Aust Fam Physician
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Appropriate care of minor burns is key if complications, leading to the need for surgical intervention and increased likelihood of poor outcomes, are to be avoided. ⋯ Correct initial assessment of the patient with a thermal burn will determine whether they can be managed at home or require burns unit care, hospital admission for analgesia or specialist outpatient review. Factors that may impact on healing include the size, depth and location of the wound; the presence of oedema and blisters; as well as the patient's social circumstances, age and health status. First aid with cool running water should be applied to the burn for at least 20 minutes. Cooling and the application of an occlusive dressing will minimise the pain associated with partial thickness burns. Oral analgesics or short term hospital admission for adequate pain control may be necessary. Definitive management of minor burns involves dressings, rest, elevation and oedema control, and regular review as the burn wound evolves and heals. Referral should be considered for any burn wound that appears unlikely to heal within 14 days postinjury.
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Numerous studies indicate that companion animal ownership is associated with a range of physical, psychological and social health advantages, yet there is little discussion around the practical ways to integrate companion animals into healthcare and health promotion. ⋯ The subject of companion animals can be a catalyst for engaging patients in discussions about preventive health. General practitioners are in an ideal position to understand the human-pet dynamic, and to encourage patients to interact with their pets to improve their own health and wellbeing. Questions relating to companion animals could be asked during routine social history taking. The knowledge gained from this approach may facilitate more tailored patient management and personalised lifestyle recommendations.
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This article forms part of our 'Tests and results' series for 2012, which aims to provide information about common tests that general practitioners order regularly. It considers areas such as indications, what to tell the patient, what the test can and cannot tell you, and interpretation of results. Functional gut symptoms are a common problem in the community and many patients present to their general practitioner for assessment and guidance. While part of the GP's role is excluding other pathology, helping patients to manage their symptoms is also important.
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Acute knee injuries are a common presentation in the primary care setting. The Ottawa knee rules provide guidance on how to identify which cases of knee injury require radiographic investigation. ⋯ The Ottawa knee rules are a valuable tool for clinicians in the routine management of acute knee injuries. Studies show that they are highly sensitive at identifying patients with fractures of the knee and have a high degree of interobserver agreement and reproducible results. Application of the Ottawa knee rules in appropriate clinical scenarios may reduce the number of unnecessary radiographs ordered, streamlining patient throughput and allowing for significant cost savings. Although designed for use in adults, some studies have suggested that the Ottawa knee rules may also be applicable to the paediatric population.
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Osteoporosis remains undertreated in Australian primary care, with as few as 30% of postmenopausal women with a fracture and 10% of men with osteoporosis receiving pharmacological treatment. ⋯ Lifestyle factors and ensuring adequate calcium and vitamin D intake are important in preventing and treating osteoporosis. Pharmacological treatments are recommended for patients with a minimal trauma fracture, for those aged 70 years or over with a T-score of -3.0 or lower, or for those who are currently taking prolonged high dose corticosteroids and who have a T-score of -1.5 or lower. Bisphosphonates are recommended as first line therapy for established postmenopausal osteoporosis. Medicine selection is guided by patient gender, menopausal status, medical and fracture history, patient preference and eligibility for government subsidy.