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Out of Hours: |
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Ability to manage common medical,
surgical and psychiatric emergencies in the out-of-hours setting |
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Understanding of the organisational
aspects of NHS out-of-hours care |
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Ability to make appropriate referrals
to hospitals and other professionals in the out-of-hours setting |
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Appropriate communication skills
required for out-of-hours care |
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Individual personal time and stress
management |
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Maintenance of personal security and
awareness and management of the security risks to others |
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Demonstrate an
ability to use telephone triage:
to decide to use ambulance where speed of referral to secondary care or
paramedic intervention is paramount
to make appropriate arrangements to see the patient
to give advice where appropriate |
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Symptoms: |
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Cardiovascular – chest pain,
haemorrhage, shock. |
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Respiratory – wheeze, breathlessness,
stridor, choking. |
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Respiratory – wheeze, breathlessness,
stridor, choking. |
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Central nervous system – convulsions,
reduced conscious level, confusion. |
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Mental health – threatened self-harm,
delusional states, violent patients. |
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Severe pain. |
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Common and/or important conditions: |
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Shock (including no cardiac output), acute coronary
syndromes, haemorrhage (revealed or concealed), ischaemia, pulmonary
embolus, asthma. |
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Dangerous diagnoses
click here to
see this document |
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Common problems that may be expected with certain
practice activities: anaphylaxis after immunisation, local anaesthetic
toxicity and vasovagal attacks with, for example, minor surgery or
intra-uterine contraceptive device insertion. |
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Parasuicide and suicide attempts. |
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Recognise death |
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Investigations: |
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Blood glucose |
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ECG |
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Emergency care: |
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The ‘ABC’ principles in initial management. |
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Appreciate the response time required in order to
optimise the outcome. |
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The Doctor should have Foundation Level 2 acquired skills
whilst in hospital.
Click here to see these skills |
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Understand the organisational aspects of NHS out-of-hours
care. |
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Understand the importance of maintaining personal
security and awareness and management of the security risks to others |
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Treatment: |
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Pre-hospital management of convulsions and acute
dyspnoea. |
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Resources: |
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Appropriate use of emergency services, including
logistics of how to obtain an ambulance/paramedic crew. |
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Familiarity with available equipment in own car/bag and
that carried by emergency services. |
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Selection and maintenance of appropriate equipment and
un-expired drugs that should be carried by GPs. |
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Being able to organise and lead a response when required,
which may include participation by staff, members of the public or
qualified responders. |
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Knowledge of training required for practice staff and
others as a team in the appropriate responses to an acutely ill person. |
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Demonstrate the use of time as a tool and to use
iterative review and safety-netting as appropriate |
