a
stethoscope.
DRESSINGS AND FIRST AID SUPPLIES
The first aid supplies are items to provide a first aid in home before a medical advice or bringing the
patient to the hospital. The first aid supplies include dressings, first aid kits, scissors, tweezers and
applicators.
pharmacy with a comprehensive health-accessories department should also stock first aid supplies. The
pharmacist is a distributor of these items and provider of the information on them. A pharmacist must
advise for use of a family medicine cabinet for storage of these items and drugs, particularly in homes
where there are children to avoid chances of poisoning. A family medicine cabinet is a place where
medicines are kept in locked or completely out of the reach of children. Pharmacist must also instruct for
appropriate and clear labeling of each bottle or box. Unused or expired medications and empty bottles
should be removed. Some pharmacists provide folders containing information on first aid, poison
antidotes and simple home medication.
COMPONENTS OF FIRST AID BOX
Heat applications
1. Hot-water bottles.
Hot bottle is an instrument for applying dry heat. Electric heating pads is alternate of hot-water
bottles. Made of rubber, hot-water bottle has an opening through which warm water is added
and a stopper securely sealed with a washer. Pharmacist must instruct that bare rubber should
never be allowed to come in contact with the skin, or burns may result. Rubber pads or a towel
wrapped around the hot-water bottle will give adequate passage of heat and comfort and
convenience.
2. Electric heating pads
The advantages of the electric heating pad over the hot-water bottle include 'no possibility of
leaking and precisely control over temperature.
3. Moist-Heat Packs
Various commercial moist-heat packs are now in common use in hospitals and nursing homes,
and are also available for use at home. These steam packs appear as compartmented, cloth bags
when are new and filled with tiny beads. When boiled in water, however, the beads become
hydrated and combine into a gelatinous substance which has the unique property of holding its
temperature far longer than any other pack -about 30 to 40 minutes. Moist-heat packs should never
be used directly in contact with the skin

11. Cold Application
In deep inflammation the effects of external application of either heat or cold are essentially similar, due
to reflexes arising from stimulation of nerves conducting temperature sensation. However, there are
some conditions (such as appendicitis) where the application of cold is the more desirable. The cold
application include:
o Ice cap The ice cap is a reusable instrument of application of cold. It is usually a circular rubber
or rubberized mackintosh cloth bag, circular in shape, with a large opening to admit cracked ice.
It usually requires a cover of some type such as thin rubber or cloth to protect the skin
o Tonsillectomy ice bag An adaptation of the ice cap is used for throat inflammation. It is the
collar-shaped rubber bag and it fits snugly around the neck, holding the ice on the parts
o Redi-Freeze ice pack These are also called cold packs, which are instead of using ice, filled with
glycerin or an isopropyl alcohol-water mixture. These are refrigerated until needed and are
exchanged for bags which have become warm in use. Thus, cold packs are immediately available
at all times, and the liquid contents conform mare readily to the contours of the body.
o Instant hot/cold packs Instant hot or cold packs containing an inner packet filled with an
activating fluid. When these packs are struck firmly on skin, inner packet is broken and the
activating fluid comes into contact with the base chemical to initiate a reaction. This chemical
reaction is either endothermic producing cold, or exothermic producing heat. They maintain
heat or cold for about 30 minutes, and then must be discarded. This modality provides heat and
cold therapy instantaneously in situations where refrigeration or heating units are not accessible