A registrar survival guide … emergencies

Take pain seriously

Be aware that emergencies happen. They will happen to you — don’t assume that everyone just has a cough or cold. Take chest pain seriously. Faced with an emergency, call for help early. It is difficult to manage well on your own.

Know where the emergency gear is kept

Familiarise yourself with the emergency equipment in the surgery.  If it is locked find out who has the key. If your surgery has a defibrillator, don’t assume someone else will know how to work it — in fact the other GPs may look to you for advice as you did hospital jobs more recently.  If you are unsure, approach your ambulance service for training. CPR algorithms have recently changed so make sure you are familiar with them.

Although not a requirement for a GP, it is useful to keep your advanced life support course up to date. Many hospitals run one-day refresher courses. Keep doses of adrenaline and anaphylaxis drugs handy for adults and children.

Know your hospitals

Be available to practice staff when on-call and attend requests for a doctor promptly knowing you may have to leave surgery and patients.

Be aware of the methods of referrals for emergencies as they can differ between hospitals. Find out where different conditions need to be referred to.  For example, does chest pain go to casualty or the medical assessment unit?  This will save time.

If you are called out of the surgery, always keep yourself safe if attending patients’ homes, and tell someone where you are going.

Call an ambulance

Recognise the limit of your abilities and call the ambulance service as soon as you need them. Always respect their opinion, because their knowledge of emergency treatment is generally excellent.

Debrief with colleagues after the emergency and discuss what went well and what could be improved to further learning.

Dr Lizzie Croton is a GP registrar in Birmingham 

Essentials checklist

  • Your wits.
  • Emergency equipment.
  • Advanced life support course.
  • An ambulance. 


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