In article <000801bdb5c8$5d184440$7be9b094@trowell>, Dr Mark Trowell
<[log in to unmask]> writes
>I have been asked to draw a list of reasons that GP should automatically
>attend our Cottage Hospital after nurses ring to see patients.  Any comments
>gratefully received.

Who wants this done and why?

We have no fixed rules - but excellent nurses who deal with loads of
stuff - most importantly we have trust (that's with a small _t_)
>
>So far:  Loss of consciousness, Chest pain not relieved within 20 minutes by
>GTN, Probable fracture if no transfer to another hospital, Breathlessness at
>rest, CVA.
>

Our nurses would deal with a youngsters faint - no probs.  An older one
they might stick in a bed for us to review later.

We see _all_ chest pains - 20 minutes is wasted in pain to needle time
if they need thrombolysing - we are best part of an hour from DGH so
other pathologies also often benefit from our attention (ambulance not
allowed to decompress tension pneumothoraces etc).

(Nurses would automatically exclude slight knock to ribs with bruising
in 25 year old from this system)

The only rule is that they have to discuss all kids before discharging
them (not our rule).

We could not operate in any other way in our geographic and demographic
situation.


HTH

Cheers - must dash - dinners under the grill - fish tonight - ooh I
think its burning - off I go to Turn the Pike ;-)
-- 
Jelly Bean

                        'When you get fed up surfing....
                                        .....go find some waves'


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