At 12:54 PM 12/2/98 +0000, you wrote:
>This is an extract from a letter from Lincolnshire LMC. I don't belive
>that is is a breach of our T.O.S or am I wrong?
>
>"As regards the other issue involving a GP who refuses to attend cardiac
>arrest situations we feel that we would need clarification from you of
>he exact circumstances in which he is refusing. In the ordinary course
>of events a refusal to attend a cardiac arrest would be deemed a breach
>of the GPs terms of service. However, that clearly could not be made to
>stick if the Paramedics had indicated that the patient was already dead
>or moribund and the sole reason was to obtain Certification of Death
>from the GP so as not to have to take the patient to Hospital."
>
>Rob
>Dr R I Johnson
>The Family Practice, Church Lane, Sleaford, NG34 7DF
>Tel. 01529 305595 Mobile 0378 206475 Fax No 01529 305589
>Single handed GP. Send email to [log in to unmask]
IMNSVHO
If a patient has had a cardiac arrest somewhere other than in the surgery
most GPs will be significanly slower to attend than an ambulance. We are
not an emergency service _in that sense_.
If we cannot attend within about 4 minutes our role will be to
confirm death
comfort the grieving relatives.
In our patch a paramedic ambulance is sent. The patient is managed and if
appropriate taken to hospital.
I would see about 1 patient every 5 - 10 years who needed intervention if I
attended. This is not often enough to maintain proficiency even to paramedic
standard, let alone be able to do more.
The journey to hospital should take no more than 10 - 15 minutes. That is
where lives can be saved and that is where the patient should be.
By nearly unanimous agreement that is also the position of our 100+ doctor
co-op. If I was practicing in a very rural community I might well feel very
differently, but in urban / suburban MK with some of the best town / city
roads in the UK this seems the correct policy for both patients and doctors.
Some parts of Lincolnshire seemed very rural last time I was there. What are
the ambulance response times like?
Julian
Dr. J. Bradley, The Stonedean Practice,
Stony Stratford Health Centre, Milton Keynes MK11 1YA
Telephone 01908 261155, Fax 01908 265818
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