Everyone runs to the hospital pharmacy. It's locked, in the basement, and emptied first. What's valuable is elsewhere, on the wards, and nobody thinks of it.
UNDERSTAND
A hospital is a vertical town, organised never to stop. Everything is duplicated and stored close to where it's used: a nurse doesn't go down to the basement for a syringe. That's why the real stock is spread across the wards, and the central pharmacy is only part of it.
It's also a place where you find sick people, the dead, and people who need help. If staff are still there, what they know is worth more than anything in the cupboards.
ACT
Where to look, in order
1. The crash carts. One per ward, red or yellow, in the corridor or near the nurses' station, often closed with a simple plastic seal. Each holds the same thing everywhere: adrenaline, atropine, amiodarone, IV fluids, syringes, cannulas, intubation kit, a bag-valve mask, sometimes a defibrillator on top. It's full resuscitation, in a kit, laid out in the same order from one hospital to the next.
2. The ward stock rooms. On each ward, a storeroom: dressings, antiseptics, gloves, gauze, drips, common painkillers, frequently used antibiotics. Controlled drugs are in a separate safe; other medicines are freely accessible to staff.
3. Central sterile services. Often in the basement or near the operating theatres. Sealed metal boxes, labelled by procedure: forceps, scissors, needle holders, retractors, already sterile and dated. A complete suture kit weighs a few hundred grams. See L’infection d’une plaie.
4. The operating theatre. Suture thread, sterile drapes, head torches, manual suction pumps, gowns.
5. The maternity ward. Infant formula, powdered and ready to drink, bottles, teats, nappies, delivery kits. It's what runs out fastest in a city in crisis. See Accoucher sans médecin.
6. The kitchen and the laundry. Food stocks for hundreds of meals, large containers, sheets, blankets, clean gowns.
7. The plant rooms. The generator and its fuel tank (hospitals keep several days of autonomy), the UPS batteries, the maintenance team's tools, the pumps.
Oxygen
Large hospitals have a liquid oxygen tank outside, and cylinders on the wards and in a storage room. In Europe, a medical oxygen cylinder has a white shoulder.
- A 5-litre cylinder full at 200 bar gives about 1,000 litres of oxygen, so more than 8 hours at 2 litres per minute.
- Modern cylinders have a built-in regulator with a gauge: you can read what's left.
- Never grease or oil on an oxygen valve, never a flame nearby: pure oxygen makes anything greasy burn violently.
ADAPT
What not to touch
- Yellow bins (sharps and infectious waste): used needles, soiled dressings. They're not supplies.
- Chemotherapy drugs, often marked with a purple label or a specific symbol: toxic on contact.
- Anything with the radiation trefoil, in nuclear medicine and radiotherapy. In 1987, in Goiânia, Brazil, scrap collectors opened an old caesium source from an abandoned radiotherapy machine. The powder glowed blue in the dark; they showed it to their families. Four people died, hundreds were contaminated. A very heavy lead container with that symbol is never opened.
- Vaccine and insulin fridges without power for a long time: insulin keeps about a month at room temperature, vaccines much less.
Expired medicines
The US military had its expired stocks tested for years (the SLEP programme): the great majority of solid medicines (tablets, capsules) kept their efficacy years after their date, if stored cool and dry. The exceptions to know: liquids, insulin, adrenaline, eye drops and some antibiotic suspensions lose their efficacy quickly. See L’infection d’une plaie.
Tips you won't find in any manual
- The outpatient floors (dermatology, ophthalmology, ENT, dental) are ignored by everyone and full of equipment: lamps, magnifiers, fine instruments, local anaesthetics.
- Veterinary clinics have the same antibiotics, antiparasitics and suture thread, in bigger packs, and nobody goes there.
- The dialysis unit has a water treatment system: filters, a reverse-osmosis unit, stocks of purified water.
- The lead aprons from radiology are heavy but stop X-rays and some low-energy gamma rays.
- Trolleys, wheelchairs and stretchers are the best tools to carry what you find. See Démonter, déplacer, rapporter.
- Bottles of hand sanitiser, by the pallet, are a disinfectant, a stove fuel and a fire starter.
- Go in pairs, by day, knowing the way out. A hospital is a maze of identical corridors, and without power, many fire doors close by themselves. See Fouiller un bâtiment abandonné.