since space is at a premium within an ambulance , it has been attempted to make this barrier / sheath kit as compact as possible while maintaining ease of use . it is possible to reconfigure the kit to be possibly more conformable to spaces available in the ambulance without deviating from the scope of the invention . for this description , envelope 1 of fig1 of the dimensions shown ( and ⅛ ″ thick ) contains all of the items within a barrier paper envelope made of material similar to that used to package sterile adhesive bandages and pads . item 2 is a zip opening that maintains a sterile seal ( or a cutting string ). fig2 shows a family of barriers / sheaths formed of the same material ( eg . 60 to 100 ga . vinyl or polyethylene plastic film ) mounted on cardboard substrate 11 . although other manufacturing techniques can be used , an efficient semi - automated method involves treating one side of cardboard 11 surface with a very low tack adhesive , laying flat a single surface of plastic film with a second film surface on those areas requiring two layers . then , the edges of the two layer parts are bonded by heat sealing where needed . a following step involves die cutting of the plastic film using a steel rule die of appropriate shapes to cut the individual barriers or sheaths keeping them attached to the cardboard to be separated by the emt when needed . item 20 is a sheath for use over a patient finger isolating contact with a pulse oximeter or pulse oximeter probe . note that the edge is heat sealed ( double lines shown ) except for the end . fig3 shows a patient finger 30 poised to enter sheath 20 and then further insertion into a pulse oximeter 31 . a paper entitled “ the effect of a disposable probe cover on pulse oximetry ” by cheung , hardman , and whiteside was published in the apr . 30 , 2002 issue of anaesth intensive care . the limited study indicates that a polyethylene cover may introduce a small error in pulse oximetry reading , but “ this error is unlikely to be of clinical significance ”. since this is the only usage of barrier material in this “ family ” that could impact actual readings or metrics , it should be the one determining the actual barrier material selected based on further testing . item 15 with closed distal end 17 and open top y section 17 is for covering a stethoscope . adhesive tabs 18 attach sheath 15 around the tubing forming the ear pipes of stethoscope 35 in fig4 which shows sheath 15 in use . long section 16 houses the sound hose 37 and is wide enough to accommodate stethoscope head 36 which obviates the need for a separate head or diaphragm cover as in the prior art . note that cardboard substrate 11 is folded up at site 12 to permitting fitting in envelope 1 . item 25 is a single layer sheet with two formed fold lines 26 ( heated to a low is temperature ). this is the optional necktie sheath which can also double as a protective bib to limit emt / patient contact . it has four adhesive patches 27 preferably formed of cut lengths of double sided tape such as scotch brand type 9415pc with high / low tack film with poly coated liner . this would have the high tack adhesive side against the plastic film with the low tack adhesive under the easily removable liner . the necktie sheath use is illustrated in fig5 where release liner is removed from the two patches 27 on panel b but not removed from panel a . then sheath 25 is positioned as shown behind the lower portion of necktie 40 and panel a is folded inwards against the necktie . then panel b is folded inwards over panel a with patches 27 attaching b to a with low tack ( for easy removal ). a tie clip such as 41 is required to attach the assembly to a shirt to keep it from touching a patient when an emt or other health care provider leans over ( main mode of cross contamination for the unprotected necktie !). as an alternative , panel 25 can be used open as a barrier in the form of a bib attached to the front shirt portion of emt 45 as shown in fig6 . here , the release liners from all four patches 27 are removed to provide 4 points of shirt attachment . note that if a tie is worn , this also prevents cross contamination when used in this open mode . fig7 - 10 relate to a separate barrier sheet 50 of different material that is also enclosed in sterile envelope 1 . this is a rectangular sheet of approximate dimensions as shown in fig7 . it consists of two bands of blown stretch wrap ( linear low density polyethylene - lldpe ). the 10 ″ ( 25 cm ) band is made of 60 ga or thinner film while the 8 ″ ( 20 cm ) to which it is linearly bonded is of 120 ga stretch wrap . note that sheet 50 is folded at line 53 over a separator sheet ( not shown ) of paper with a non - stick coating to facilitate fitting in sterile envelope 1 . usage is a simple fast three step process . sheet 50 is wrapped around the upper arm of a patient 60 as in fig8 with thinner material band 52 pushed and distorted toward the armpit . sheet 50 should self - adhere with low tack to stay in place with section 51 providing a smooth base surface for installation of a typical blood pressure ( bp ) cuff 55 with pressure gage 56 as in fig9 . the last step in fig1 is to pull down and forward on layer 52 over cuff 55 to protect against splatter of bodily fluids . note that as per the cleaning instructions , if the cuff velcro gets contaminated the bp cuff must be discarded as “ red ” waste . the entire bp cuff 55 should be protected except for pressurizing bulb 57 and its flexible line which can be easily cleaned by wiping . barrier sheet 50 isolates the inner surface of bp cuff 55 from touching patient skin . note that layer 52 is transparent and pressure gage 56 may be read adequately through it , but it can also be raised up is while actual reading is taken . fig1 and 12 relate to a substitution of a stethoscope head cover 75 for the full stethoscope cover 15 shown in fig2 . head cover 75 is circular in shape ( approximately 2 . 75 ″ in diameter or 70 mm when flat ). it has a solid bottom layer which is heat sealed around the edge to a top layer with access slit 76 and hose connection hole 77 near the edge . this is shown in fig1 as part of family 70 ; note also that cardboard substrate 71 no longer requires the folded extension of substrate 11 shown in fig2 . fig1 shows stethoscope head 36 installed through slit 76 inside cover 75 . note that hose 37 fits through hole 77 at the end of slit 76 . although head cover 75 could be a rectangular or square shape , a round shape was selected to offer better conformability to the round head 36 . in the foregoing description , certain terms and visual depictions are used to illustrate the preferred embodiment . however , no unnecessary limitations are to be construed by the terms used or illustrations depicted , beyond what is shown in the prior art , since the terms and illustrations are exemplary only , and are not meant to limit the scope of the present invention . it is further known that other modifications may be made to the present invention , without departing the scope of the invention , as noted in the appended claims .