Criterion 5.2.1 Health service equipment
Our health service has access to medical equipment necessary for comprehensive primary care and resuscitation.
► A. Equipment for comprehensive primary care and resuscitation is available within our health service, including (direct observation):
- blood glucose monitoring equipment
- disposable syringes and needles
- equipment for resuscitation, equipment for maintaining an airway, equipment to assist ventilation (including bag and mask), intravenous access, and emergency medicines
- examination light
- eye examination equipment (eg. fluorescein staining)
- gloves (sterile and nonsterile)
- height measurement device
- measuring tape
- monofilament for sensation testing
- oxygen (and the means to administer it)
- patella hammer
- peak flow meter or spirometer
- spacer for inhaler
- specimen collection equipment
- urine testing strips
- vaginal speculae
- visual acuity charts
- X-ray viewing facilities.
► B. Our health service has timely access to the following equipment:
- dental mirror (direct observation, interview).
► C. Our medical and other clinical staff can describe the procedures commonly performed within our health service and can demonstrate that available equipment is safe and sufficient for these procedures (interview).
► D. Our health service has a schedule for the maintenance of our clinical equipment (document review).
► E. Our health service has an automated external defibrillator which staff can readily access in an emergency (direct observation).
Health services in prisons need to have the necessary equipment for comprehensive primary care and resuscitation. To meet this criterion, the equipment must be present and in good working order.
There is a wide range of equipment that health services may need in order to provide comprehensive primary care, including emergency resuscitation, within a prison. Additional equipment may be required depending on the particular interests and requirements of medical and other clinical staff, the procedures the health service undertakes and the patient population. For example, it is likely that health services in correctional settings will need equipment and medicines to treat patients who are suffering from drug overdoses or drug withdrawal.
If a health service offers spirometry, it is not essential to also have a peak flow meter (as outlined in Indicator A). Health services need to have timely access to spirometers and electrocardiographs. Some health services will have these diagnostic devices on their premises, other health services will have ready access to this equipment but not own it. Health services that do not have an electrocardiograph or spirometer on their premises need to be able to describe their arrangements for accessing this equipment when necessary on the day of a consultation. Similarly, if the health service does not provide dental care on its premises, the arrangements for accessing a dental mirror or dental care by an external provider need to be demonstrated.
Equipment that requires calibration or that is electric or battery powered (eg. electrocardiographs, spirometers, autoclaves, vaccine refrigerators, scales, defibrillators) needs to be serviced on a regular basis to ensure it is maintained in good working order. To ensure equipment operates safely, effectively and accurately, manufacturers’ guidelines should be used to determine maintenance schedules for health service equipment.
There is evidence both internationally and in Australia to suggest that immediate defibrillation significantly improves the chance of a patient’s survival after cardiac arrest. Although cardiac arrest in primary care situations is a very rare event, the difference in outcomes between early defibrillation and later defibrillation is significant (10% increase in mortality for each minute from the time of the arrest).58 The ability of patients in prisons to directly access mainstream emergency care is restricted. Health services in prisons therefore need to have equipment for emergency care and resuscitation including an automated external defibrillator. As the health service is unlikely to be staffed 24 hours per day, it is recommended that the defibrillator be placed in an area where prison staff can access it in case an emergency arises outside the service’s normal opening hours (eg. outside the main door to the health service).