{[~“—
Major
probiems
include
a
lack
of chemically pure water,
inadequate
reagent supplies, inordinate delay in obtaining supplies and repairs, and no
mechanism to develop new staff to fill vacancies caused by normal attrition.
Ebeye Field Hospital has two laboratory assistants and is very limited
in
procedures
available.
The
x-ray
Complete Blood Counts and urinalyses.
project
laboratories
obtained.
Lab
for
service
needs
has
technician
jis
cross-trained
to
do
Unofficial assistance from DOE and DOD
beyond
been
its
planned
capability
for
the
occasionally
super
clincs,
are
but
implementation thus far has not succeeded. Dip-stick or Clinitest tablet
testing for urinary glucose is available in some of the community health
centers,
Recommendations :
The
increased
consultants
to
clinical
hospital
capability
staff
and
planned
providing
by
some
adding
tertiary
specialty
capability
requires major enhancements to the laboratory service.
1.
Senior
technologists
(Medical
(American
Laboratory Technician)
Society
or
of
Clinical
equivalent)
are
Pathologists
needed
at
both
hospitals to expand the types of procedures available, particularly in
clinical chemistry.
2.
Chemically pure water must be provided at both hospitals.
multiple
cartridge
(Barnstead
type)
recirculating
should
be
filter
installed
at
A permanent
deionized
water
Ebeye
jis
and
system
absolutely
essential at Majuro.
3.
Analytic balances, pH meters, and volumetric glassware for preparation
of
reagents,
standards,
and
quality
contro]
materials
should
be
available at both hospitals.
4.
Both
should
subscribe
to
and
participate
in
a
proficiency survey
service.
5.
Additional equipment and instrumentation should be provided to measure
blood gases, enzymes, lipids, and a complete elecrolyte panel.
6.
Arrangements
should
be
made
for
timely
support
by
reference
laboratories for those tests that remain beyond the capability of the
local hospital laboratories.
7.
Normal
and abnormal
level quality control
specimens must be run in
parallel with patient samples.
8.
Budget and time for all lab staff to participate in workshops and other
continuing education activities must be provided.