Scottish Government

Interim Guidelines for Smallpox Response and Management in Scotland in the Post-Eradication era

Appendix 4: suggested equipment and supplies for Regional Smallpox Diagnosis and Response Teams

1. Each member of the RSDRT will be allocated a set of equipment and supplies that they will need to store at a safe and easily accessible location so that it is available any time should they be called to manage a suspected case.

2. Personal protective equipment

• Non-sterile gloves.

• Disposable gowns.

• Face and eye protection.

• Shoe covers.

1. Diagnostic equipment

• Thermometer, torch, spatula, stethoscope, sphygomanometer, watch and other routine diagnostic equipment.

• Equipment for taking diagnostic clinical specimens as described in Appendix 1.

1. Treatment supplies

• Antipyretics. Paracetamol tablets and liquid for symptomatic treatment of fever in adults and children (with dosage chart for child doses - for example to BMA child dose charts or paediatric vademecum).

• Analgesics. Strong analgesic such as injectable codeine phosphate (controlled drug may be more difficult), or rectal diclofenac, for the relief of severe pain (again with dosage chart for child doses). In addition, an analgesic mouth spray.

• Antibiotics. A small (ie. 24 hours) supply of oral and injectable broad-spectrum antibiotic such as co-amoxyclav and cefotaxime at doses appropriate for meningococcal disease.

• Intravenous fluids. IV cannulae (range of sizes), two bags of normal saline for infusion (with infusion volume chart for children) and an IV giving set. Possibly an infusion machine, to reduce the need for nursing input to watch the infusion.

• Antiseptic lotions and dressings.

• Blankets and Tyvek coveralls.

• Charts - for recording temperature, pulse and BP.

1. Resuscitation equipment.

• They will also be given training in Advance Life Support.

1. Disinfection, decontamination and waste disposal equipment

• Disinfection. Ready-for-use hypochlorite spray for local disinfection and spillage control. Alcohol hand rub would also be useful for personal hygiene and to use before carrying out procedures.

• Waste disposal. 6 large, yellow clinical waste bags, and tape for sealing them. Ready-written luggage labels describing the contents as 'incinerate without delay', or some similar agreed instruction. Large rigid yellow plastic bins for safe storage of clinical waste during transport.

1. Vaccine supplies. Sufficient vaccine supplies, including needles and other equipment for administration (see Appendix 12), to be able to vaccinate household contacts and healthcare workers who have been exposed to the initial confirmed cases.

2. Other support equipment and supplies

• Communication and IT. Phone/email/fax, with programmed-in protocol files and contact numbers/addresses.

• Electrical plugboard with extension cable in case there is no electrical access in a field situation.

• Refreshments. Juice cartons with attached straws to provide a safe source of hydration for the team (though locally-provided cups of hot tea and coffee would also be safe in most settings).

• Clean clothing. Such as theatre greens that can be provided for people who need to remove their clothes due to heavy contamination.

• Forms for recording details of cases (see Appendix 16) and information sheets for contacts (see Appendix 17).