A

HOSPITAL TRAINING REPORT-1

Submitted

In Partial Fulfillment of the Requirements for the award of Degree

of

Bachelor of Pharmacy (B. Pharm) 5thSemester

Session- 2023-24

Submitted by
Raunak Kumar Singh
(Roll No. :- 2100680500070)

Under the Guidance of

Mr. Avnesh Kumar
Associate Professor
Department of Pharmaceutical Technology

MIET, Meerut

Dr. A.P.J ABDUL KALAM TECHNICAL,

UNIVERSITY, LUCKNOW

FEBRUARY, 2024
 Dr. A.P.J. ABDUL KALAM TECHNICAL UNIVERSITY,
LUCKNOW(U.P)

DEPARTMENT OF PHARMACEUTICAL TECHNOLOGY

MEERUT INSTITUTE OF ENGINEERING & TECHNOLOGY, MEERUT

DECLARATION BY STUDENT

This is to certify that the project reportentitled “Hospital Training Report” is a bonafide and
genuine training work done by me under the guidance of Mr. Avnesh Kumar,Associate
Professor, Department of Pharmaceutical Technology, MIET, Meerut.

Signature of

Student

Date:-

Place: - MIET, Meerut

 Dr. A.P.J ABDUL KALAM TECHNICAL UNIVERSITY,
LUCKNOW(U.P)

DEPARTMENT OF PHARMACEUTICAL TECHNOLOGY

MEERUT INSTITUTE OF ENGINEERING & TECHNOLOGY, MEERUT

DECLARATION BY GUIDE

This is certified that the project report entitled “Hospital training Report” is a bonafide and
genuine training work done by Mr. Raunak Kumar Singh(Roll No.-2100680500070)
B.Pharm III-Year, V-Semester, Session: 2023-24 under my guidance.

Mr. Avnesh Kumar

Associate Professor
Dept. of Pharm. Tech.
M.I.E.T., Meerut
Date:-

Place:-MIET, Meerut
 Dr. A.P.J ABDUL KALAM TECHNICAL UNIVERSITY,
LUCKNOW(U.P)

DEPARTMENT OF PHARMACEUTICAL TECHNOLOGY

MEERUT INSTITUTE OF ENGINEERING &TECHNOLOGY,MEERUT

CERTIFICATE

This is certified that the project report entitled “Hospital training Report” is a bonafide and
genuine training work done by Mr. Raunak Kumar Singh (Roll No.-2100680500070)
B.Pharm 5th Semester, Session 2023-24 under the guidance of Mr. Avnesh kumar, Associate
Professor, Department of Pharmaceutical Technology, Meerut Institute of Engineering &
Technology, Meerut.

Prof. (Dr.) Vipin K. Garg Dr. Garima Garg

Head Principal
Dept. of Pharm. Tech. Dept. of Pharm.
Tech.
M.I.E.T., Meerut M.I.E.T., Meerut
 ACKNOWLEDGEMENT

The training was a great chance for learning and professional development. Therefore, I consider
myself as a very lucky as I was provided with an opportunity to be a part of it. I am also grateful
for having a chance to meet so many wonderful people and professional who led me through this
training period.

I am using this opportunity to express my deepest gratitude and special thanks to Meerut Institute
of Engineering & Technology, Meerut who gave us an opportunity so that we could learn
something so important.

I express my deepest thanks to Doctor for taking part in useful decision & giving necessary advices
and guidance and arranged all facilities to make life easier. I choose this moment to acknowledge
his contribution gratefully.

I perceive as this opportunity as a big milestone in my career development. I will strive to use
gained skills and knowledge in the best possible way, and I will continue to work on their
improvement.

Raunak Kumar Singh

B. Pharm 3rd Year

Rollno.: 2100680500070
 DEPARTMENT OF PHARMACEUTICAL TECHNOLOGY

MEERUT INSTITUTE OF ENGINEERING & TECHNOLOGY, MEERUT

Vision

 To be an outstanding department in the country that imparts high quality, need based, value
based and career based education with a strong research programme to produce self-reliant
competitive pharmacy professionals.

Mission

 To educate the graduate and undergraduates in the field of pharmaceutical sciences.

 To fulfill the requirement of skilled human resources with focus on sustainable quality
education, training and research of students coming from all socioeconomic levels.
 To convert students into socially responsible and self-reliant competent professionals, to bridge
the gap between the physician and patient and to improve industry institution interaction.
 DEPARTMENT OF PHARMACEUTICAL TECHNOLOGY

MEERUT INSTITUTE OF ENGINEERING & TECHNOLOGY, MEERUT

Program Educational Objectives (PEOs)

1. To produce pharmacy graduates who are able to apply principles of pharmaceutical sciences
utilizing modern tools and build their career in the field of pharmaceutical and allied
sectors.

2. To produce pharmacy Graduates who are able to demonstrate leadership skill, problem
solving skill and strong communication skills, along with professional and ethical values.

3. To produce pharmacy graduates who are able to fulfill the needs of skilled human resources
to serve the health care needs of the society.

4. To produce pharmacy graduates who will pursue higher studies and involve in research and
development.
 DEPARTMENT OF PHARMACEUTICAL TECHNOLOGY

MEERUT INSTITUTE OF ENGINEERING & TECHNOLOGY, MEERUT

PROGRAM OUTCOMES (POS)

1. Pharmacy Knowledge: Possess knowledge and comprehension of the core and basic
knowledge associated with the profession of pharmacy, including biomedical sciences;
pharmaceutical sciences; behavioral, social, and administrative pharmacy sciences; and
manufacturing practices.

2. Planning Abilities: Demonstrate effective planning abilities including time management,

resource management, delegation skills and organizational skills. Develop and implement
plans and organize work to meet deadlines.

3. Problem analysis: Utilize the principles of scientific enquiry, thinking analytically, clearly
and critically, while solving problems and making decisions during daily practice. Find,
analyze, evaluate and apply information systematically and shall make defensible decisions.

4. Modern tool usage: Learn, select, and apply appropriate methods and procedures,
resources, and modern pharmacy-related computing tools with an understanding of the
limitations

5. Leadership skills: Understand and consider the human reaction to change motivation
issues, leadership and team-building when planning changes required for fulfillment of
practice, professional and societal responsibilities. Assume participatory roles as
responsible citizens or leadership roles when appropriate to facilitate improvement in health
and wellbeing.

6. Professional Identity: Understand, analyze and communicate the value of their

professional roles in society (e.g. health care professionals, promoters of health,
educators, managers, employers, employees).

7. Pharmaceutical Ethics: Honour personal values and apply ethical principles in professional
and social contexts. Demonstrate behavior that recognizes cultural and personal variability
 in values, communication and lifestyles. Use ethical frameworks; apply ethical principles
while making decisions and take responsibility for the outcomes associated with the
decisions.

8. Communication: Communicate effectively with the pharmacy community and with society
at large, such as, being able to comprehend and write effective reports, make effective
presentations and documentation, and give and receive clear instructions.

9. The Pharmacist and society: Apply reasoning informed by the contextual knowledge to
assess societal, health, safety and legal issues and the consequent responsibilities relevant
to the professional pharmacy practice.

10. Environment and sustainability: Understand the impact of the professional pharmacy
solutions in societal and environmental contexts, and demonstrate the knowledge of, and
need for sustainable development.

11. Life-long learning: Recognize the need for, and have the preparation and ability to
engage in independent and life-long learning in the broadest context of technological
change. Selfassess and use feedback effectively from others to identify learning needs and
to satisfy these needs on an ongoing basis
 COURSE OUTCOMES

Student will be able to:

1. Explain prescriptions and dispensing of drugs in relation with modern hospitals.

2. Make use of concepts of different routes of injection in patient care and treatment.
3. Apply the principles of First aid in providing patient care in hospital and community.
4. Examine the patient observation charts for better personnel management.
5. Assess Simple diagnostic reports.
 Table of contents

S.NO TITLE PAGE NO.

1. Introduction 1-4

2. First aid 5-17

3. Handling of prescription 17-22

4. Study of patient observation chart 22

5. Simple diagnostic 23

6. Dispensing 24-27

7. Different Routes of Injection 27-31

 INTRODUCTION
A Hospital is a health care institution providing patient treatment with specialized medical and
nursing staff and medical equipment. The best-known type of hospital is the General hospital,
which typically has an emergency department to treat urgent health problems ranging from fire and
accident victims to a heart attack. A district hospital typically is the major health care facility in its
region, with a large number of beds for intensive care and additional beds for patients who need
long-term care. Specialized hospitals include trauma centers, rehabilitation hospitals, children's
hospitals, seniors' (geriatric) hospitals, and hospitals for dealing with specific medical needs such
as psychiatric treatment (see psychiatric hospital) and certain disease categories. Specialized
hospitals can help reduce health care costs compared to general hospitals. Hospitals are classified
as general, specialty, or government depending on the sources of income received.

Pathology is a branch of medical science primarily concerning the cause, origin and nature of
disease. It involves the examination of tissues, organs, bodily fluids and autopsies in order to study
and diagnose disease.

Here are some common tests performed during the hospital training in hospital.

1. Widal test

2. Pregnancy test

3. Glucose test

4. Blood group test

5. Urine test

1. Widal Test

Salmonella typhi and Salmonella paratyphi A, B and C cause enteric fever (typhoid and
paratyphoid) in human. Laboratory diagnosis of enteric fever includes Blood culture, Stool Culture
and Serological test. Widal test is a common agglutination test employed in the serological
diagnosis of enteric fever. This test was developed by Georges Ferdinand Widal in 1896 and helps
to detect presence of salmonella antibodies in a patient's serum.
2. Pregnancy test

Pregnancy tests look for a special hormone —human chorionic gonadotropin (HCG) — that only
develops in a person’s body during pregnancy. These tests can use either your pee or blood to look
for HCG. At-home pregnancy tests that use your pee are the most common type. When used
correctly, home pregnancy tests are 99% accurate.

3:Glucose test
Both low blood sugar (hypoglycemia) and high blood sugar (hyperglycemia) are of concern for
patients who take insulin. It is important, therefore, to carefully monitor blood glucose levels. In
general, patients with type 1 diabetes need to take readings four or more times a day. Patients
should aim for the following measurements:

• Pre-meal glucose levels of 70-130 mg/dL

• Post-meal glucose levels of less than 180 mg/dL

Different goals may be required for specific individuals, including pregnant women, very old and
very young people, and those with accompanying serious medical conditions.

Finger-Prick Test. A typical blood sugar test includes the following:

A drop of blood is obtained by pricking the finger.

• The blood is then applied to a chemically treated strip.

• Monitors read and provide results.

Home monitors are less accurate than laboratory monitors and many do not meet the standards of
the American Diabetes Association. However, they are usually accurate enough to indicate when
blood sugar is too low.

To monitor the amount of glucose within the blood a person with diabetes should test their blood
regularly. The procedure is quite simple and can often be done at home.

Some simple procedures may improve accuracy:

• Testing the meter once a month.

• Recalibrating it whenever a new packet of strips is used.

• Using fresh strips; outdated strips may not provide accurate results.

•Keeping the meter clean.

• Periodically comparing the meter results with the results from a laboratory

4: Blood group test

A test kit can be used to test blood type. It involves pricking finger and placing a drop of blood on a
card that will react to a serum on the card that contains antibodies. Now we will be given the
opportunity to test blood type using this technique.

In accordance with the original meaning of the word, hospitals were originally "places of
hospitality", and this meaning is still preserved in the names of some institutions such as the Royal
Hospital Chelsea, established in 1681 as a retirement and nursing home for veteran soldiers. Some
of the Training parts are as Follows:

 FIRST AID (wound dressing, artificial respiration) .

 HANDLING OF PRESCRIPTION
 STUDY OF PATIENT OBSERVATION CHART
 SIMPLE DIGNOSTIC
 DISPENSING
 DIFFERENT ROUTES OF INJECTION HOSPITAL TRAINING

FIRST AID
First aid is the first help or assistance given to any person suffering a sudden illness or injury, with
care provided to preserve life, prevent the condition from worsening, and/or promote recovery. It
includes initial intervention in a serious condition prior to professional medical help being
available, such as performing CPR while awaiting an ambulance, as well as the complete treatment
of minor conditions, such as applying a plaster to a cut. First aid is generally performed by the
layperson, with many people trained in providing basic levels of first aid, and others willing to do
so from acquired knowledge. Mental health first aid is an extension of the concept of first aid to
cover mental health. There are many situations which may require first aid, and many countries
have legislation, regulation, or guidance which specifies a minimum level of first aid provision in
certain circumstances. This can include specific training or equipment to be available in the
workplace (such as an Automated External Defibrillator), the provision of specialist first aid cover
at public gatherings, or mandatory first aid training within schools. First aid, however, does not
necessarily require any particular equipment or prior knowledge, and can involve improvisation
with materials available at the time, often by untrained persons. First aid can be performed on all
mammals, although this article relates to the care of human patients.

AIMS OF FIRST AID

The key aims of first aid can be summarized in three key points, sometimes known as 'the three
P's'.

Preserve life: The overriding aim of all medical care which includes first aid, is to save lives and
minimize the threat of death.

Prevent further harm: Prevent further harm also sometimes called prevent the condition from
worsening, or danger of further injury, this covers both external factors, such as moving a patient
away from any cause of harm, and applying first aid techniques to prevent worsening of the
condition, such as applying pressure to stop a bleed becoming dangerous.

Promote recovery: First aid also involves trying to start the recovery process from the illness or
injury, and in some cases might involve completing a treatment, such as in the case of applying a
plaster to a small wound.
SKILLS OF FIRST AID

Certain skills are considered essential to the provision of first aid and are taught ubiquitously.
Particularly the "ABC"s of first aid, which focus on critical life-saving intervention, must be
rendered before treatment of less serious injuries. ABC stands for Airway, Breathing, and
Circulation. The same mnemonic is used by all emergency health professionals. Attention must
first be brought to the airway to ensure it is clear. Obstruction (choking) is a life-threatening
emergency. Following evaluation of the airway, a first aid attendant would determine adequacy of
breathing and provide rescue breathing if necessary. Assessment of circulation is now not usually
carried out for patients who are not breathing, with first aiders now trained to go straight to chest
compressions (and thus providing artificial circulation) but pulse checks may be done on less
serious patients. Some organizations add a fourth step of "D" for Deadly bleeding or Defibrillation,
while others consider this as part of the Circulation step. Variations on techniques to evaluate and
maintain the ABCs depend on the skill level of the first aider. Once the ABCs are secured, first
aiders can begin additional treatments, as required. Some organizations teach the same order of
priority using the "3Bs": Breathing, Bleeding, and Bones (or "4Bs": Breathing, Bleeding, Burns,
and Bones). While the ABCs and 3Bs are taught to be performed sequentially, certain conditions
may require the consideration of two steps simultaneously. This includes the provision of both
artificial respiration and chest compressions to someone who is not

breathing and has no pulse, and the consideration of cervical spine injuries when ensuring an open
airway

SPECIFIC DISCIPLINES OF FIRST AID

There are several types of first aid (and first aider) which require specific additional training. These
are usually undertaken to fulfill the demands of the work or activity undertaken.

Aquatic/Marine first aid is usually practiced by professionals such as lifeguards, professional

mariners or in diver rescue, and covers the specific problems which may be faced after waterbased
rescue and/or delayed MedEvac.

Battlefield first aid takes into account the specific needs of treating wounded combatants and non-
combatants during armed conflict.

Hyperbaric first aid may be practiced by SCUBA diving professionals, who need to treat
conditions such as the bends.

Oxygen first aid is the providing of oxygen to casualties who suffer from conditions resulting in
hypoxia.
Wilderness first aid is the provision of first aid under conditions where the arrival of emergency
responders or the evacuation of an injured person may be delayed due to constraints of terrain,
weather, and available persons or equipment. It may be necessary to care for an injured person for
several hours or days.

•Mental health first aid is taught independently of physical first aid. How to support someone
experiencing a mental health problem or in a crisis situation. Also how to identify the first signs of
someone developing mental ill health and guide people towards appropriate help.

CONDITION THAT OFTEN REQUIRE FIRST AID

• Altitude sickness, which can begin in susceptible people at altitudes as low as 5,000 feet, can
cause potentially fatal swelling of the brain or lungs.

•Anaphylaxis, a life-threatening condition in which the airway can become constricted and the
patient may go into shock. The reaction can be caused by a systemic allergic reaction to allergens
such as insect bites or peanuts. Anaphylaxis is initially treated with injection of epinephrine.

• Battlefield -This protocol refers to treating shrapnel, gunshot wounds, burns, bone fractures, etc.
as seen either in the traditional battlefield setting or in an area subject to damage by largescale
weaponry, such as a bomb blast.

• Bone fracture, a break in a bone initially treated by stabilizing the fracture with a splint.

• Burns, which can result in damage to tissues and loss of body fluids through the burn site.

• Cardiac Arrest, which will lead to death unless CPR preferably combined with an AED is started
within minutes. There is often no time to wait for the emergency services to arrive as 92 percent of
people suffering a sudden cardiac arrest die before reaching hospital according to the American
Heart Association.

•Choking, blockage of the airway which can quickly result in death due to lack of oxygen if the
patient's trachea is not cleared, for example by the Heimlich Maneuver.

• Childbirth.

•Cramps in muscles due to lactic acid build up caused either by inadequate oxygenation of muscle
or lack of water or salt.

•Diving disorders, drowning or asphyxiation.

•Gender-specific conditions, such as dysmenorrhea and testicular torsion.

•Heart attack, or inadequate blood flow to the blood vessels supplying the heart muscle.
• Heat stroke, also known as sunstroke or hyperthermia, which tends to occur during heavy exercise
in high humidity, or with inadequate water, though it may occur spontaneously in some chronically
ill persons. Sunstroke, especially when the victim has been unconscious, often causes major
damage to body systems such as brain, kidney, liver, gastric tract. Unconsciousness for more

than two hours usually leads to permanent disability. Emergency treatment involves rapid cooling
of the patient.

•Hair tourniquet a condition where a hair or other thread becomes tied around a toe or finger tightly
enough to cut off blood flow.

• Heat syncope, another stage in the same process as heat stroke, occurs under similar conditions as
heat stroke and is not distinguished from the latter by some authorities.

•Heavy bleeding, treated by applying pressure (manually and later with a pressure bandage) to the
wound site and elevating the limb if possible

•Hyperglycemia (diabetic coma) and Hypoglycemia (insulin shock).

•Hypothermia, or Exposure, occurs when a person's core body temperature falls below 45.7 °C
(92.6 °F). First aid for a mildly hypothermic patient includes rewarming, which can be achieved by
wrapping the affected person in a blanket, and providing warm drinks, such as soup, and high
energy food, such as chocolate. However, rewarming a severely hypothermic person could result in
a fatal arrhythmia, an irregular heart rhythm.

• Insect and animal bites and stings.

• Joint dislocation.

• Poisoning, which can occur by injection, inhalation, absorption, or ingestion.

• Seizures, or a malfunction in the electrical activity in the brain. Three types of seizures include a
grand mal (which usually features convulsions as well as temporary respiratory abnormalities,
change in skin complexion, etc.) and petit mal (which usually features twitching, rapid blinking,
and/or fidgeting as well as altered consciousness and temporary respiratory abnormalities).

• Muscle strains and Sprains, a temporary dislocation of a joint that immediately reduces
automatically but may result in ligament damage.

• Stroke, a temporary loss of blood supply to the brain.

• Toothache, which can result in severe pain and loss of the tooth but is rarely life-threatening,
unless over time the infection spreads into the bone of the jaw and starts osteomyelitis.
•Wounds and bleeding, including lacerations, incisions and abrasions, Gastrointestinal bleeding,
avulsions and Sucking chest wounds, treated with an occlusive dressing to let air out but not in.

FIRST AID KIT

A first aid kit is a collection of supplies and equipment that is used to give medical treatment, and
can be put together for the purpose by an individual or organization or purchased complete. There
is a wide variation in the contents of first aid kits based on the knowledge and experience of those
putting it together, the differing first aid requirements of the area where it may be used and
variations in legislation or regulation in a given area. The international standard for first aid kits is
that they should be identified with the ISO graphical symbol for first aid (from ISO 7010) which is
an equal white cross on a green background, although many kits do not comply with this standard,
either because they are put together by an individual or they predate the standards. First aid kits can
be assembled in almost any type of container, and this will depend on whether they are
commercially produced or assembled by an individual. Standard kits often come in durable plastic
boxes, fabric pouches or in wall mounted cabinets. The type of container will vary depending on
purpose, and they range in size from wallet sized through to large rucksacks. It is recommended
that all kits are in a clean, waterproof container to keep the contents safe and aseptic.Kits should
also be checked regularly and restocked if any items are damaged or are expired out of date.

CONTENTS OF FIRST AID KIT

•Commercially available first aid kits available via normal retail routes have traditionally been
intended for treatment of minor injuries only. Typical contents include adhesive bandages, regular
strength pain medication, and gauze and low grade disinfectant. Specialized first aid kits are
available for various regions, vehicles or activities, which may focus on specific risks or concerns
related to the activity. For example, first aid kits sold through marine supply stores for use in
watercraft may contain seasickness remedies. AIRWAY, BREATHING AND CIRCULATION.

•First aid treats the ABCs as the foundation of good treatment. For this reason, most modern
commercial first aid kits (although not necessarily those assembled at home) will contain a suitable
infection barrier for performing artificial respiration as part of cardiopulmonary resuscitation,
examples include:

• Pocket mask

• Face shield

• Advanced first aid kits may also contain items such as:

Or pharyngeal airway
• Nasopharyngeal airway

• Bag valve mask

• Manual aspirator or suction unit

• Sphygmomanometer (blood pressure cuff).

• Stethoscope

• The common kits mostly found in the homes may contain: Alcohol, Band-Aids, Cotton Balls,
Cotton Swabs, Iodine, Bandage, and Hydrogen Peroxide.

TRAUMA INJURIES

• Trauma injuries, such as bleeding, bone fractures or burns, are usually the main focus of most
first aid kits, with items such as bandages and dressings being found in the vast majority of all kits.

• Adhesive bandages (Band-Aids, sticking plasters) - can include ones shaped for particular body
parts, such as knuckles o Moleskin-for blister treatment and prevention.

Dressings (sterile, applied directly to the wound) o Sterile eye pads o Sterile gauze pads o Sterile
non-adherent pads, containing a non-stick teflon layer of Petrolatum gauze pads, used as an
occlusive (air-tight) dressing for sucking chest wounds, as well as a non-stick dressing

. Bandages (for securing dressings, not necessarily sterile) o Gauze roller bandages - absorbent,
breathable, and often elastic o Elastic bandages - used for sprains, and pressure bandages o
Adhesive, elastic roller bandages (commonly called 'Vet wrap') very effective pressure bandages
and durable, waterproof bandaging. Triangular bandages - used as slings, tourniquets, to tie splints,
and many other uses. -

• Butterfly closure strips - used like stitches to close wounds, usually only included for higher level
response as can seal in infection in uncleansed wounds.

• Saline-used for cleaning wounds or washing out foreign bodies from eyes.

Soap - used with water to clean superficial wounds once bleeding is stopped.

• Antiseptic wipes or sprays for reducing the risk of infection in abrasions or around wounds. Dirty
wounds must be cleaned for antiseptics to be effective.

• Burn dressing, which is usually a sterile pad soaked in a cooling gel.

• Adhesive tape, hypoallergenic.

• Hemostatic agents may be included in first aid kits, especially military or tactical kits, to promote
clotting for severe bleeding..

PERSONAL PROTECTIVE EQUIPMENT

• The use of personal protective equipment or PPE will vary by kit, depending on its use and
anticipated risk of infection. The adjuncts to artificial respiration are covered above, but other
common infection control PPE includes:

• Gloves which are single use and disposable to prevent cross infection Goggles or other eye
protection

Surgical mask or N95 mask to reduce possibility of airborne infection transmission (sometimes
placed on patient instead of caregivers. For this purpose the mask should not have an exhale valve).

● Apron

INSTRUMENTS AND EQUIPMENTS

• Trauma shears for cutting clothing and general use.

• Scissors are less useful but often included.

• Tweezers, for removing splinters amongst others.

Lighter for sanitizing tweezers or pliers etc.

• Alcohol pads for sanitizing equipment, or unbroken skin. This is sometimes used to debride
wounds, however some training authority'sadvice against this as it may kill cells which bacteria can
then feed on.

• Irrigation syringe - with catheter tip for cleaning wounds with sterile water, saline solution, or a
weak iodine solution. The stream of liquid flushes out particles of dirt and debris. • Torch (also
known as a flashlight).

• Instant-acting chemical cold packs.

• Alcohol rub (hand sanitizer) or antiseptic hand wipes.

• Thermometer

Space blanket (lightweight plastic foil blanket, also known as "emergency blanket"). Penlight. .
Cotton swab

• Cotton wool, for applying antiseptic lotions.

• Safety pins, for pinning bandages.

MEDICATION

Medication can be a controversial addition to a first aid kit, especially if it is for use on members of
the public. It is, however, common for personal or family first aid kits to contain certain
medications. Dependent on scope of practice, the main types of medicine are lifesaving
medications, which may be commonly found in first aid kits used by paid or assigned first aiders
for members of the public or employees, painkillers, which are often found in personal kits, but
may also be found in public provision and lastly symptomatic relief medicines, which are generally
only found in personal kits.

LIFE SAVING:

• Aspirin primarily used for central medical chest pain as an anti-platelet.

● Epinephrine auto injector (brand name Epipen) - often included in kits for wilderness use and in
places such as summer camps, to temporarily reduce airway swelling in the event of anaphylactic
shock. Note that epinephrine does not treat the anaphylactic shock itself, it only opens the airway to
prevent suffocation and allow time for other treatments to be used or help to arrive. The effects of
epinephrine (adrenaline) are short-lived, and swelling of the throat may return, requiring the use of
additional epipens until other drugs can take effect, or more advanced airway methods (such as
intubation) can be established.

•Diphenhydramine (Brand name:-Benadryl) - Used to treat or prevent anaphylactic shock. Best

administered as soon as symptoms appear when impending anaphylactic shock is suspected Once
the airway is restricted, oral drugs can no longer be administered until the airway is clear again,
such as after the administration of an epipen. A common recommendation for adults is to take two
25mg pills.

Non-solid forms of the drug, such as liquid or dissolving strips, may be absorbed more rapidly than
tablets or capsules and therefore more effective in an emergency.

PAIN KILLERS:

• Paracetamol (also known as Acetaminophen) is one of the most common pain killing medication,
as either tablet or syrup.

• Anti-inflammatory painkillers such as Ibuprofen, Naproxen or other NSAIDs can be used as part
of treating sprains and strains.

• Codeine which is both a painkiller and anti-diarrheal.

SYMPTOMATIC RELIEF:

Anti-diarrhea medication such as Loperamide - especially important in remote or third world

locations where dehydration caused by diarrhea is a leading killer of children

• Oral rehydration salts

• Antihistamine, such as diphenhydramine

Poison treatments

• Absorption, such as activated charcoal.

• Emetics to induce vomiting, such as syrup of ipecac although first aid manuals now advise against
inducing vomiting.

• Smelling Salts (ammonium carbonate).

ARTIFICIAL RESPIRATION

Artificial ventilation, also called artificial respiration is any means of assisting or stimulating
respiration, a metabolic process referring to the overall exchange of gases in the body by
pulmonary ventilation, external respiration, and internal respiration. It may take the form of
manually providing air for a person who is not breathing or is not making sufficient respiratory
effort on his/her own, or it may be mechanical ventilation involving the use of a mechanical
ventilator to move air in and out of the lungs when an individual is unable to breathe on their own,
for example during surgery with general anesthesia or when an individual is in a coma. Pulmonary
Anton ventilation (and hence external parts of respiration) is achieved through manual insufflation
of the lungs either by the rescuer blowing into the patient's lungs (mouth-to mouth resuscitation), or
by using a mechanical device to do so. This method of insufflation has been proved more effective
than methods which involve mechanical manipulation of the patient's chest or arms, such as the
Silvester method.

In some situations, mouth to mouth is also performed separately, for instance in near-drowning and
opiate overdoses.

The performance of mouth to mouth in its own is now limited in most protocols to health
professionals, whereas lay first aiders are advised to undertake full CPR in any case where the
patient is not breathing sufficiently.

Mechanical ventilation: Mechanical ventilation is a method to mechanically assist or replace

spontaneous breathing. This may involve a machine called a ventilator or the breathing may be
assisted by a registered nurse, physician, physician Associate, respiratory therapist, paramedic, or
other suitable person compressing a bag valve mask or set of bellows.

Mechanical ventilation is termed "invasive" if it involves any instrument penetrating through the
mouth (such as an endotracheal tube) or the skin (such as a tracheostomy tube). There are two main
modes of mechanical ventilation within the two divisions: positive pressure ventilation,

Where air (or another gas mix) is pushed into the trachea, and negative pressure ventilation, where
air is, in essence, sucked into the lungs. Tracheal intubation is often used for short term mechanical
Ventilation. A tube is inserted through the nose (nasotracheal intubation) or mouth (orotracheal
intubation) and advanced into the trachea. In most cases tubes with inflatable cuffs are used for
protection against leakage and aspiration. Intubation with a cuffed tube is thought to provide the
best protection against aspiration. Tracheal tubes inevitably cause pain and coughing. Therefore,
unless a patient is unconscious or anesthetized for other reasons, sedative drugs are usually given to
provide tolerance of the tube. Other disadvantages of tracheal intubation include damage to the
mucosal lining of the nasopharynx or oropharynx and subglottic stenosis. There are two main types
of mechanical ventilation: positive pressure ventilation, where air (or another gas mix) is pushed
into the lungs through the airways, and negative pressure ventilation, where air is, in essence,
sucked into the lungs by stimulating movement of the chest. Apart from these two main types there
are many specific modes of mechanical ventilation, and their nomenclature has been revised over
the decades as the technology has continually developed.

Mechanical ventilation is indicated when the patient's spontaneous ventilations inadequate to

maintain life. It is also indicated as prophylaxis for imminent collapse of other physiologic
functions, or ineffective gas exchange in the lungs. Because mechanical ventilation serves only to
provide assistance for breathing and does not cure a disease, the patient's underlying condition
should be correctable and should resolve over time. In addition, other factors must be taken into
consideration because mechanical ventilation is not without its complications

In general, mechanical ventilation is instituted to correct blood gases and reduce the work of
breathing.

Common medical indications for use include:

•Acute lung injury (including ARDS, trauma)

•Apnea with respiratory arrest, including cases from intoxication

•Acute severe asthma, requiring intubation

•Acute on chronic respiratory acidosis most commonly with Chronic obstructive pulmonary disease
(COPD) and obesity hypoventilation syndrome
•Acute respiratory acidosis with partial pressure of carbon dioxide (PCO 2) > 50 mmHg and pH <
7.25, which may be due to paralysis of the diaphragm due to Guillain-Barré syndrome, myasthenia
gravis, motor neuron disease, spinal cord injury, or the effect of anesthetic and muscle relaxant
drugs

• Increased work of breathing as evidenced by significant tachypnea, retractions, and other physical
signs of respiratory distress[³]

• Hypoxemia 2) 2) = 1.0 with arterial partial pressure of oxygen and (PaO55 mm Hg with
supplemental fraction of inspired oxygen (FIO

•Hypotension including sepsis, shock, congestive heart failure

•Neurological diseases such as muscular dystrophy and amyotrophic lateral sclerosis.

HANDLING OF PRESCRIPTION

A prescription is a health-care program implemented by a physician or other qualified health care

practitioner in the form of instructions that govern the plan of care for an individual patient. The
term often refers to a health care provider's written authorization for a patient to purchase a
prescription drug from a pharmacist. Prescriptions may be entered into an electronic medical record
system and transmitted electronically to a pharmacy. Alternatively, a prescription may be
handwritten on preprinted prescription forms that have been assembled into pads, or printed onto
similar forms using a computer printer. In some cases, a prescription may be transmitted from the
physician to the pharmacist orally by telephone; this practice may increase the risk of medical
error. The content of a prescription includes the name and address of the prescribing provider and
any other legal requirement such as a registration number (e.g. DEA Number in the United States).
Unique for each prescription is the name of the patient. Each prescription is dated and some
jurisdictions may place a time limit on the prescription. In the past, prescriptions contained
instructions for the pharmacist to use for compounding the pharmaceutical product but most
prescriptions now specify pharmaceutical products that were manufactured and require little or no
preparation by the pharmacist. Prescriptions also contain directions for the patient to follow when
taking the drug. These directions are printed on the label of the pharmaceutical product.

The word "prescription", from "pre-" ("before") and "script" ("writing, written"), refers to the fact
that the prescription is an order that must be written down before a compound drug can be
prepared. Those within the industry will often call prescriptions simply "scripts".

'Rx' is a symbol meaning "prescription". It is sometimes transliterated as "Rx" or just "Rx". This
symbol originated in medieval manuscripts as an abbreviation of the Late Latin verb recipe, the
imperative form of recipe, "to take" or "take thus". Literally, the Latin word recipe means simply
"Take...!" and medieval prescriptions invariably began with the command to "take" certain
materials and compound them in specified ways.

Contents

In some countries, drug companies use direct-to-prescriber advertising in an effort to convince

prescribers to dispense as written with brand-name products rather than generic drugs. Many brand
name drugs have cheaper generic drug substitutes that are therapeutically and biochemically
equivalent. Prescriptions will also contain instructions on whether the prescriber will allow the
pharmacist to substitute a generic version of the drug. This instruction is communicated in a
number of ways. In some jurisdictions, the preprinted prescription contains two signature lines: one
line has "dispense as written" printed underneath; the other line has "substitution permitted"
underneath. Some have a preprinted box "dispense as written" for the prescriber to check off (but
this is easily checked off by anyone with access to the prescription).

Other jurisdictions the protocol is for the prescriber to handwrite one of the following phrases:
"dispense as written", "DAW", "brand necessary", "do not substitute", "no substitution", "medically
necessary", "do not interchange". In other jurisdictions they may use completely.

Different languages, never mind a different formula of words. In some jurisdictions, it may be a
legal requirement to include the age of child on the prescription. For pediatric prescriptions some
advice the inclusion of the age of the child if the patient is less than twelve and the age and months
if less than five. (In general, including the age on the prescription is helpful.) Adding the weight of
the child is also helpful. Prescriptions often have a "label" box. When checked, the pharmacist is
instructed to label the medication. When not checked, the patient only receives instructions for
taking the medication and no information about the prescription itself. Some prescribers further
inform the patient and pharmacist by providing the indication for the medication; i.e. what is being
treated. This assists the pharmacist in checking for errors as many common medications can be
used for multiple medical conditions. Some prescriptions will specify whether and how many
"repeats" or "refills" are allowed; that is whether the patient may obtain more of the same
medication without getting a new prescription from the medical practitioner. Regulations may
restrict some types of drugs from being refilled. In group practices, the preprinted portion of the
prescription may contain multiple prescribers' names. Prescribers typically circle themselves to
indicate who is prescribing or there may be a checkbox next to their name.

Who can write prescriptions (that may legally be filled with prescription-only items?)

National or local (i.e. state or provincial) legislation governs who can write a prescription. In the
United States, physicians (M.D., D.O., or D.P.M) have the broadest prescriptive authority. All 50
states and the District of Columbia allow licensed certified Physician Associates (PAS) prescription
authority (with some states, limitations exist to controlled substances). All 50 states allow
registered certified nurse practitioners and other advanced practice registered nurses (such as
certified nurse-midwives) prescription power (with some states including limitations to controlled
substances). Many other healthcare professions also have prescriptive authority related to their area
of practice. Veterinarians and dentists have prescribing power in all 50 states and the District of
Columbia. Clinical pharmacists are allowed to prescribe in some states through the use of a drug
formulary or collaboration agreements. Florida pharmacists can write prescriptions for a limited set
of drugs. In all states, optometrists prescribe medications to treat certain eye diseases, and also
issue spectacle and contact lens prescriptions for corrective eyewear. Several states have passed
RxP legislation, allowing clinical psychologists (PhDs or PsyDs) who are registered as medical
psychologists and have also undergone specialized training in script-writing to prescribe drugs to
treat emotional and mental disorders. Chiropractors may have the ability to write a prescription,
depending on scope of practice laws in a jurisdiction.

LEGIBILITY

Prescriptions, when handwritten, are notorious for being often illegible. In the US, illegible
handwriting is at least indirectly responsible for the deaths of 7,000 people annually, according to a
July 2006 report from the National Academies of Science's Institute of Medicine (IOM).
Historically, physicians used Latin words and abbreviations to convey the entire prescription to the
pharmacist. Today, many of the abbreviations are still widely used and must be understood to
interpret prescriptions. At other times, even though some of the individual letters are illegible, the
position of the legible letters and length of the word is sufficient to distinguish

The medication based on the knowledge of the pharmacist. When in doubt, pharmacists call the
medical practitioner. Some jurisdictions have legislated legible prescriptions (e.g. Florida). Some
have advocated the elimination of handwritten prescriptions altogether and computer printed
prescriptions are becoming increasingly common in some places

Conventions for avoiding ambiguity

Over the years, prescribers have developed many conventions for prescription-writing, with the
goal of avoiding ambiguities or misinterpretation.

These include:

•Careful use of decimal points to avoid ambiguity:

• Avoiding unnecessary decimal points: a prescription will be written as 5 mL instead of 5.0 mL to

avoid possible misinterpretation of 5.0 as 50.
• Always using zero prefix decimals: e.g. 0.5 instead of .5 to avoid misinterpretation of .5 as 5.

Avoiding trailing zeros on decimals: e.g. 0.5 instead of .50 or 0.50 to avoid misinterpretation
of .50 as 50.

•"mL" is used instead of "cc" or "cm³" even though they are technically equivalent to avoid
misinterpretation of 'c' as '0' or the common medical abbreviation for "with" (the Latin "cum"),
which is written as a 'c' with a bar above the letter. Further, cc could be misinterpreted as "c.c.",
which is a rarely used abbreviation for "take with meals" (the Latin "cum ciao")

• Directions written out in full in English (although some common Latin abbreviations are listed
below).

• Quantities given directly or implied by the frequency and duration of the directions.

• Where the directions are "as needed", the quantity should always be specified.

• Where possible, usage directions should specify times (7 am, 3 pm, and 11 pm) rather than simply
frequency (three times a day) and especially relationship to meals for orally consumed medication.

• The use of permanent ink.

• Avoiding units such as "teaspoons" or "tablespoons."

• Writing out numbers as words and numerals ("dispense #30 (thirty)") as in a bank draft or cheque.

• The use of the degree symbol (°), which is commonly used as an abbreviation for hours (e.g., "q
2-4°" for every 2 4 hours), should not be used, since it can be confused with a '0'. Further, the use
of the degree symbol for primary, secondary, and tertiary (1°, 2°, and 3°) is discouraged, since the
former could be confused with quantities (i.e. 10, 20 and 30, respectively).

• The use of apothecary/avoirdupois units and symbols of measure - pints (O), ounces (3), drams
(3), scruples (3), grains (gr), and minims (m) -- is discouraged given the potential for confusion.
For example, the abbreviation for a grain ("gr") can be confused with the gram, abbreviated g, and
the symbol for minims (m), which looks almost identical to an 'm', can be confused with
micrograms or meters. Also, the symbols for ounce (3) and dram (3) can easily be confused with
the

numeral '3', and the symbol for pint (O) can be easily read as a '0'. Given the potential for errors,
metric equivalents should always be used.

STUDY OF PATIENT OBSERVATION AND RESPONSE CHART

In medicine, monitoring is the observation of a disease, condition or one or several medical
parameters over time. It can be performed by continuously measuring certain parameters by using a
medical monitor (for example, by continuously measuring vital signs by a bedside monitor), and/or
by repeatedly performing medical tests (such as blood glucose monitoring with glucose meter in
people with diabetes mellitus). Monitoring and documenting physiological observations is a key
component of recognition and response systems. An observation and response chart is a document
that allows the recording of patient observations, and specifies the action to be taken in response to
deterioration from the norm. The purpose of these charts is to support accurate and timely
recognition of clinical deterioration, and prompt action when deterioration is observed. The way in
which observation charts are designed and used can contribute to both the poor recording of
observations and failure to interpret them correctly.

Observation and response charts should:

• Be designed according to human factor principle.

• Have the capacity to record the core physiological observations specified in element 1.6 of the
National Consensus Statement (respiratory rate, oxygen saturation, heart rate, blood pressure,
temperature and level of consciousness).

• Specify the physiological parameters and other factors that trigger an escalation of care.

• Specify the actions require when care is escalated.

Prototype general observation chart section

 SIMPLE DIGNOSTICS REPORTS

Many mental health professionals use the manual to determine and help communicate a patient's
diagnosis after an evaluation; hospitals, clinics, and insurance companies in the US also generally
require a DSM diagnosis for all patients treated. The DSM can be used clinically in this way, and
also to categorize patients using diagnostic criteria for research purposes. Studies done on specific
disorders often recruit patients whose symptoms match the criteria listed in the DSM for that
disorder. An international survey of psychiatrists in 66 countries comparing use of the ICD-10 and
found the former was more often used for clinical diagnosis while the latter was more valued for
research A diagnostic test is a procedure performed to confirm, or determine the presence of
disease in an individual suspected of having the disease, usually following the report of symptoms,
or based on the results of other medical tests. This includes posthumous diagnosis. Such tests
include

• Utilizing nuclear medicine techniques to examine a patient having a lymphoma.

• Measuring the blood sugar in a person suspected of having diabetes mellitus, after periods of
increased urination.

• Taking a complete blood count of an individual experiencing a high fever, to check for a bacterial
infection.

The Diagnostic Report resource is a suitable for the following kinds of diagnostic reports:

• Laboratory (Clinical Chemistry, Hematology, Microbiology etc.

•Pathology / Histopathology / related disciplines.

• Imagine Investigations (X-Ray, CT scan, MRI etc.)

• Other diagnostics - Cardiology, Gastroenterology etc. The Diagnostic Report resource is not
intended to support cumulative result presentation (tabular presentation of past and present result in
the resource). The Diagnostic Report resource does not yet provide full support for detailed
structured reports of sequencing; this is planned for a future release.
 DISPENSING

Remote dispensing is used in health care environments to describe the use of automated systems to
dispense (package and label) prescription medications without an on-site pharmacist. This practice
is most common in long-term care facilities and correctional institutions that do not find it practical
to operate a full-service in-house pharmacy.[citation needed] Remote dispensing can also be used
to describe the pharmacist controlled mote prescription dispensing units which connect patients to a
remotely located pharmacist over video interface to receive counseling and medication dispensing.
Because these units are pharmacist

controlled, the units can be located outside of typical healthcare settings such as employer sites,
universities and remote locations, thus offering pharmacy services where they have previously
never existed before.

A typical remote-dispensing system

A typical remote-dispensing system is monitored remotely by a central pharmacy and includes
secure, automated medication dispensing hardware that is capable of producing patient-specific
packages of medications on demand. The secure medication dispensing unit is placed on-site at the
care facility or non-healthcare locations (such as Universities, workplaces and retail locations) and
filled with pharmacist-checked medication canisters. [Citation needed] When patient medications
are needed, the orders are submitted to a pharmacist at the central pharmacy, the pharmacist
reviews the orders and, when approved, the medications are subsequently dispensed from the on-
site dispensing unit at the remote care facility. Medications come out of the dispensing machine
printed with the patient's name, medication name, and other relevant information. If the medication
stock in a canister is low, the central pharmacy is alerted to fill a canister from their bulk stock.
New canisters are filled, checked by the pharmacist, security sealed, and delivered to the remote
care facility.

Perceived Advantages

In theory, access to dispensing services 24 hours a day in locations previously unable to support
full pharmacy operations. Advocates for remote dispensing additionally claim that the service
provides focused, uninterrupted and personalized time with a pharmacist as the system manages the
physical dispensing process while the pharmacist simply oversees it. Certain prescription
dispensing units can carry over 2000 different medications [citation needed] tailored to the
prescribing habits of local healthcare providers? Furthermore, remote dispensing terminal
manufacturers state that this technology can facilitate patient continuity of care between prescriber
and pharmacist.

Disadvantages
While some may purport that travel time to pharmacies is reduced, this point has been negated by
an Ontarian study published in the journal Healthcare Policy as over 90% of Ontarians live within a
5 km radius of a pharmacy. [1] Remote dispensing also places a physical barrier between the
patient and pharmacist, limiting the pharmacist's ability to detect a patient's nonverbal cues. A
patient with alcohol on his or her breath would go undetected via remote dispensing, increasing the
risk for dangerous interactions with drugs such as tranquilizers, sleeping pills, narcotics, and
Warfarin to name a few. This problem may be amplified through telecommunication service
disruptions, which were reported in previous studies examining the utility of remote dispensing
technology.

DIFFERENT ROUTE OF INJECTIONS

1:Parental routes of administration

An injection is an infusion method of putting fluid into the body, usually with a syringe and a

hollow needle which is pierced through the skin o a sufficient depth for the material to be

administered into the body.

1. Intradermal injection

Intradermal injection of small amounts of material into the corium or substance of the skin, done in
diagnostic procedures and in administration of regional anesthetics, as well as in treatment
procedures. In certain allergy tests, the allergen is injected intracutaneously.

2. Intramuscular injection

Intramuscular injection injection into the substance of a muscle, usually the muscle of the upper
arm, thigh, or buttock. Intramuscular injections are given when the substance is to be absorbed
quickly. They should be given with extreme care, especially in the buttock, because the sciatic
nerve may be injured or a large blood vessel may be entered if the injection is not made correctly
into the upper, outer quadrant of the buttock.

3. Subcutaneous injection

Subcutaneous injection injection made into the subcutaneous tissues. Although usually fluid
medications are injected, occasionally solid materials such as steroid hormones may be injected in
small, slowly absorbed pellets to prolong their effect. Subcutaneous injections may be given
wherever there is subcutaneous tissue, usually in the upper outer arm or thigh.

5. Intravenous injection
 g

Intravenous is a term that means "into the vein". Intravenous medication administration occurs
when a needle is inserted into a vein and medication is administered through that needle. The
needle is usually placed in a vein near the elbow, the wrist, or on the back of the hand. Different
sites can be used if necessary.

 List of Injections

Various injections and vaccines are used in department of pharmacy, some of them are:

Vaccines, Tetanus, Anti-rabies vaccines (ARV), Anti-snake venom (ASV), Hepatitis

Injections

Antibiotics ( Gentamycin 80mg, Ampicillin 500mg, Monoceff 500mg, Ciprofloxacin 500mg.

Metrogyl 400mg, Tetracycline 500mg, etc )

Steroids (Dexamethasone Sodium Phosphate Injection 4mg. Betamethasone injection)

Hydrocortisone Sodium Succinate injection 100mg

Antiemetic (Metoclopramide HCL Injection 10mg. Ondem 10mg)

Gastritis (Ranitidine HCL Injection 150mg, Omeprazole 20 mg. Pan tab 20mg, Homotidine

20mg), Anti-allergic ( Phenaramine maleate 25mg )

 Injection pain

The pain of an injection may be lessened by prior application of ice or topical anesthetic, or
simultaneous pinching of the skin. Recent studies suggest that forced coughing during an injection
stimulates a transient rise in blood pressure which inhibits the perception of pain. Sometimes, as
with an amniocentesis, a local anesthetic is given. The most common technique to reduce the pain
of an injection is simply to distract the patient. Babies can be distracted by giving them a small
amount of sweet liquid, such as sugar solution, during the injection, which reduces crying.

 Injection safety

40% of injections worldwide are administered with unsterilized, reused syringes and needles, and
in some countries this proportion is 70%, exposing millions of people to infections .Another risk is
poor collection and disposal of dirty injection equipment, which exposes healthcare workers and
the community to the risk of needle stick injuries. In some countries, unsafe disposal can lead to re-
sale of used equipment on the black market. Many countries have legislation or policies that
mandate that healthcare professionals use a safety syringe (safety engineered needle) or alternative
methods of administering medicines whenever possible. Open burning of syringes, which is
considered unsafe by the World Health Organization, is reported by half of the non-industrialized
countries. According to one study, unsafe injections cause an estimated 1.3 million early deaths
each year. To improve injection safety, the WHO recommends:

1. Changing the behavior of health care workers and patients

2. Ensuring the availability of equipment and supplies.

3. Managing waste safely and appropriately a needle tract infection is an infection that occurs when
pathogenic micro-organisms are seeded into the tissues of the body during an injection. [Such
infections are also referred to as needle stick infections.]
 CONCLUSION

The project Hospital Training is the working in a hospital. The process takes care of all the
requirements of an average hospital and is capable to provide easy and effective storage of
information related to patients that come up to the hospital.

It generates test reports; provide prescription details including various tests, diet advice, and
medicines prescribed to patient and doctor. It also provides injection detail and billing facility on
the basis of patient's status whether it is an indoor or outdoor patient.
The system also provides the facility of backup as per the requirement. Patients who are non-local
language speakers or come from migrant populations or ethnic minority groups often are not able
to communicate effectively with their clinicians to receive complete information about their care.
At the same time, clinical staff is often not able to understand the patients' needs or to elicit other
relevant information from the patient.

Professional interpreter services should be made available whenever necessary to ensure good
communication between non-local language speakers and clinical staff.

The task force brings together practitioners, managers, scientists and community representatives
with specific expertise and competence in policy-relevant knowledge in the field.

Raunak Kumar
Singh

(2100680500070)