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  of the pharmacy in the supply tent would have some benefits if the
  pharmacy were connected to the Emergency Room with a vestibule.

  p. Drug security: This was an ongoing problem for both the pharmacy
  and medical logistics. Controlled drug storage capabilities were severely
  limited and totally inadequate for the volume of drugs stocked. Additional
  locking cabinets or lockable nesting boxes are required. At the peak of
  the supply buildup, our pharmacy had four nesting boxes of controlled
  substances on hand; Logistics was able to store bulk controlled substances
  outside-in a tent box during the cooler winter months. This was not an       -
  acceptable procedure during the hotter months.

       q. Miscellaneous problems:

  (l) at the time of deployment, over one-third of pharmacy
  supplies were expired.

  (2) Several drug products were degraded by severe environmental
  factors during-the initial marshalling, shipment, and set-up. Products
  known to be subpotent included isoetharing (Bronkosol) solution, silver
  nitrate applicators, and several parenteral forms of lidocaine and
  bupivacaine.

  (3) Prescription labels were not available. Labels were
  borrowed from another facility until supplies were forwarded from the
  home base, and levels established through the MEDSOM.

  (4) Drug information resources were limited. Attempts to
  transfer the Micromedex computer system from Jeddah to our location were
  unsuccessful.

  (5) The TA was severely deficient in several key therapeutic
  areas including chemical warfare antidotes, muscle relaxants, and
  nonsteroidal anti-inflammatories.

  (6) A computer, printer, and database management program would
  have been extremely useful. This equipment would have facilitated supply
  management and formulary maintenance in the pharmacy

   (7) A microfiche reader was not available to permit use of the
   MEDCAT medical supply catalog. Research of stock numbers and other 
  medical loigistics data was a slow and difficult process.

.
   ALAN J. HESS, LtCol, uSAF, BSC                  Cy: 31 Med Gp/SGA
   Chief, Pharmacy Services
   CENTAF Pharmacy Consultant

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