How well stocked our the theatre drug cupboards

1
How well stocked our the theatre drug cupboards?

• October 2006
• R. Marcus
• Birmingham Childrens Hospital

2
(No Transcript)
3
What should be there?

• ANAESTHETIC AGENTS
• THIOPENTONE
• 1 PROPOFOL
• MIDAZOLAM
• MUSCLE RELAXANTS
• ATRACURIUM
• ROCURONIUM
• SUXAMETHONIUM
• ATROPINE
• NEOSTIGMINE
• ANALGESICS
• FENTANYL
• MORPHINE

• LOCAL ANAESTHETICS
• 0.25 BUPIVICAINE
• 0.75 ROPIVICAINE
• OTHERS
• CYCLIZINE
• ONDANSETRON
• NALOXONE
• EPHEDRINE
• DEXAMETHASONE
• HYDROCORTISONE
• ADRENALINE
• I also looked for the following (not on regular
  list)
• Metaraminol/Phenylephrine
• Calcium chloride
• Sodium Bicarbonate

4
The good bits

• ALWAYS PRESENT
• Adrenaline
• Atropine
• Suxamethonium
• Morphine
• Neostigmine
• Cyclizine
• Hydrocortisone

• ABSENT ONLY ONCE
• Propofol
• Fentanyl
• Naloxone
• Dexamethasone

5
Cardiovasular drugs on all visits

• Ephedrine
• All except Th 2 and Endoscopy
• Metaraminol or Phenylephrine
• All except Th 4, 5, 6, 7 and endoscopy
• CaCl2
• All except Th 5, 6, 7
• NaHCO3
• All except Th 5, 7 (2/3 visits)

6
Most often missed drugs(that should be there)

• Ropivacaine 7.5mg/ml 9
• Bupivacaine 0.25 4
• Ondansetron 4
• Rocuronium 4
• Atracurium 3
• Midazolam 3

7
Good, bad and Ugly theatres

• Only 2 missing
• Th 3
• Endoscopy
• Th 7
• Only 3 missing
• Angio
• Th 8

• 4 missing
• Th 1
• Th 4
• Th 6
• 5 missing
• Th 5
• 7 missing
• Cardiac (LA drugs)

8
Conclusions

• We stock too many drugs
• Hatchet man Cray looking into this
• Theatres OK on the whole
• LA, ondansetron, midazolam and muscle relaxants
  missing most often
• What about Ca, Bic, Vaso-constrictors
• Need in Th 6 now it is emergency theatre
• Add to all theatres as most stock them?