----- Original Message -----
From: "Craig Ellis"
> I dont agree Matt (obviously). We prescribe and administer all sorts of
> drugs infrequently with a whole collection of potential serious
> side-effects. PEP is just another set of drugs. I'm famililar enough with
> the drugs to provide an overview of how they work and the frequency of
their
> side-effects. I also feel comfortable providing the first 2-3 doses until
> they are reviewed by sexual health or the ID team. I dont see that as been
> the "junior" to any speciality, any more so than providing the initial
> management to a patient who is going to OT as a "junior" to the surgeons.
We
> deal in the initial management of emergencies.
> Im not suggesting that if you have no experience or training with
something
> that you should do it, but in my personal opinion assessing needlesticks,
> doing a basic risk assessment, +/- starting PEP and then refering to the
ID
> or Sexual health for ongoing management for further care is core Emergency
> medicine.
I think an important principle however, is that whatever we do, we should do
it 24 hours a day. By all means take on PEP, but then you should really do
it in-hours as well as out-of-hours, both to maintain your experience and to
maintain your professional dignity! Basically, if you take on something for
out-of-hours only, then there's something seriously wrong with your
department and there's something seriously wrong with your colleagues'
perception of your worth. Then you really are the other guy's lackey, and
that's something our specialty's got to avoid! Returning to my situation,
Occy Health are happy to do PEP, but only 9 to 5. They're obviously very
happy for us to take it on at night, but I suspect if we offered to take it
over wholesale, they'd feel very threatened! Personally I think this sort of
attitude is highly suspect!
Adrian Fogarty
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