R.Ray, AM/E&S, NV September 22, 1975 -7- easy to use and innocuous); (2) would be digitalis leaf, grain 1% for the cardic case; (3) they need isopropyl] alcohol to clean the hypos; (4) an examining table or a return of the bed that was there; (5) a curtain across the dispensary; (6) some insecticide, possibly just the kind that you could The spray would be less Paint on would be alright rather than a spray. dangerous except that it would have to be taken care of so the children couldn't get it. Several asthma cases have been treated with intravenous aminophylline which is good medication but should be used with great caution. There is a medication on the market which is the same epinephrine. It is called Susphrine by Cooper Laboratories and it seems to work much more rapidly than That might be thought of as a the regular adrenalin that we use to give. possibility to help obviate or lessen the use of aminophylline intravenously. Although aminophylline cannot completely be abandoned in the treatment of asthma, it can be given intramuscularly in the 2% cc ampule as compared to the 20 cc ampule for the I.V. I am sure that when the regular aide comes gack to the dispensary he will bring some new ideas with him from Majuro. Just to run through the headings, some things written down that I will send - along, but I mention the “Marshallese Medical Cookbook" which is something to think about and I have a-list of. suggestions for the medical aides. Aide responsibilities would include regular dispénsary hours, records on each patient, daily log for each patient, and the inventory and order supplies. He should be responsible for the. security of the building, the premises and the supplies, and hé should also be responsible for sending reports to the home office every six months. periodic refresher trips. He of course should continue to be given , The related suggestions about medication I have gone over already: The refrigerator storage, the alphabetical drug storage, and the use of oral medications wherever possible to replace injections. Perhaps having on the premises an up-to-date Merc Manual or Interns Manual or something on that order would be helpful to refresh his memory. . The sterilization procedures for the dispensary basically would be boiling, followed by antiseptic sterilizing liquid. Steam pressure could be used to sterilize packaging. These things are easy to say and may be difficult to implement. offered in good innocent faith ~ hope they are of value. G - P\O. /Box woods 6 Kula, Maui, Hawail ook They are