(—
Major prob:ems
include
a
lack of chemically oure
gater,
inadecuate
reagent supplies, inordinate delay in obtaining supplies and
repairs, and no
mechanism to develop new staff to fill vacancies caused by hormal attrition.
Ebeye Field Hospital has two laboratory assistants anf
in
procedures
The
available.
x-ray
Complete Blood Counts and urinalyses.
project
laboratories
Lab
obtained.
for
service
needs
has
technician
is
croqs-trained
Unofficial assistancd@
its
beyond
been
planned
capability
for
is very limited
the
to
do
from DOE and DOD
pPccasionally
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
and
staff
planned
providing
fdding
by
some
tertiary
specialty
capability
requires major enhancements to the laboratory service.
1.
Senior
(American
technologists
(Medical
Laboratory Technician)
Society
or
of
Pathologists
Clinifal
are
equivalent)
at
needed
both
hospitals to expand the types of procedures availablel particularly in
clinical chemistry.
2.
Chemically pure water must be provided at both hospitBls.
multiple
cartridge
(Barnstead
type)
recirculating filter
should
be
installed
at
A permanent
deioniz
water
Ebeye
is
a
system
absolutely
essential at Majuro.
3.
Analytic balances, pH meters, and volumetric glasswarg@
of
reagents,
standards,
and
quality
control
for preparation
materials
should
be
available at both hospitals.
4.
Both
should
subscribe
to
and
participate
in
a prpficiency survey
service.
5.
Additional equipment and instrumentation should be pr@vided to measure
blood gases, enzymes, lipids, and a complete elecrolyje panel.
6.
Arrangements
should
be
made
for
timely
suppo
by
reference
laboratories for those tests that remain beyond the qapability 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 wofkshops and other
continuing education activities must be provided.