the next season...

Okay we are still full of turkey from yesterday but onward we go at the Guesthouse in San Juan.   It's been awesome having our fall teams in town and now we are preparing for the Winter Season/team arrivals.

I've heard from many of you asking which supplies you should bring and I'm excited to hear from and see every one of you.   We have teams back to back to back from December 31st to the first week in April this year so.....the list will change FREQUENTLY based on what the team before YOURS brings, uses and replenishes.  :)    After eyeballing the pharmacy here, I'm going to ask for some things that we may already HAVE but which I know we will use great amounts of...and the same for the OR supplies.    Some of these things will ALWAYS be on the list.    We are aware that not everyone can bring every medication- these are suggestions.

Medications
Ibuprofen (each barrio team should bring at least 6000-10,000 pills of 200 mg strength)
Adult Vitamins (at least 8000 to 10,000 multivits)
Child Vitamins (at least 10,000 chewables.   Gummies are okay but chewables are better)
Child vitamins drops (at least 50-100 with iron if possible)
Antifungals creams (50-200)
Hydrocortizone creams
Vaseline (5-10 per team)
BP meds (beta blockers, ACE, calcium channel blockers- we always have a need for these.  Many of the patients in the barrios are taking enalapril, amlodopine, lisinopril, or nifidipine)
Children's tylenol/ibuprofen suspension/drops (at least 50-100 per team)
Children's cough medicine suspension
Singulair/Clarinex/Claritin- You will see a lot of asthma/allergies in the barrios
Inhalers-  We do not have ANY in stock.  We do, however, have a lot of albuterol for nebulizers.
Toothbrushes/toothpaste- These are excellent to hand out in the barrios.
Diflucan- There are always complaints of yeast infections  in the barrios.  You can bring diflucan or vaginal creams but the diflucan is a lot easier.  
Hygeine products- It is a good idea to hand out soaps/lotions/small shampoos in the barrios as well.  You will then want to bring at least 300-400 to hand out.
Shampoo for "hongos"- There is often a large amount of tinea capitis noted in the barrios.   We can treat with antifungal creams but bringing medicated shampoos would also be a good idea.
Permethrin cream for scabies:  bring at least 10-30.
Small plastic baggies for meds:  Barrio teams should plan on prebagging most medications BEFORE going out to the barrios (this is often how you will spend your Sunday afternoon or evening).   Your vitamins, ibuprofen, tylenol, etc should DEFINITELY be prebagged.     You will need at least 2000-5000 small baggies to put your medications in.   It's also a good idea to bring brown paper bags to put the medications, toothbrushes/toothpaste, and hygeine products in for the patients in the barrios.    You should prebag a month's supply of most of the medications (30 vitamins, tylenol, ibuprofen, BP meds, etc).  Antibiotics are bagged differently based on type and prescription.
Antibiotics- This is obviously dependent on which antibiotics the doctors like to prescribe.  However, we recommend Amoxicillin, Doxy, Cipro, Flagyl, Augmentin, Keflex, Azithro...to start.  :)
Glucometers-  this is a very tricky request- because I probably have at least 100 glucometers in the med room.  However- most of them DO NOT HAVE test strips orrrr they have test strips that will last one month..orrrrr the test strips are expired......orrrr there is no way to do quality control on them.   My recommendation would be that you bring a glucometer with plenty of test strips to use while you are here    or bring one with at least a years worth of test strips.   We do NOT need lancets or alcohol wipes or insulin syringes.  We do not have insulin here, nor will we give out insulin in the barrio clinics.
BP cuffs/stethoscopes:  for triaging patient in the barrios.
Small measuring cups for water/cough syrup, etc.  Dixie cups for handing out water with the albendazole.

OR supplies:
* This is based on assessment at this moment.  We have a month before the first surgical team arrives but there are Dominican doctors operating in the clinic during this month and using some of these supplies. Therefore- this supply list CAN and will fluctuate/change.
Instruments:  There are many many basic instruments here.  However, any specialty instruments should come with your group.
Blades:  We have some 10s,11s, 15s but please plan to bring what you would like to use.
Foley catheters:  There is an abundance of straight caths but NO Foley catheters in stock.
JP drains- we have a few (very old) drains but no bulbs.  
Gloves: sterile AND clean
OR packs/drapes
Sterile Bovies
Sterile suction tubing
Sterile spinal needles if you plan to use them.
IV tubing of your preference (but not insytes- we have a lot of IV insytes at this moment)
STERILE Laps/sponges/ratex/ towels:  We will always have a need for these.
Wrapping material for your instruments/packs
Anesthesia- it's a good idea to bring your own laryngoscopes/bulbs.
Pain meds:  Most of the post-op patients will go home with tylenol or ibuprofen.  If you would like your patients to have anything else at discharge- you'll probably want to bring it.  :)  We can order Fentanyl (IV) and Morphine (but only in 0.2 mg IV dosage form) here a few days before your arrival if you would like.
Circuits:  We have an abundance of anesthesia circuits at this time.  I will update this if we start to run low.
ET tubes:  There is a variety of ET tubes available, however- we do not have many small sizes/ children sizes.
O2 tubing/masks/oral airways:  There is an abundance of tubing/masks/oral airways at this time.  I will continue to update if we start to run low.
Anesthesia meds:  We have sevo/iso/propy/succs in stock.   HOWEVER, there is surgery in the clinic in December so I cannot guarantee quantities at this time.   You may want to bring what you would like to use...or call me at 829-982-1136 to check in closer to your arrival time.  We can order ketamine but Ephedrine is in VERY SHORT SUPPLY here and very very difficult to obtain.   Please bring it if you can.  

Well- here is a start. As I stated previously, because we have patients in our clinic at this time, the lists above can fluctuate greatly.   Please let me know if you have any questions or feel free to email me at phillynic@gmail.com.   I am sooooooo looking forward to working with all of you and can't wait til you get here!

Nicole Eby
829-982-1136