Grid Down Hospital: Part III – Tools


Flighterdoc sends:

Basic Tools

Certain basic tools are needed to perform medicine. While all are not needed on every patient, some are and are needed to properly perform an exam and diagnose patients.

Stethoscope – A cheap stethoscope is good for taking blood pressures in a quiet room and not much more. A good stethoscope can cost several hundred dollars, without getting into electronic ‘scopes. Good brands include 3-M Littman, Welch-Allyn and Hewlett-Packard, ADC is a mid-range brand. It is possible to find good stethoscopes at reasonable prices. Be careful with “Sprague-Rappaport” (a style and not a brand) dual tube scopes, if the tubes rub against each other you get noise. If that’s all you have, tape the two tubes together. Sources include Amazon, Ebay, and, among others.

BP Cuff set – Actually called an aneroid sphygmomanometer, these are the common things that get wrapped around your arm and pumped up. You should have a kit with different sized cuffs, a cuff that is too small for the arm will read high, and too large for the arm will read low. Automated home BP units are nearly worthless – they are expensive, use power, and are frequently quite inaccurate. If you should happen on a mercury sphygmomanometer that is still intact, great – they are fairly accurate over the long haul, and as long as the glass doesn’t break, safe enough.

Headlamp – Preferably a bright and adjustable output LED version. Actually, you should have several. This can be one you use for camping, it doesn’t have to be a medical version. I keep one in my locker at work and occasionally use it in day to day work in my ED.

LED lights have pretty well changed flashlights in the last few years. LED’s are typically whiter, can be brighter and certainly uses less battery power. A headlamp can be used to perform minor or major surgical procedures, work on patients at night, and just is a handy thing to have. They can be purchased almost anywhere, including Amazon or even Wal-Mart for $10-15 or less. Combined with a small solar battery charger and rechargeable batteries, you should be able to have light for quite some time.

Thermometer, normal range, oral – Get a digital version and a bunch of the plastic sleeves for it, and just replace it yearly (it’s cheaper than trying to find the battery and replacing it). Wal-Mart, your local drug store, or Amazon.

For when you can’t replace the digital battery, get (several) glass medical thermometers – oral and rectal, (the only real difference is the taste) and a small dish or tray to disinfect them in. You will also need a program or policy to clean them between different patients: I suggest having one for each admitted patient and do a thorough sterilization between patients, don’t use them across patients. You can use the same sleeves as for the digital thermometers on them to make hygiene a bit easier.

Thermometer, hypothermia – This is a lower than normal reading thermometer. Most of the same comments for regular thermometers apply, with the exception of finding them at Wal-Mart, and they are a bit more expensive. Handy when treating a suspected hypothermia patient.

Tuning fork, 128 Hz and 256 Hz – Refer to for reasons. (Accessed 1 Oct 2016)

Oto-Ophthalmoscope – This is the tool that doctors use to look at your eyes, and in your ears. While it is two different tools, they are usually combined with a common handle/battery pack. Of the two, the otoscope is probably the most useful, and the least expensive: You can get them at Wal-mart for less than $10, while a professional tool is several hundreds. They require batteries.

Pulse Oximeter – A small device that usually clips onto a fingertip and provides a reading on the amount of oxygen in the blood (showing how well oxygen is getting to the rest of the body) and usually the pulse. These can be purchased from Amazon and the usual sources for around $25 and up, and require battery power.

Watch with second hand, wind-up – This can be a simple and inexpensive watch, if you don’t already have a wind-up look for an old Timex at a swap meet, pawn broker or online. You should have a wind-up for when you can’t get a replacement battery, and the sweep second hand makes it easier to time things like respirations.

Patient Charts -There’s a saying in medicine – if you didn’t write it down, you didn’t do it. So, some sort of charting for your patients is in order. The government, of course, has all sorts of forms for this, some of which are actually useful. You can download government forms from
(Accessed 1 October 2016).

Some of the more useful ones include SF 88, SF 93, and some of the 500-series forms. You can download and print them out if they will be useful for you. You could also make your own if you want, on plain paper. You will need clip boards, pens, 3-ring binders, large envelopes and file folders. Some post-it notes might be useful as well as 3×5 and 4×6 index cards, all of which are commonly available. Don’t forget pens and pencils.

Tool and Supply Sources

As mentioned, many tools are commonly available at Wal-Mart, your local drug store, online at Amazon, Ebay, etc.

Other sources include some of the following online stores – I’ve purchased from them all. (All accessed on 16 May 2015).

Government Surplus

Sometimes, if you know what you’re looking for you can buy US Government surplus. Generally the government isn’t getting rid of equipment that works well, that is complete, or is even safe to use so extreme caution is necessary.

The website is

Refer to the upcoming “Grid Down Hospital: Central Supply” for more tools and storage.

We will talk about what to do with this stuff in another article.

29 responses to “Grid Down Hospital: Part III – Tools

  1. Wow this series is great. Thanks for the information and all the links. As a RN and ex Medic I gave familiarity with most thus stuff, and that the author is spot on. I tip my hat to you.

  2. Pingback: WRSA Sends: The Grid Down Hospital /Continued – Mason Dixon Tactical

  3. Are these articles compiled on a website or just rolling through on WRSA?

  4. .

  5. Do you have much experience playing around with the cheap pulse ox readers? I am curious if they have the same range of accurate readings and pick up the heart beat waveform decently?

    • They’re probably good enough. The cheaper ones are a little more sensitive to where on the finger location than the more expensive ones but I have compared the readings from my Nonin Onyx and 9500’s, a cheap Walmart unit and the Welch-Allyn patient monitors ar the hospital and they’re within 1% saturation.

      • Yup.
        They are all “accurate enough”, in that if inaccurate at all, it will be the same inaccuracy, and what you’re looking for is more “trends over time” than a one-off reading this second.

        Overall, given the choice, put the bargain $20 Sprague, a good enough BP cuff, and a drug store fingertip pulse-ox in your carry kit(s), and if you get better examples, put them in your aid station/hospital before going Rolls-Royce on your knockaround field kit(s).
        Just like with everything else in the real world.

        I’m not a cardiologist, but the number of times I’ve needed anything better than my EDC $20 Sprague I can count on my thumbs in 20 years. But don’t get one; get 5, all the same. The eartips and diaphragms fail or get lost long before you’ll have any trouble with the tubes or bells.

        One other tip with a stethoscope: get the longest-tubed model they sell. The first time someone sick, or spewing blood, phlegm, or leftover vomitus is directly opposite your too-close head, and coughing – or worse, you’ll understand why distance is your friend.

        Also, DO NOT get the steth/BP cuff combination where the steth is PART OF the BP cuff, in a Siamese twin sort of way. That’s three kinds of stupid, and eliminates the ability to use the steth as an independent assessment tool. Which is kind of the point.

        And when you get a BP cuff, get one that lets you release air one-handed, easily. As it is, doing manual BPs (a skill set vanishing from most RNs not weaned on it, because of automatic machines) requires full use of both hands, and a stubborn air release wheel is not your friend there.

        Getting a double-eared steth (two sets of ears, one bell, which is a training stethoscope, isn’t a bad idea, because it allows someone who knows what they’re doing to train you, and later allows you to train someone else who doesn’t know what they’re doing yet, both with BP measurement, and general auscultation. If you’re thinking you’d like to cross-train newbs at some point, put it on your wish list.

        And you will find hypothermia-range thermometers at good backpacking stores/websites.
        An excellent electronic version will do oral and rectal, and include hypothermia range, only requiring separate probes (red is rectal, blue is oral). But electronics and batteries fail; whereas mercury without external power lasts – until you break it. Two is one and one is none.

        Re: clinic use of thermometers.
        A small kitchen juice glass, filled with isopropyl alcohol and with a cover (we don’t want thermometer flambe’ from a stray spark!) and several – say 4-12 – thermometers. Alcohol kills cooties, but it takes 10 minutes to work. The bulbs go down in the glass, which kills the germs from the last patient, and cools the mercury back to the bulb, so in a few minutes’ time, it’s ready for re-use. Change the alcohol daily during frequent use.

        And without jumping the gun on supplies, nota bene that any glass 4-canister kitchen set, or individual jars, works just as well for flour, sugar, salt, and coffee as it does for gauze, q-tips, cotton balls, and thermometers.

  6. Enlighten this old goat. I understand what a Oto-Ophthalmoscope is used for. (I have had it shoved in my ear often enough…) But does it have its place/use in trauma situations? Thx.

    • Sometimes to check for blood in the ear canal potentially indicating a basal skull fracture but the majority of my qriting here isnt about trauma…it’s about grid down medical and health care.

  7. Flood headlamps might be a better choice than spot headlamps. Some, like the Fenix HP25, have spot *and* flood beams.

    • Id rather have a fairly tight spot. The idea is to light up the body part I’m working on, not the room.

      My Welch-Allyn loup/light is almost laserlike. Good for examining deep wounds but expensive as hell, fragile and tied to a power supply. A $20 Headlamp does 85% as well for 1/50th the price.

  8. outlawpatriot

    Excellent series. Really. But how many have this capability? Not many. Just a fact.

    Truth is, you get hit bad, you’re gonna die. Best at the moment. Mebbe you get dragged somewhere with the basics. Your torture is just extended.

    The best way to deal with medical issues? Don’t get hit.

    I leave it to you to figure that out. 🙂

    • Hope is not a plan.

      • outlawpatriot

        Ain’t hope fucker. Know that.

        You got an agenda. Good for you. Couple here same same. You want some recognition. I want nothing but the freedom that is my birthright.

        Fuck off. 🙂

        • Well, aren’t you precious.

          None too beight though since you seem to have missed the intro to the series.

          Think your feces lacks odor? Great. Good for you. But your lack of planning and narrow world view is not conducive to your long term survival.

          So just one final question….after your hope fails you, where can I get your gear?

        • What the fuck are you talking to him like that for? Add value to the discussion or keep your lip zipped.

        • That’s the liquor talking again.
          Ignore the drunk, or punch it in the face.

        • op you asshole.

          This man is a Doctor.
          He has given his time and expertise.

          Have some fucking respect.

      • Don’t waste time with that punk, it’ll be dead in less than 30 days after the grid goes down. It’s mouth and small brain will do it in.

        The rest of us thank you for your effort.

  9. Pay no attention, doc.
    His entire medical plan is to shoot the wounded.

    Anything that interferes with that perspective (facts, reality, etc.) just harshes his mellow.
    Pearls, swine, and all that.

  10. Pingback: Grid Down Hospital: Part III – Tools | Oath Keepers Nebraska