This article relates to the CQC key questions: Is your practice safe? and Is your practice effective?
CQC cannot be 100 per cent prescriptive around the exact emergency drugs that should be available to GPs because it depends on the situation.
One thing is for sure, GPs need the knowledge, skills, drugs and equipment for managing medical emergencies. Practices also need treatment rooms that enable emergencies to be managed while waiting for an ambulance.
The doctor’s bag
GPs need to carry a range of drugs for use in acute situations when on home visits.
Exactly which drugs they should carry is very dependent on the location of the practice. The drugs required by a remote and rural GP can be very different to drugs required by an inner city GP.
Therefore the choice of what to include in the GP's bag is determined by:
- the medical conditions they are likely to face.
- the medicines they are confident in using.
- the storage requirements.
- shelf-life.
- the extent of ambulance paramedic cover.
- the proximity of the nearest hospital.
- the availability of a 24-hour pharmacy.
In the GP practice
Below is a suggested list of emergency drugs for GP practices. This list is based on current practice modified from a Drugs and Therapeutics Bulletin in 2005.
This is not intended to be either exhaustive or mandatory and that final decision needs to be taken contextually so that choices/omissions can be professionally justifiable.
| Drug | Indication |
|---|---|
|
Adrenaline for injection |
Anaphylaxis or acute angio-oedema |
|
Atropine for practices that fit coils or minor surgery is performed |
Bradycardia |
|
Benzylpenicillin for injection |
Suspected bacterial meningitis |
|
Chlorphenamine for injection |
Anaphylaxis or acute angio-oedema |
|
Glucagon (needs refrigeration) or Glucagel |
Hypoglycaemia |
|
Hydrocortisone for injection |
Acute severe asthma, Severe or recurrent anaphylaxis |
|
Salbutamol either nebules or inhaler with volumatic |
Asthma |
|
Antiemetic – Cyclizine or Metoclopramide |
Nausea and vomiting |
|
Opiates – Diamorphine or Morphine or Pethidine |
Severe pain |
|
Naloxone (dependent on if opiates are kept at the practice) |
Opioid overdose |
|
Diclofenac (intramuscular injection) |
Analgesia |
|
GTN Spray or unopened in date GTN SL tabs |
Chest pain of possible cardiac origin |
|
Aspirin soluble |
Suspected myocardial infraction |
|
Rectal diazepam and/or IV diazepam |
Epileptic fit |
We would want to see evidence that an appropriate risk assessment has been carried out to identify a list of medicines that are not suitable for a practice to stock, and how this is kept under review. There should be a process and system in place to check that drugs are in date and equipment is well maintained.
You may also find this article helpful as a reference guide.
- Professor Nigel Sparrow is senior national GP advisor and responsible officer at the CQC
More CQC resources
- View the full CQC Essentials series on Medeconomics
- CQC's recommended reading to help practices meet regulations and prepare for an inspection
Picture: iStock
