SEVERE EMERGENCIES IN RURAL GENERAL PRACTICE

Abstract

ABSTRACT: The objective of this study was to examine the frequency, nature, management and outcomes of life‐threatening emergencies in rural general practice in the Hunter region of Australia in order to help assess the need for training in, and provision of, emergency medical services. Emergencies seen by 18 rural general practitioners over a period of 1 month in 1988 in four different towns in the Hunter region are described. All emergency and after hours attendances during the study period were recorded by the doctors at the time. A measurement of severity validated against the opinion of specialists in appropriate fields was applied for each case. This paper undertakes detailed analysis of data for those patients with life‐threatening illness. Of the total of 1196 emergency attendances recorded, very urgent problems comprised 2.3% and life‐threatening problems comprised 6.1%. These 59 patients had a wide range of diagnoses, the most common being cardiovascular disease, abdominal pain and respiratory distress. The rural doctors treating the patients required a large range of skills, not normally needed by city general practitioners. It was concluded that severe emergencies occur frequently in rural practice and involve a wide range of diagnoses, the most common being medical problems such as cardiovascular disease. Rural doctors require adequate facilities and special skills in emergency medicine to treat these people.