A Comprehensive Guide to Editing The Part Application
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Steps in Editing Part Application on Windows
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PDF Editor FAQ
Do military expenditures build products that enhance anyone's quality of life?
I love this question because there is just so much to talk about. There are literally thousands of technologies that can be traced back to the military funding or military necessity that we now use daily in our everyday lives. That said, I scavenged around the internet for a list of the some my favorite uses that come from direct military research. For that reason, I take no responsibility or credit for writing any of the sections (besides vaccines and refrigerators. You can blame me there if you disagree.) I'm just delivering the information to new readers. You can see all my sources for more information at the bottom.The InternetProbably the most visible product of military research is what you’re using to read this very article. The research, protocols, and basic hardware that became the foundation of the Internet were all developed by primarily military government agencies, beginning with the Defense Advanced Research Projects Agency’s 1962 mandate to connect the computers of the Pentagon, the Strategic Air Command, and the bombproof defense command centers buried deep below Cheyenne Mountain.In August 1962, JCR Licklider’s paper entitled “On-Line Man Computer Communication” described a connected global network, and by October he’d been appointed director of the new Information Processing Techniques Office (IPTO) at ARPA, as it was called back then. His brief was to create a network to connect Department of Defense computers at three disparate locations. It wasn’t until another internet pioneer, Robert Taylor, took over as the head of IPTO and brought in Larry Roberts from MIT that work on building the network began. The first host-to-host connection between PCs on the new Arpanet was established at 10.30pm on 29 October 1969, creating the world’s first fully operational packet-switching network. By December, a four-node network was up and running, the first email was sent across it in 1972, and people started referring to it as the internet in 1973.DARPA research teams came up with the fundamental technologies that made computer networking possible, and when the military computers were successfully linked, the government made the technology available to America’s college system, where it was further refined until it became the preferred distribution channel for all the world’s news, entertainment, and pornography.Although there are many individuals to whom the development of the net can be attributed, without DARPA it simply wouldn’t exist.Internet anonymityI know right? Privacy, anonymity and government agencies aren’t natural bedfellows, but bear with us. Those who care about online privacy will probably have heard of the Tor privacy service, which, when used in conjunction with the Tor private browser, offers possibly the most anonymous method of being on the internet.The core principle behind Tor – namely, “onion routing” – was originally funded by the US Office of Naval Research in 1995, and the development of the technology was helped along by DARPA in 1997. Three years later, the Tor network emerged as a direct result of the earlier DARPA-funded work.So, what is an onion network? It involves adding a layer of encryption for each router node along the path that your data travels, each encryption layer being peeled back one at a time by routers along the way.Each router unpeels a single layer to get instructions on where to send the data packets next, but can’t see where the data packets have come from. None of these nodes knows the origin of those packets, nor the ultimate destination, nor does it have access to the contents of your data transfer.VaccinesModern vaccines probably date back to practices developed during the American Revolutionary War and can probably be traced back even further to ancient Africa. While in Valley Forge, the Colonial army suffered a hard winter. Among problems such as no food, poor clothing and the freezing winter, Valley Forge was wrought with the diseases that run in such camps. Among them a smallpox epidemic.It was seen in those days that one population of Americans had a surprising resistance to various diseases such as Smallpox. This group was the slaves brought over from Africa. According to them, the slaves owed their resilience to a strange practice brought over by the slaves that was said to protect them from the disease. This practice would appear to regular people like you and me to be barbaric at best and to many, looks much more like dark arts and evil magic. This practice involved a practitioner to pierce with a knife the puss ridden whelps of an animal diseased with Cowpox, a relative of the Smallpox virus. With the knife now contaminated with the bovine's infected puss, the practitioner would then wipe the puss against an open wound on the patient's body. This wound was usually a large cut and usually self inflicted for the purposes of the procedure. Now let's go back a few hundred years before our understanding of modern microbiology. This sounds completely stupid. Honestly I have no idea how anyone would have ever thought to do this, or why any doctor in his right might would go for it, but for the Africans it seemed to noticeably work. Perhaps pushed by desperation or lack of knowing any better, Colonial doctors tried something revolutionary, or at least very stupid by conventional wisdom of the day. The Americans gave it a stab.The immediate results were devastating. About 1 in 10 came down with a severe outbreak of a disease similar to the Smallpox virus. Many died. Yet this was a win for the men of Valley Forge. How? Because 1 in 10 is much better than the 1 in 4 that would have been expected to die given no protection from the virus. Considering where we were in history of medicine, this amounted to a medical miracle.Since that time we have come a long way in how we understand diseases and how we make and use vaccines. So much so that diseases like one of the world's deadliest diseases in history, Smallpox has been eradicated completely. Polio went from being a disease that could still take down one of the wealthiest and most powerful people in the world in the 1920's (Franklin D. Roosevelt) to almost non-existent in the 2020's. Thousands of diseases are loosing the battle for our lives and now millions of people who wouldn't be here are. Still there is an important lesson to know from how it all got started and how that applies today. When vaccines were first used in practice that we know of, it came with a 1 in 10 casualty rating. This was seen as blessing because of the very real threat that the disease posed. the 10% chance of getting sick to Cowpox was far better than the 25% chance of dying to Smallpox. That is what we today have to accept. No good thing comes without some risk, but with vaccines the risk of not putting your faith in them is far, far greater than if you do.The Global Positioning SystemWhen you rely on the GPS app on that Android phone to keep yourself from getting lost, you’re using the same Global Positioning System satellites set up by the U.S. Department of Defense starting in 1979. At President Clinton’s behest, the system became available to civilian users in 1996.The GPS, or global positioning system, was originally developed for Air Force and Navy use. Ground-based radio systems like LORAN had been a vital part of sea and air navigation since the Thirties, but the tumult of World War II had shown that a system dependent on terrestrial antennas and command centers was vulnerable to enemy attack. The United States Navy, in great need of an all-weather navigation system practically invulnerable from enemy action, commissioned the “Transit/NAVSTAR” satellite system in the Sixties as an aid to their Polaris-class nuclear missile subs, and the navigational system soon spread to the rest of the American military establishment.Transit was so useful that NATO adopted and enlarged it to form a navigational network named “Navstar-GPS,” a system that the Reagan administration released to the public shortly after a Korean airliner strayed into Russian airspace and was shot down.Between 1973 and 1978, Dr. Bradford Parkinson worked with both military branches to develop the Navstar GPS system, which relies on numerous satellites positioned at staggered points around the earth. The system uses multiple satellites to triangulate users' location and help navigate. It can be very accurate any time of day, anywhere in the world. It is accurate enough for the military, which uses it to guide missiles and track aircraft and vessels. In The technology can now be found in many commercial applications, including airlines, cars and smartphones. In the late 1980s and early '90s, the United States launched a second generation of satellites, which are more accurate than the first. The European Union and China have begun to develop their own independent networks.Today, the technology is so ubiquitous that it’s hard to buy a cellphone that doesn’t have a GPS antenna built into it.Freeze DryingDippin’ Dots, anyone? The technology that’s now used to make freeze-dried ice cream was first used widely during World War II as a way of preserving medical supplies that otherwise required refrigeration.EpipenEpiPens, the auto-injecting syringes that allow you to give yourself a quick shot of epinephrine to stave off an allergic reaction, sprung from a similar device designed to protect soldiers from nerve agents and chemical weapons.In fact, I still remember the rhyme my HAZMAT specialist taught me.ANTROPENETWO-PANCLORIDEDANTROPENETWO-PANCLORIDEDAlright it doesn't rhyme. The military doesn't do good at rhyming, just remember the "TWO". It goes in second, or you die.Cargo PantsBritish soldiers began sporting cargo pants in the 1930s because they offered a convenient way to carry vital military gear like ammunition. American troops adopted them just a few years later, and the general public began to wear them in the 1990s.Duct TapeIn 1942, duct tape was invented for the military as a way to seal ammunition cases so that water couldn’t get in. Soldiers during WWII quickly realized that it worked well for fixing army gear, too. In World War II, Johnson & Johnson’s Revolite Permacell division developed the widely purposable tape most Americans recognize as duct, or “duck” tape. The tape’s ease of use, durability and water-resistance made it useful to seal containers and fix windows and equipment during the war. The basic components of the product is medical tape with polyethylene backing. When used in the army, it was typically green, but after the war, it was used in civilian applications such as construction and repair and became recognizable for its silver-gray color. Several companies now manufacture duct tape, including Scotch and Duck-brand.Gas CansYou know those canisters you use in order to get gasoline to put in your lawnmower? They were initially developed for the German military in the 1930s.JeepThe Jeep has come a long way since it was first manufactured for American troops to use on reconnaissance missions in WWII. Now celebrating its 70th anniversary, some new models of the world’s oldest SUV come equipped with luxuries such as leather-wrapped steering wheels, DVD players, and touchscreen media consoles.Four-wheel-drive technology actually had been around since the turn of the 20th century. By the 1930s, the military needed a scout car that could have speed and versatility in addition to hauling power and all-terrain capacity. The problem was that these two features were mutually exclusive from an engineering standpoint. The first Jeep that made it to battle, the Willys-Overland MB, provided the answer as the perfect army scout vehicle. Its performance in the war was so outstanding that Dwight D. Eisenhower said, “America could not have won World War II without it.” With war hero status, the military buggy had no trouble transitioning into a civilian car, with Americans appreciating the new light utility vehicles. Now, the Jeep brand continues to market itself on military toughness, going as far as joining with the Call of Duty video game franchise to promote its vehicles.ComputersENIAC, the first electronic computer that was capable of being programmed to serve many different purposes, was designed for the U.S. military during WWII. The army paid for the computer to be built so they could use it in their Ballistic Research Laboratory.Microwave OvensOne of the most dramatic technological advantages to come out of WWII was the power and sophistication of radar: beginning the war in the form of giant antenna installations that couldn’t measure distance, altitude, and bearing at the same time and ending it in applications small enough to fit in some of the world’s first guided missiles. While you’re not likely to be using a lot of guided missiles in your everyday life, you’re almost certain to use an accidental byproduct of radar research—the microwave oven.The technology behind the microwave oven was developed during World War II. At the time, the U.S. and British militaries engineered the magnetron, which was the result of research conducted on radio transmission and radar detection. The magnetron produced much smaller radio waves, known as microwaves, and was small and powerful enough to be used in airplanes. Its detection capabilities helped solve the persistent problem of accurately bombing towns. Microwaves' ability to heat food was discovered accidentally after the war in 1945. An American scientist realized that the radar transmitters used by the U.S. Army throughout WWII actually released enough heat—in the form of “microwaves”—that they could cook food. Percy Lebaron Spencer, who was employed at the time by the American defense contractor Raytheon Company, realized at work one day that radar waves had melted a candy bar in his pocket. After confirming that he himself had not also melted and presumably getting a new coat, Spencer determined that the microwave radiation was responsible for heating the candy bar but not the wrapper, and proposed to use this phenomenon to cook foods. This technology was used to construct the first microwave oven within the next 2 years. Eight years later, Raytheon produced the gigantic 1161 Radarange for commercial and institutional use; a further thirteen years of tweaking and tinkering shrank the Radarange’s size and price tag down to civilian levels, selling the new model under Raytheon’s domestic badge Amana. Raytheon produced the first commercially available microwave oven in 1954. Today, microwaves are used in a variety of applications, including in detecting speed, sending telephone and television communications, curing plywood, treating muscle soreness and of course in microwave ovens.RefrigeratorsRefrigeration has existed for many years. At any point where you could stick a block of ice inside a box, you had a working refrigerator unit. It wasn't until World War II that there came a great need to ship massive amounts of food goods overseas for long voyages and, preferably, keep them fresh. With this came the advent of the Freon. The introduction of Freon in the 1920s expanded the refrigerator market during the 1930s and provided a safer, low-toxicity alternative to previously used refrigerants. Separate freezers became common during the 1940s, the popular term at the time for the unit was a deep freeze. These devices, or appliances, did not go into mass production for use in the home until after World War II.Freon usage in refrigeration units also led the way for modern air conditioning.Digital CamerasMajor governments have launched sophisticated spy satellites with super-high-resolution cameras into orbit since the late fifties in order to sneak a peek on each others’ troop concentrations and industrial developments. While the photos from these satellites were priceless in intelligence terms, there was one major technical snag that made relying on them a pain in the ass: the only way to get at these pictures was to grab the undeveloped film canisters that the satellite would periodically poop out, a complicated operation that involved a mid-air snagging of the canister’s tiny parachute as it drifted through the atmosphere.Almost a third of the results of America’s otherwise successful “Keyhole” spy satellite program were lost due to this tricky retrieval program, but the NASA/USAF KH-11 “Kennan” satellite of 1976 put an end to the problem with the use of a revolutionary electro-optical camera that transmitted images in encoded digital format. The fundamentals of the technology are still in use in modern digital cameras, and the updated form of the KH-11 is still a major part of American surveillance technology.AntibioticsPenicillin was first isolated in a usable anti-bacterial agent in 1928 by Scottish scientist Alexander Fleming, but its medical usefulness wasn’t apparent until the beginning of the Second World War. The rots and infectious diseases that plagued the wounded soldiers of World War One were largely eliminated by early antibiotic treatments like sulfonamide and benzylpenicillin. After the war, these antibiotics became a common part of Western medicine, so much so that the overuse of these medicines is now a major health problem.Canned FoodBack when France was an unstoppable military superpower instead of a tired joke about cheese eating, the French government under Napoleon offered an astonishing 12,000 franc reward to any inventor that could create a way to preserve and store lots of cheap crappy food. At the time, France was busy kicking ass throughout almost all of Europe and was seriously considering launching an assault on a completely new and different continent, so the French military was extremely interested in any new developments in feeding a huge number of people as cheaply as possible.Chef and brewer Nicolas Appert happened to notice that food cooked in sealed jars never seemed to spoil, and his discovery was soon adapted to the use of tin cans for preservation. Unfortunately for French soldiers, the invention of the can-opener came a full thirty years after the invention of the can, so troops in the field had to make do with bayonets, entrenchment tools, and sharp rocks in order to eat the carefully-preserved foods within the can.Ambulance ServicesA refinement of the traditional process of carting away the dead and dying to someplace where they would stink less, the ambulance first made an appearance in the Spanish army of the late 15th century. The “ambulancias” more properly referred to the portable military hospitals that followed the troops around, but came to be attached to the wagons and litters that would remove the wounded from the battlefield after the fight had been won.The “flying ambulance” of Napoleon’s army is closer to our modern conception of the ambulance—a two or four-wheeled carriage that would venture out into enemy fire to rescue the wounded and provide basic first aid until the patient reached the hospital camp.The ambulance cart became standard issue for Union troops during the Civil War, and in 1869 former Army surgeon Edward Dalton introduced the first large-scale ambulance service to the Commercial Hospital of Cincinnati. By the end of the following year, the service had answered 1401 emergency calls.SunglassesAviators soon became inextricably linked in the public mind with the classic cool of the victorious American Air Force, as well as the grandiose swaggering of General Douglas MacArthur, who was rarely seen without his aviators. The characteristically dark shades of the aviator sunglasses were at one time necessary for test pilots pushing the limits of the airplane. Today almost exclusively sported by ironic hipsters and extremely un-ironic cops, the classic “aviator” style of sunglasses was invented by the Ray-Ban corporation to protect pilots’ eyes from glints and glares.At high altitudes, a pilot’s eyes could either be severely damaged by the extremely bright light in the upper atmosphere, or they could freeze in temperatures approaching -80 degrees Fahrenheit. In such conditions, goggles with dark lenses and a tear-drop shape were ideal. A design that prevented as much sunlight as possible from reaching the eye led to Ray-Ban Aviator sunglasses, which became standard gear for men enlisted in the military during World War II. Covering as much of the eye as possible and tempered to block up to 80% of incoming light, the original Aviators were essential equipment for fighter pilots and bomber crews who always had to keep an eye out for enemy planes coming out of the angle of the sun.Since the war, Ray-Bans have made prominent appearances in movies such as Taxi Driver and Top Gun, and were famously worn by celebrities such as Michael Jackson.Safety RazorsMany believe that King Camp Gillette was the originator of the so-called “razor and blades” business model (sometimes expressed as “give ‘em the razor, sell ‘em the blades”) as a fundamental part of the disposable “safety” razor concept he had developed in 1903. In fact, Gillette screwed up his launch, pricing blade refills much higher than the public was willing to pay for, and when his patents lapsed copycat companies adopted the sold nearly identical designs at much cheaper rates—a lower profit margin but a steady source of income.Gillette regrouped and started pricing his stuff smarter, but he really hit it big when he snared the contract to supply every American soldier in WWI with a Gillette shaving kit. Practically overnight, the safety razor became an indispensable part of a man’s grooming kit, assuring the success of the Gillette brand up to this day.Tampons, Pads and other Feminine Hygiene ProductsThe biggest problem with war is that it tends to put holes in people, thus encouraging blood to take a scenic stroll through places it's not supposed to visit. Especially during World War I, when the dead and wounded toll hit the double-digit millions. And especially when a cotton shortage made the bandaging of dying soldiers a pain in the neck.In 1914, Kimberly-Clark was a paper mill company that realized you could do more with wood pulp besides just make it into paper. In fact, by carefully mixing and forming the right combination of pulp, you could get a material that was five times more absorbent than cotton, yet significantly cheaper to produce. Kimberly-Clark began selling their new “cellulocotton” to the military at cost, providing the Allied soldiers of WWI with an excellent new material to use for bandaging and sealing wounds, but then nurses began using it also during their menstrual cycle.After the war, Kimberly-Clark found itself in possession of a number of huge factories dedicated to producing cellulocotton, but not nearly as much demand from civilian doctors and surgeons. It looked like a lot of plants would have to close, at the cost of hundreds of jobs and millions of dollars, when one Kimberly-Clark executive came across an odd rumor concerning the Army nurses that had served at or near the front lines of the war.At the time, women’s menstrual pads were cumbersome cloth flaps that had to be washed and re-worn. Many women felt embarrassed by these “sanitary napkins,” partly because it was considered outstandingly rude to talk about anything period-related in public and partly because these early pads were more similar to diapers than the little numbers of today.The war nurses, being practical women, soon ditched their pads (which were a nightmare to keep clean in battlefield conditions) and cut themselves snips of cellulocotton, allowing them greater freedom of movement and comfort. When K-C found this out, they immediately launched the “Cellunap” sanitary napkin and eventually the Kotex (for “cotton textile”) women’s hygiene brand. Initially, according to the company, it struggled to market Kotex due to social taboos. In an effort to sell more of its wadding, the company, using a slightly altered ingredient blend, began producing Kleenex tissues. Kotex ads were unusually upfront about the taboo subject of periods, and often made mention of the product’s military roots and close connection to the military nurses. With a quick re-branding that actually capitalized on their product's origin, and that those nurses LOVED using their bandages during their periods.Meanwhile, cellulocotton has typically been replaced in both field dressings and tampons by newer synthetics like Curlex, although medics today have been known to plunder the female hygiene sections of PXes and supply cars when they’re running short of purpose-designed bandages.A Bunch of Classic ToysIn 1943, naval engineer Richard James was working on a doozy of a problem. Delicate equipment aboard battleships had this way of getting knocked the hell around during high seas. So James was messing around with springs to support the phonogram machines or whatever, when what do you know? He dropped one of the springs. And instead of just sitting there like a punk, the little spring kind of stepped away in a very slinky-like manner.Knowing that there was nothing kids loved more than coiled metal, James figured he just might have invented the world's greatest toy ever. Within two years, James found the perfect metal for his toy idea and scored a $500 loan to build his first batch, which he sold in 90 minutes.While the Slinky was discovered by accident, tons of government dollars worth of research were poured into Silly Putty. Silly Putty was born out of desperation during World War II. In 1943, the wartime rubber shortage was so bad that the government asked private companies to create a synthetic rubber substitute. Japanese forces had invaded rubber producing nations, limiting American access to the material. As a result, the U.S. military requested the private sector to create an alternative for the rubber used in boots and tires. General Electric had a whole team of scientists throw together every chemical they could think of in hopes that it would create something rubber-like. In 1943, James Wright, an engineer with General Electric, developed the putty from boric acid and silicone oil. This squishy mixture proved to have surprising qualities: It bounced and stretched, it would not stick and it only melted at very high temperatures. Things were looking up until someone pointed out that you can't make tires out of something with the malleability of wet chewing gum, even if it can totally copy the newspaper.While the material had no practical uses, it caught-on very quickly as a novelty. It was so useless at replacing rubber that GE tried to send it to scientists around the world in hopes that someone, anyone, could figure out something to do with it. Eventually, a toy manufacturer mentioned that little kids will pretty much play with anything you give them. Silly Putty became particularly popular after Peter Hodgson, who had first marketed the putty for a store in New Haven, recognized that people liked the goo for its unique properties -- it stretches and bounces but can be easily snapped into pieces. Hodgson began targeting children in the Silly Putty ads and selling it in the now-famous egg-shaped container. The rest is history.Finally, there's Walter "Fred" Morrison, the patron saint of hipsters.Fred, like most other college kids in the 1930s, spent a great deal of time throwing around pie pans from the Frisbie Baking Company. But it wasn't until he joined the Air Force that he learned about aerodynamics and he realized he was doing science during those pan-flinging sessions.So, Fred took what he learned about basic aerodynamics from the Air Force and made a prototype of a better flying disc, that didn't have bits of pie crust stuck to it. And instead of tin, he went with plastic. He dubbed his creation the "Pluto Platter," which was ultimately renamed the "Frisbee" and went on to provide hardcore leaping motivation for extreme college kids everywhere.Super GlueDate invented: 1951Super Glue was inadvertently first created by Harry Coover and Fred Joyner, Tennessee-based employees of Eastman Kodak, in 1951. At the time, they were looking to find a substance that could be used as a heat-resistant coating for jet cockpits. But not until seven years later, in 1958, did Super Glue, which did not need heat or pressure for the adhesive to work, hit the market. The product never made its acknowledged inventor, Coover, wealthy. The product eventually had both medical and military uses — it could be used in medical procedures and was used to treat wounded troops during the Vietnam War.***Edit to reflect someone who blocked me's comments which don't really make a lot of sense, especially given that so many answers were already written over a month ago.Are the products worth what the military spends developing it? It depends. Are you talking about Slinkies or the Internet? Are you talking about panty hose or modern aviation? Are you talking about vaccines or antibiotics? Oops. Guess both those last two were worth it. If you think about this rationally, some percentage of everything fails. Even successful projects don't meet their creators best expectations. For example, I heard today that there are places on the internet where you can see naked ladies. I hope no one discovers that. Going beyond that, there are regular failures where projects need to be scrapped and wasted. If you think that private sector somehow doesn't do this, you should check out the Silicon Valley boneyard of startups that flopped, wasting billions of investor capital.Could that money be put to better use? There is no way to answer that. People value different things. You may value healthcare so you would argue that it could have been spent on giving you free stuff. Others may value science, engineering, jobs, technology, or a better world through increases in funding to virtually every field, so they would argue that a person wanting only a few handouts and luxuries doesn't quite a clear set of priorities.Could the private sector have developed it more efficiently? This point shows such a fundamental misunderstand of how the world works. The private sector are who makes all these technologies. The government, whether Department of Defense, Department of Homeland Security, or Department of Agriculture don't do anything as far as directly creating these technologies. They only communicate a need to industries so that those interested try to put out bids to get contracts. The military just provides the necessary start-up funding for projects and incentive for those companies to grow. If not for them, there would be no known need for things like nuclear energy research which led to so much more important things than a bomb.My Sources:Famous Products Invented for the Military10 brilliant DARPA inventions5 Inventions You Won't Believe Came From War10 Everyday Items We Can Thank the Military for Inventing9 Things Invented For Military Use That You Now Encounter In Everyday LifeMilitary inventions hit the civilian marketFamous Products Invented for the MilitaryThanks for reading!For more answers like this check out On War by Jon Davis and follow my blog War Elephant for more new content. Everything I write is completely independent research and is supported by fan and follower pledges. Please consider showing your support directly by checking out my Patreon support page here: Jon Davis on Patreon: Help support in writing Military Novels, Articles, and Essays.
Why did Argentina think it could beat Britain in a war over the Falklands/Malvinas knowing Britain has the best soldiers in the world and never ever gives up as Germany learned the hard way?
Fewer Falklands War suicides than feared, study suggestsThe claim that more Falklands veterans have killed themselves since the war ended than died in action is not borne out by statistics, a study says.Some 255 UK personnel died in action, but a veterans group has said the suicide toll since 1982 exceeds that.However, the Ministry of Defence has found 95 deaths were recorded as suicides or open verdicts.The MoD said every suicide was a tragedy and urged veterans of any conflict needing support to seek help.In 2002, The South Atlantic Medal Association, which represents veterans, said it was "almost certain" the number of suicides exceeded the conflict death toll.It placed the blame predominantly on a lack of care for those suffering post traumatic stress disorderBut the MoD has now investigated the circumstances of 21,432 Falklands veterans three decades after the end of the conflict, and found that as of 31 December 2012, some 1,335 had died.That compares with an estimated 2,079 deaths that would have been expected among men of a similar age and background who did not serve in the forces, according to the MoD.Of those Falklands veterans, 7% of deaths - or 95 individuals - were due to "intentional self-harm and events of undetermined intent (suicides and open verdict deaths)".That finding means that on average across the whole 30-year period, veterans were actually 35% less likely to kill themselves than the equivalent group of British men with no military background.An MoD spokesman said: "Every suicide is a tragedy and our thoughts remain with the families and relatives of all those lost who bravely served in the Falklands conflict."He said the government had committed £7.2m to improving mental health support for military personnel, including creating a 24-hour helpline in conjunction with charity Combat Stress.The spokesman added: "We would encourage any Falklands veterans or serving personnel who need help to come forward to access the wide range of support available."The study also found:78% of veterans' deaths (1,046) were the result of disease, while 19% (247 deaths) were the result of external causes of injuryCancer was the primary cause of disease-related deaths, with 455 cases recordedBut veterans were 30% less likely to die from cancer and 40% less likely to die from disease in general than men with no military background over the period since 1982Of the 1,335 Falklands deaths, 140 occurred while the individual was still in service - the rest died after leaving the Armed ForcesThe MoD said military personnel were likely to have higher levels of fitness and lower levels of ill health than the general UK population, which could account for the lower incidence of death from disease observed by the study.The death toll of 255 from the Falklands War includes 237 UK servicemen, along with four personnel from the Royal Fleet Auxiliary, six from the Merchant Navy and eight Hong Kong sailors.Falklands suicides 'overestimated'2008 - Veterans Assistance in the UKDr. Eduardo C. GERDINGBulletin of the Naval Center Year 126-Vol. CXXVI-Nº 822-Oct-Dec 2008PrefaceThe medical care of war veterans is inserted, like that of the ordinary British citizen, in the so-called National Health Service (NHS ) which is comparable in its structure to our National Institute of Social Services for Retirees and Pensioners ( INSSJP ). There are population differences, given that the United Kingdom has a significant immigrant group from India, Pakistan, Somalia and the Philippines to the point that 21.9 percent of children born in Great Britain are to foreign mothers. On the other hand, his retirement system has been in trouble for a long time. ( BBC News, Pensions in Crisis- December 10, 2002). In 2003 total health spending per capita in the UK was US $ 2,317.There are serious healthcare problems in military hospitals. In March 2007, Selly Oak Hospital was charged with mistreating British war veterans returning from Iraq. ( BBC, March 11, 2007 ) The British government, arguing that military hospitals cannot provide the same level of care as NHS hospitals has been closing them since 1990. In fact, the Royal Naval Hospital in Haslar, dating from 1753, It is the last military hospital to close its doors in 2009 and the remaining military personnel ( 200 people ) will be transferred to a Ministry of Defense hospital unit located at Queen Alexandra Hospital in Cosham, Portsmouth.The National Health Service ( NHS )The NHS is the UK's public health service, serving 57 million people. England, Scotland, Wales and Northern Ireland each have their own NHS. The NHS budget in 2007 was £ 90 billion and is to be increased by 4 per cent by 2010. ( HealthInsider-10 Oct 2007 ).The Scottish doctor Archibald Joseph Cronin, author of the famous novel The Citadel, was the one who established the innovative ideas that gave rise not only to the NHS but to the triumph of the Labor Party in 1945. In primary care or First Level of the NHS the pillars are GPs ( General Practitioners ) or family doctors and RN ( Registered Nurses ) or Registered Nurses .Note:The General Practitioner (GP) or family doctor is the professional who provides primary or first level assistance. GPs treat acute and chronic illnesses, provide preventive measures, and offer health education to patients of both genders. The English word physician is generally reserved for physicians specializing in internal medicine. In hospitals, GPs can perform minor surgery and / or obstetrics practices. In the UK to receive a GP, you must complete 4 years of postgraduate studies at a Faculty of Medicine. According to the OECD (Organization for Economic Cooperation and Development) of which Great Britain is a part, in 2007 the number of doctors increased by 35 percent in the last 15 years, reaching 2.8 million.Structure of the British National Health System (NHS)To get an idea of the size of the NHS let's say that in March 2005 it had 1,300,000 employees making up the third largest workforce in the world after the Chinese Army and the Indian Railways. Despite this, the figure dropped by 17,000 from 2005 to 2006 (The Independent-Alarm at significant drop in number of NHS workers, April 27, 2007).Seventy percent of NHS costs are to pay salaries and two-thirds of health expenditures go to patients over 60 years of age who have a growing demand for care. As in our country, medical equipment is becoming more sophisticated every day and the public demands treatments with new and expensive drugs. (Adam Smith Institute-Three quarters of NHS cash is needed just to stay still says think tank).The National Service Frameworks (NSFs) constitute long-term health strategies (eg, prevention of coronary heart disease) and are developed by health professionals and associated agencies. Strategic Health Authorities (SHAs) are They are also part of the NHS and are the ones that direct and execute the fiscal policies dictated by the Department of Health at the regional level. On April 12, 2006, Patricia Hewitt, Secretary of State for Health announced that there was going to be a reorganization and the SHAs would be reduced to 10. Each SHAs in turn contains several Trusts The National Institute for Health and Clinical Excellence (NICE) is the health authority of the NHS that publishes evaluations made on specific treatments based on cost / benefit.The TrustsThe First Level Trusts (PCTs) number 152 and comprise 29,000 family doctors (GPs) and 18,000 dentists. PCTs control 80 percent of the NHS budget. Ambulance Services Trusts comprise 290 organizations covering 1600 NHS hospitals. NHS Care Trusts provide Medical and Social care but do not exist in Scotland. The Mental Health Services Trusts provide psychiatric care but are not linked to the Combat Stress organization. Such is the case with the Oxfordshire and Buckinghamshire Mental Health Service NHS Trust. Foundation Trusts are intended to decentralize the NHS so that communities decide based on their wants and needs.However, UNISON, which is the union that groups all public service workers, thinks that this undermines the principles of public health services and sees this as a trend towards the privatization of public services.Monitor is an autonomous entity, independent from the government, which monitors the NHS Foundation Trusts by ensuring that they are well managed and financially sound.Note:A Trust is a group of companies under the same management whose purpose is to control the market for a specific product or sector.You criticize the UK's National Health ServiceBasically the British complain about the following points:Lack of access to medical benefitsPatients who do not conform to the resolutions dictated by the NHS must seek and pay for medical care in the private sphere.2. PoliticizationFiona Godlee, editor of the British Medical Journal, said on April 1, 2006 that ¨the National Health System needs a scheme that replaces political dogma with decisions based on clinical criteria, that replaces confrontation with consensus, lack of reliability with democracy and short-term decisions with long-term stability schemes.The NHS is too complex and vital to our future prosperity to be governed by interests of its own or of any specific party.The continuous use of the NHS as a theater of experimentation of management constitutes a waste ”.(BMJ 2006; 332: 1518 June 24)3 . Double paySometimes patients choose the private setting to be treated more quickly. So they are paying twice: one is withholding tax for the NHS (which they don't use) and the other is private consultation.4 . Long Waiting ListsAccording to the Daily Telegraph, the UK Health Department admitted that approximately 500,000 people in England suffer from shift expectations of a year or more. The worst first-rate care centers are in London, on the east and south coasts of England. The government's goal for 2008 is that no patient has to wait more than 18 weeks to be seen. (Daily Mail-500,000 wait over a year for NHS treatment- 7th June, 2007)5 .SupergermsHigh concentrations of antibiotic resistant bacteria such as methicillin-resistant Staphylococcus aureus (MRSA) and Clostridium difficile are considered to be the result of poor hygiene observed in NHS hospitals. Deaths linked to these two nosocomial infections have increased in one year by 59 percent. According to the Office of National Statistics, MRSA and Clostridium difficile caused more than 5,400 deaths in 2005. The highest peak in mortality (69 percent) according to death certificates were attributable to C. difficile. MRSA deaths increased 39 percent ( The Independent-Targets blamed as hospital infection deaths rised 59% -February 23, 2007 )6. ComputerizationIt is believed that an organization the size of the NHS should be able to meet the costs of developing and maintaining information systems.7. DentistryIn some areas there is reduced access to dental services and a tendency for these professionals to attend only private patients (BNN Online-March 1, 2006). In 2006 approximately 2000 dentists in England refused to sign a new type of contract introduced by the government according to which professionals would not charge from the NHS for treatment but would be assured an annual income of £ 80,000 for three years. The oral exam will be charged £ 15 and £ 40 will cover the repair of up to six cavities. (BNN Dentists ditch NHS, 8 April 2006 )8 . CoverageThe lack of accessibility to certain drugs in certain areas (due to the cost / benefit ratio) has led the British to jokingly nickname this "the postal code lottery"9 . DeficitsSome hospitals and trusts suffer from deficits and have incurred debt. A full report on this point and the allegations to the NHS can be found at BNN Online- NHS charges a complete mess, 18 July 200610 . Scandalsa) The scandal of the organs of Alder HeyIn December 1999 a team of researchers set about investigating the extraction of human organs that took place at the Royal Liverpool Children's Hospital NHS Trust.b) The Bristol Cardiac Surgery ScandalAn investigation was carried out on 290 children who died between 1984 and 1995 after having undergone cardiac surgery at the Bristol Royal Infirmary RegisteredNurses (RN)The history of nursing in the UK dates back to Florence Nightingale. On March 31, 2006 the number of nurses and midwives exceeded 682,000 making the Council of Nurses and Midwives or NMC the largest regulatory agent in the UK. There are approximately 400,000 nurses working for the NHS. The Royal College of Nursing (RCN), which has 395,000 members, was founded in 1916, in 1928 it received the Royal Charter and its patron was Queen Elizabeth II. The title of RN (Registered Nurse) is awarded only to those nurses endorsed by the Nurses, Midwives and Health Visitors Act of 1997. The bulk of them are dedicated to primary care. There are also Specialized Nurses, such as the Nurse Practitioner that complements the work of the GP,Registered Mental Health Nurses (RMN) are trained to care for the mentally ill, recognize symptoms, and even administer psychotropic drugs. In Trinidad Tobago, these nurses not only avoid unnecessary psychiatric hospitalizations but also provide prevention programs at the group level. (Health Sector Reform Program of Trinidad & Tobago)Registered nurses and their financial problemsNurses, policemen, teachers, ambulancemen and firefighters cannot afford housing in 65 per cent of British cities, whereas five years ago this was limited to only 24% of cities. (BNN Online-Key workers are priced out of homes-29 July 2006) During the course of the year, nurse Jusine Whitaker (37 years old) who, eight months ago was named Nurse of the Year, decided to resign from her job as nurse specialized in the treatment of lymphedema in protest at the permanent stress to which their peers are subjected by the constant health reforms. (The Independent, October 17, 2007). According to the RCN, during 2007 22,000 nursing positions were requested. (The Independent, April 5, 2007).The prescriptionsCancer drug prescriptions have placed a heavy burden on the NHS. Such has been the case with trastuzumab (Herceptin®). NICE recommends Herceptin® for women with early stages of breast cancer that are HER2 positive except when there are doubts about the patient's cardiac status. The NHS and NICE have approved the prescription in England and Wales of the so-called “smart drug” MabThera® (Rituximab). This drug is used for non-Hodgkin lymphomas. Rheumatoid arthritis affects 400,000 people in the UK (BBC News, 21 August 2007). However, the drug abatacept (Orencia®) was not approved. Orencia®, which costs £ 9,333 / year / patient could potentially benefit 12,000 patients in the UK alone (BBC News, 2 August 2007).The NHS offers financial assistance to those who cannot afford their treatments due to their low income. Patients who must receive chronic treatments can pay for their prescriptions through a prepaid certificate with considerable discounts. (Department of Health http: // www. Dh. Gov. Uk / en / Policyandguidance / Medicinespharmacyandindus try / Prescriptions /NHScosts/index.htm)Mental healthIt is estimated that 30 per cent of the world's population suffers from some type of mental disorder annually and at least two-thirds receive no care or receive inadequate treatment (The Independent-4 November 2007) .In the UK one in every six people suffer from chronic depression or anxiety and this affects one in three families. In most of Great Britain you have to wait nine months to receive sessions of Cognitive Therapy (CBT), (BNN-Therapy on NHS ¨must be increased¨, 18 June 2006).The impact on war veteransA study of 64 British Falklands war veterans revealed that half of them had some symptoms of post traumatic stress disorder (PTSD) and 22 percent had the full syndrome. (British Journal of Psychiatry (1991), 159, 135-141). 250 war veterans from the Malvinas, Northern Ireland, Bosnia, the Gulf War and other conflicts brought the Ministry of Defense to justice for not having been adequately treated by the PTSD upon their return, and another 1,600 were added to them. According to the South Atlantic Medal Association (SAMA) in the Malvinas Conflict 256 British combatants died but since then 264 have already committed suicide. (CMAJ-Suicide claiming more British Falkland veterans than fighting did-May 28, 2002). According to Roger Gabriel and Leigh A. Neal from the Gulf War Medical Assessment Program or MAP (a Veterans' Warfare Survey Program) at St. Thomas Hospital in London, any GP can diagnose a PTSD which will carry out the consultation with the psychiatrist as appropriate. (BMJ –Vol 324 -9 February 2002).Statue of the Abandoned SoldierThis statue, located in a Combat Stress, made by sculptor JamesNapier and modeled on Daniel Twiddy who wasseriously wounded in his face by splinters in Basra in 2003.The Combat Stress organization (Veterans Welfare Society)This society was founded in 1919 and is the only public welfare entity that provides assistance to war veterans who have suffered mental trauma as a result of combat. It has 13 regional centers and an experience based on 86 years of service. To date, more than 85,000 veterans and their families have been assisted and 8,000 veterans are currently registered. For hospitalizations (which cannot exceed six weeks a year) they have three centers: Hollybush House, Ayr (Scotland and Ireland) with 25 beds, Audley Court, Newport, Shropshire (England and North Wales) with 27 beds, and Tyrwitt House, Leatherhead, Surrey (England and South Wales) with 30 beds. They have a President, a Committee and an Executive Director on which report a Director of Clinical Services (a retired military psychiatrist), a Director of Finance and Administration (a civil accountant), a Director of Welfare and a Director in charge of collecting funds. The Director of Clinical Services controls Hollybush House, Tyrwitt House and Audley Court. There are no psychologists here but 15 registered nurses and two health assistants work. The clinical part is handled by the NHS GP. The patients have an average age of 44 years, have served 11 years, and on average it has been 13 years since they left active duty until they entered Combat Stress. 35 percent of applicants are rejected due to alcoholism or other severe addictions. According to the 2006 data, 80 percent belonged to the Army, 8, 7 percent to the Royal Air Force. 8 percent to the Royal Navy, 2.7 percent to the Royal Marines and 0.6 percent to the Merchant Navy. 10 percent of patients come from NHS referrals and 46 percent from friends or acquaintances.The so-called Comprehensive Care Plan (The Whole Person Care Plan) includes Cognitive Therapy (CBT), EMDR (Eye Movement Desensitization and Reprocessing). EMDR It is a method of desensitization and reprocessing of emotionally traumatic experiences through bilateral stimulation of the brain, education on Post Traumatic Stress, anxiety management, anger management, Creative Therapies, Relaxation Techniques , Sleep Hygiene, Occupational Therapy and Social Skills.Financial support for Combat Stress comes from the Ministry of Defense.The Robertson Truce, Seafarers UK, The Scottish Executive, The Officers´Association Scotland, The Corporation of Trinity House, The royal Army Chaplains Department, The Boughton Trust, Payroll Givers, Queen Mary´s Roehampton Trust, 51st Highland Division and Ross Bequest Trust , The Far East Prisoner-of-War Association, The Wates Foundation, and JP Getty Jr. Charitable Association. The day of admission to Combat Stress comes out £ 264 .. On March 31, 2007 they had received £ 2,732,000.The author at the Residential Treatment Center at Tyrwhitt House, Leatherhead, Surrey, England. The center provides the war veteran with a safe therapeutic environment in the company of their peers. Receive medical care that meets your needs with a team that seeks the most appropriate solutions.From right to left: Commodore Toby Elliott OBE RN (Executive Director ), Claire Evans (Head of Clinical Services) and Dr. Eduardo C.Gerding founder of the Nottingham-Malvinas Group. Photo taken atCombat Stress in Audley Court.The War Veteran's Personal FileEach War veteran has their own file which includes:a) The Medical History provided by their Family Physician (GP) and their Psychiatrist,b) A detailed report of their actual performance in combat made by an officer who was in charge andc) A final report made by a Welfare Officer.Files marked with a blue dot indicate new admissions.A neat bedroom in Audley Court. War veterans aregenerally reluctant to share the same. As theend of the year festivities approach many war veterans apply for admission due to amatter of loneliness.Veterans Recreation Activities at Audley Court. Thisincludes reflexology, relaxation techniques, Tai Chi, cookingclasses, computer classes, bowling, cycling, ping pong etc. On the rightMr. Jim Banks (Head Nurse).This painting was made by a Falklands War veteran interned at Audley Court. He himself had received a shot that destroyed his jaw. The image describes the intense pain suffered that he was not able to express in words. This constitutes part of the so-called Occupational Therapy. War veterans can also express their feelings through poetry, existing specialized therapists for them. (Arthur Lerner Ph.D ( Ed-Poetry in the Therapeutic Experience, 2nd edition )Special bathtub for disabled patientsThe War Pension SystemIn the UK, only war veterans who have been left with some degree of disability, widowers and orphans, receive a war pension. There are two systems: One for those affected before April 6, 2005 called the War Pensions Scheme and another for those who have suffered injuries after that date called the Armed Forces Compensation Scheme (AFCS). The latter does not prevent the veteran, if he wishes, from taking legal action against the Ministry of Defense .How War pensions are currently calculated according to the AFCSLevels from 1 to 15 are established depending on the severity of the injury.Level I correspWave to the most severe injuries and receive the largest amounts. Level 15 covers less severe injuries such as burns or knee dislocation. Those with Levels 1 to 11 receive a Guaranteed Income Payment GIP (Guaranteed Income for Life). This GIP is calculated by multiplying the pension payment by a factor that depends on the age on your last birthday. The younger the person, the greater the factor because the age that would normally be left to retire. The final GIP is a percentage of the rate that corresponds to you.The bands are as follows:Band A Levels 1 to 4 100%Band B Levels 5 to 6 75%Band C Levels 7 to 8 50%Band D Levels 9 to 11 30%Example:A 23-year-old soldier loses a foot as a result of a combat action. He is currently receiving a salary of £ 20,000. The corresponding factor is applied to a combatant of that age, which in this case is 0.878. The Guaranteed Income for Life (GIP) is calculated like this = Salary x Factor or £ 20,000 x 0.878 = £ 17,560. Since the injury is considered to correspond to Level 8, the person will receive 50% of their total GIP, meaning that they will receive £ 8,780 per year tax free.The case of the GurkhasLance Corporal Gyanendra Rai was seriously wounded by Argentine artillery at Bluff Cove during the Malvinas Conflict. Gyanendra Ray was discharged from the Army, receives no pension and was paid only £ 2,000 from the South Atlantic Fund. This Gurkha served 13 years in the British Army and not 15, which would have given him the right to collect a pension. ( Personal communication from Mike Seear )Apart from this, British immigration officials do not allow him to settle in Britain as they say that both Rai and other Gurkhas do not have "close ties to the United Kingdom". There is a provision stating that Gurkhas who retired before 1997 have no right to reside in the UK. An 84-year-old Gurkha named Tul Bahadur Pun who was awarded the Victoria Cross and was granted a visa called for justice for his peers. (BBC, 1 August 2007) http://www.cchero.co.ukLance Corporal Gyandendra RaiGyandendra Railost part of her backEl Grupo Malvinas-Nottingham
What did doctors carry in their black bags?
The items listed below are very comprehensive, and recommended for general practitioners working in the Highlands of Scotland (UK and European guidelines).Doctor's Bag – Contents. What to have in a Doctor's BagIntroductionThe doctor's bag is very important and the contents of it vary according to the individual doctor and their pattern of work. GPs working in remote parts of the Highlands of Scotland will obviously have very different requirements from those working in the inner city. Many GPs will no longer work out of hours but will still need to be able to assess and manage patients while out on home visits. Those working for out of hours organisations may have some, or all, of the necessary equipment and medications provided.Click to find out more »General issuesSome GPs may prefer to wear a jacket or coat with capacious pockets rather than carry a bag. Most GPs will use a bag of some variety and the following should be considered:The bag must be lockable and not left unattended.Most medicines should be stored between 4° and 25°C. A silver-coloured bag or cool bag is more likely to keep drugs cooler than a traditional black bag.Consider keeping a maximum-minimum thermometer in the bag to record extremes of temperature.Bright lights may inactivate some drugs (eg, injectable prochlorperazine) so keep the bag closed when not in use.Lock the bag out of sight in the vehicle boot when not in use.Basic and administrative equipmentPhotocard ID should be carried. Many patients may recognise their regular GP but locums or new GPs may need to confirm their identity before admission and all GPs may be required to identify themselves to other emergency services.Mobile phone - smartphones may also serve a number of other functions but this may be dependent on adequate reception.Stationery and a limited number of FP10 prescriptions, Med3 (fit notes), letter-headed paper and envelopes.British National Formulary or equivalent - but electronic versions of these which can be used via a smartphone or tablet are available and can replace the need for printed reference material.Investigation forms.Local map or electronic equivalent - satnav/GPS or smartphone.Personal alarm - several versions are readily available. The police suggest that when used, an alarm be thrown about 10-20 feet to cause distraction.Diagnostic equipmentStethoscope and pocket diagnostic set.Sphygmomanometer and infrared thermometer - sphygmomanometers should have calibration date stickers.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 equipmentSome GPs will also carry the following 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.Face mask.A selection of airways can form part of the car's first aid kit and can be extended to one's own preference and skills up to full 'BASICS' level.Reversible fluorescent jacket (with Velcro® 'Doctor' signs) carried in the vehicle boot can be helpful in emergencies.Handheld spotlight plugged into the cigarette lighter can highlight house numbers (where they exist).Out of hours services are likely to provide equipment such as an automated external defibrillator (AED), oxygen and nebulisers. Individual GPs will need to assess whether these items are appropriate to their practice.Administrative issuesThere are a number of requirements around the administration of any medications. See also separate Controlled Drugs article.A record should be kept of the origin, expiry date and batch numbers of all drugs administered.Check at least twice a year that drugs are in date and usable (more often for medications that have a short shelf life like Syntometrine® and nitrates).If oxygen is carried the car should display the appropriate 'Hazchem' sticker.Patients given more than immediate treatment should be supplied with a patient information leaflet.A separate Controlled Drug (CD) register should be kept for the CD stock held within the doctor's bag.Each doctor is responsible for the receipt and supply of CDs from their own bag.Restocking of a bag from practice stock should be witnessed by another member of the practice staff, as should the appropriate entries into the practice's CD register.Where a prescription is written by a doctor following the administration of a CD to a patient, the doctor should endorse the prescription form with the word 'administered' and then date it.Information on any medications given should be entered into the patient's record as soon as practicable.DrugsThe selection of a particular drug to be carried in a doctor's bag should be based on a number of considerations including the GP's personal familiarity with the drug, storage requirements, shelf life, cost, the availability of ambulance paramedic cover, the availability of a 24-hour pharmacy and the proximity of the nearest hospital.Out of hours centres may require their clinicians to use FP10P-REC forms to record medications dispensed to patients during out of hours consultations.The list of drugs below, based on guidance from the Drugs and Therapeutics Bulletin, can be used as the basis for a selection that can be used to meet common clinical scenarios. It is not exhaustive and neither is it expected that all GPs would carry all these medications.[1, 2]NB: when an antibiotic or antiviral is given, a full course should be provided (ie enough medication to treat the presenting condition[3]AnalgesiaParacetamol - 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).AntimicrobialsBenzylpenicillin - 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[4]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 - available as soluble tablets or solution.Oxygen - delivered via a close-fitting face mask with rebreather bag or nasal prongs.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).RehydrationOral rehydration salts - eg, Dioralyte® or Electrolade® sachets.Diabetic hypoglycaemia[5]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[6]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[7]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 vomitingDomperidone - 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[8]Aspirin - 300 mg dispersible (or chewed) tablets.Glyceryl trinitrate spray or sublingual tablets.Thrombolytics - some GPs may administer as per protocol drawn up in conjunction with local specialists. Pre-hospital thrombolysis is indicated if the time from the initial call to arrival at hospital is likely to be over 30 minutes. The National Institute for Health and Care Excellence (NICE) recommends using an IV bolus (reteplase or tenecteplase) rather than an infusion for pre-hospital thrombolysisAtropine - 600 micrograms/ml injection for bradycardia.See also separate Acute Myocardial Infarction Management article.Acute left ventricular failureFurosemide - 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[9]Syntometrine® - ergometrine maleate 500 micrograms plus oxytocin 5 units/ml injection.Psychiatric emergenciesHaloperidol - 1.5 mg tablets, 5 mg/ml injection[10].Lorazepam - 1 mg tablets, 4 mg/ml injections.Flumazenil - 100 micrograms/ml injection to reverse respiratory depression caused by lorazepam.Provide FeedbackFurther reading & referencesBaird A; Emergency drugs in general practice. Aust Fam Physician. 2008 Jul;37(7):541-7.Drugs for the doctor's bag: 1 - adults; Drug Ther Bull. 2005 Sep;43(9):65-8.Drugs for the doctor's bag: 2 - children; Drug Ther Bull. 2005 Nov;43(11):81-4.Guidelines for the management of community acquired pneumonia in children; British Thoracic Society (2011), Thorax Vol 66 Sup 2British Guideline on the management of asthma; Scottish Intercollegiate Guidelines Network (2016)Diabetes (type 1 and type 2) in children and young people: diagnosis and management; NICE Guidelines (Aug 2015)Epilepsies: diagnosis and management; NICE Clinical Guideline (January 2012)Emergency treatment of anaphylactic reactions - guidelines for healthcare providers; Resuscitation Council (UK) Guidelines (2008)Tackling myocardial infarction; Drug Ther Bull. 2000 Mar;38(3):17-22.Prevention and management of postpartum haemorrhage; Royal College of Obstetricians and Gynaecologists (May 2009 with revisions April 2011)Violence and aggression: short-term management in mental health, health and community settings; NICE Guideline (May 2015)Original Author: Dr Laurence KnottCurrent Version: Dr Roger HendersonPeer Reviewer: Prof Cathy JacksonDocument ID: 1153 (v10)Last Checked: 23/09/2016
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