Doctor's Bag

Basic Information

The Doctor's Bag is a package of medical supplies carried by a physician whilst away from their workplace (for example when visiting patients) - traditionally this was a Gladstone style leather bag, but increasingly it looks more like a tackle-box or toolkit, often green in colour (especially in the UK). In some ways the bag is as much a symbol of office as a pack of equipment, but it is also a vital adjunct to the physician's role.

The following list of contents for a generic general practitioner in the UK is taken from here:

Basic and administrative equipment:

• Stationary and a limited number of FP10 prescriptions, Med3 (fit notes), letter-headed paper and envelopes.
• British National Formulary or equivalent
• Investigation forms.
• Local map or electronic equivalent
• Personal alarm

Diagnostic equipment:

• Stethoscope and pocket diagnostic set.
• Sphygmomanometer and infrared thermometer
• Pulse oximeter.
• Glucometer including appropriate strips and lancets.
• Alcohol wipes, gloves, lubricating jelly.
• Alcohol gel for hands.
• Additional sphygmomanometer cuffs.
• Reflex hammer.
• Multistix for urinalysis.
• Tongue depressors, preferably wrapped.
• Small torch.
• Peak flow meter, preferably low-reading.
• Specimen bottles (urine/faeces) and swabs.

Other equipment:

• A selection of syringes (1 ml, 2 ml and 5 ml), needles and tourniquet will need to be included if any parenteral medication is carried.
• A small sharps box.
• Facemask.
• A selection of airways
• Reversible fluorescent jacket (with Velcro® 'Doctor' signs)

Drugs (Note that several entries are repeated under different applications)

Analgesia

• Paracetamol - 120 mg/5 ml and 250 mg/5 ml oral suspensions, 500 mg tablets.
• Ibuprofen - 100 mg/5 ml oral suspension, 400 mg tablets.
• Codeine - 25 mg in 5 ml syrup, 30 mg tablets.
• Morphine - 10 mg/5 ml oral solution, 10 mg/ml injection.
• Diamorphine - 5 mg or 10 mg (powder for reconstitution with water for injection).
• Diclofenac - 25 mg/ml injection, 25 mg tablets and 100 mg suppositories.
• Diazepam - 5 mg tablets (for muscle spasm).
• Naloxone - 400 micrograms/ml injection (to reverse opioid overdose).

Antimicrobials

• Benzylpenicillin - 600 mg vials (x 2) for reconstitution with sodium chloride or water for injection.
• Cefotaxime - 1 g vial reconstituted with water for injection.
• Chloramphenicol - 1 g vial reconstituted in water for injection.
• Amoxicillin - 125 mg/ml and 250 mg/5 ml oral suspension, 250 mg capsules.
• Erythromycin - 125 mg/5 ml and 250 mg/5 ml suspensions, 250 mg tablets.
• Clarithromycin - 125 mg/5 ml and 250 mg/5 ml suspensions, 250 mg tablets.
• Trimethoprim - 50 mg/5 ml suspension, 200 mg tablets.
• Cefalexin - 125 mg/5 ml and 250 mg/5 ml suspension, 250 mg capsules.
• Flucloxacillin - 125 mg/5 ml and 250 mg/5 ml suspensions, 250 mg tablets.
• Aciclovir - 800 mg tablets.

Asthma

• A short-acting beta agonist - salbutamol metered dose inhaler (MDI) via spacer or 1 mg/ml nebuliser solution, or terbutaline MDI or 2.5 mg/ml nebuliser solution.
• Prednisolone - 5 mg soluble tablets.
• Ipratropium - 250 micrograms/ml nebuliser solution.
• Hydrocortisone - 100 mg powder as sodium succinate for reconstitution with water for injection (also useful for anaphylactic shock, adrenal crises).

Rehydration

• Oral rehydration salts - eg Dioralyte® or Electrolade® sachets.

Diabetic hypoglycaemia

• Quick-acting carbohydrate such as GlucoGel® or Dextrogel®.
• Glucagon - 1 mg/ml injection.
• Intravenous (IV) glucose - 50 ml of 50% is available in pre-filled disposable syringes.

Seizures

• Rectal diazepam - 2 mg/ml and 4 mg/ml strengths in a 2.5 ml rectal application tube.
• Midazolam - 5 mg/ml oromucosal solution, 2 ml pre-filled syringe given buccally (unlicensed route).
• Lorazepam- 4 mg/ml injection.

Anaphylaxis

• Adrenaline (epinephrine) - 1 mg/ml ampoules (1:1,000) for intramuscular (IM) use.
• Chlorphenamine - 4 mg tablets, 2 mg/5 ml syrup, 10 mg/ml ampoules for injection.
• Sodium chloride - 0.9%, 500 ml via giving set.
• Hydrocortisone - 100 mg powder as sodium succinate for reconstitution with water for injection (also useful for asthma, adrenal crises).

Nausea and vomiting

• Domperidone - 1 mg/ml suspension, 10 mg tablets, 30 mg suppositories.
• Prochlorperazine 5 mg tablets, 3 mg buccal tablets, 12.5 mg/ml injection.
• Cyclizine - 50 mg tablets, 50 mg/ml injection.
• Procyclidine - (to reverse oculogyric crises and other dystonic reactions) 5 mg/ml injection.
• Metoclopramide - 10 mg tablets, 5 mg/ml injections.

Myocardial infarction and angina

• Aspirin - 300 mg dispersible (or chewed) tablets.
• Glyceryl trinitrate spray or sublingual tablets.
• Thrombolytics
• Atropine - 600 micrograms/ml injection for bradycardia.

Acute left ventricular failure

• Furosemide - 10 mg/ml injection, 20-50 mg by slow IV injection. It is also useful to have 40 mg tablets available for less severe congestive cardiac failure.

Postpartum haemorrhage

• Syntometrine® - ergometrine maleate 500 micrograms plus oxytocin 5 units/ml injection.

Psychiatric emergencies

• Haloperidol - 1.5 mg tablets, 5 mg/ml injection.
• Lorazepam - 1 mg tablets, 4 mg/ml injections.
• Flumazenil - 100 micrograms/ml injection to reverse respiratory depression caused by lorazepam.

Generally any given physician will customise the contents of the bag dependant on their skillss and the needs of their practice - they will also typically keep a seperate first aid kit (mainly containing bandages and dressings) in their vehicle, as well as things like medical oxygen, an automated external defibrillator (AED) and the like.

Doctor's bags in previous eras are likely to have similar things in them, but probably with a more limited range of more generic drugs. Note also the almost complete lack of anything resembling surgical intruments - those are unlikely to appear in a UK doctor's bag anytime in the 20th century (since patients could generally be moved fairly easily to a hospital and operated on by a master surgeon), but practitioners in more remote areas might still equip themselves for emergency surgery.

Sources

Here is something similar (but less detailed) from 1911.

Bibliography

1. full source reference

Game and Story Use

• Hopefully very useful for anyone playing a physician character who isn't actually a physician in real life.
• Also useful in scavenging situations.