Aust Fam Physician
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Comparative Study
GPs' perceived competence and comfort in managing medical emergencies in southeast Queensland.
Little is known about general practitioners' confidence and competence in managing medical emergencies, yet these qualities are vital to maximise patients' chances of survival. ⋯ Postgraduate training in and experience with medical emergencies is important for GPs' confidence and competence in dealing with such emergencies. A proposed update course designed specifically for GPs was strongly supported.
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Life threatening asthma is not an uncommon emergency and all doctors need to have an ordered approach to managing this problem both in the surgery and the home. ⋯ The key to successful treatment of life threatening asthma is a rapid assessment of severity, an early emergency call for an ambulance, oxygen, continuous nebulised beta 2 agonist, corticosteroids and the use of parenteral adrenaline for the patient in extremis.
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General practitioners are concerned with improving the health of the community, and Divisions are an important structure through which this can be achieved. Any focus on health outcomes needs to consider what general practice and Divisions can do to reduce inequalities in health outcomes. ⋯ Divisions see socioeconomic disadvantage as an important issue, and some are developing significant multilevel strategies to address them, although significant gaps exist in the capacity of Divisions to undertake this work.
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After choosing the best computer hardware and software to use, the next major step is to carefully plan how to implement the change from using paper based medical records to electronic medical records. ⋯ Changing from writing medical records on paper to typing to enter the same information into a computer is a major issue for many doctors, especially for older practitioners. Practice staff may lack the confidence to use computers to make appointments and issue accounts or receipts. This paper describes ways to make the changeover in a gentle and relatively easy way. Other issues briefly mentioned include ways to handle incoming correspondence and reports on paper, using the Internet, and clinical photography with digital cameras.
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Originally developed as an antidepressant, bupropion hydrochloride is a selective re-uptake inhibitor of dopamine and noradrenalin which was found to reduce nicotine withdrawal symptoms and the urge to smoke. Bupropion came onto the Australian market in November 2000 as a 150 mg sustained release preparation to be used as an aid to smoking cessation in combination with counselling. Following the PBS listing in February 2001, there was a dramatic increase in prescribing, and considerable public and professional attention focused on this drug. ⋯ Bupropion SR is a useful oral and non-nicotine form of pharmacotherapy for smoking cessation. Efficacy has been demonstrated in two key published trials. In one of these trials efficacy was superior to nicotine patch. There is also evidence of efficacy in patients with mild to moderate chronic obstructive pulmonary disease. Bupropion SR is contraindicated in a number of conditions where there is an increased risk of seizures. This includes patients with a current seizure disorder or any history of seizures. It must not be used concurrently with monoamine oxidase inhibitors and interacts with medications which can lower the seizure threshold. Minor adverse effects such as insomnia, headache, dry mouth and nausea are common. Serious adverse effects are rare but include seizures (risk of 1/1000) and hypersensitivity reactions. The latter can manifest as skin rash and a serum sickness-like reaction.