Aust Fam Physician
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For some women, pregnancy can bring a myriad of distressing symptoms. Nausea affects up to 85% of women during early pregnancy and about half of these women also experience vomiting. ⋯ Conventional anti-emetics bring with them a risk of potential teratogenic effects during the critical stage of early pregnancy. Women tend to feel more comfortable taking a natural or herbal substance to help manage these issues.
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Review Case Reports
Chronic nonmalignant pain - the rational use of opioid medication.
Every general practitioner has patients with chronic nonmalignant pain issues. At some point the possibility of using prescribed opioids is raised. ⋯ All prescribing needs to be under strict control, with patients picking up medication from a pharmacy relatively frequently. If the GP feels they have lost control of the situation, urgent advice from a specialist in pain or drug and alcohol medicine should be sought.
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Shared decision making (SDM) is a process within a patient centred consultation that involves both the patient and doctor discussing management options and agreeing on management decisions in partnership. Decision aids are designed to help patients understand the options relating to management for certain conditions and their possible benefits and potential adverse effects. We discuss the evolution and rationale behind SDM and the evidence relating to outcomes, the types of decision aids available, and research relating to their use.
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Minor injuries in children are extremely common in the general practice setting. ⋯ Wound management goals are to avoid infection, minimise discomfort, facilitate healing and minimise scar formation. The care of the patient as a whole should be the first management priority. Successful examination requires gaining the child's trust, relieving pain early, and using a flexible and creative examination technique. Superficial abrasions and lacerations can be safely cleaned with good quality water, and all foreign material removed. Deeper wounds with suspected damage to nerves, tendons or circulation need formal exploration under general anaesthetic. Good local anaesthesia can be produced by topical preparations, and many wounds can be closed with tissue adhesives with an excellent cosmetic result. All children with injuries should be checked for adequate tetanus cover for prrophylaxis.
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People with a life limiting illness may have unpredictable exacerbations of their symptoms requiring after hours care by general practitioners using medications that are readily accessible. All doctors are provided with injectable 'doctor's bag' emergency drugs for use in such a crisis. ⋯ The clinical context, including disease trajectory and patient and caregivers' wishes, must be assessed in palliative care crises. Having excluded reversible problems, symptoms can be treated using doctor's bag medications. Attention must be given to route of administration, duration of effect, and appropriate doses for effective palliation.