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Standards for general practices (4th edition)

including Interpretive guide for Aboriginal and Torres Strait Islander health services

Standard 5.2 Equipment for comprehensive care

Our practice provides medical equipment and resources that are well maintained and appropriate for comprehensive patient care and resuscitation.

Criterion 5.2.2

Doctor’s bag

Our practice ensures that each GP has access to a doctor’s bag.

Indicators

► A. Each of our GPs has access to a fully equipped doctor’s bag for emergency care and routine visits and the bag contains:

  • auriscope
  • disposable gloves
  • equipment for maintaining an airway in both adults and children
  • in-date medicines for medical emergencies
  • ophthalmoscope
  • practice stationery (including prescription pads and letterhead)
  • sharps container
  • sphygmomanometer
  • stethoscope
  • syringes and needles in a range of sizes
  • thermometer
  • tongue depressors
  • torch.

Explanation

Key points

  • The doctor’s bag should be fully equipped with required equipment
  • General medicines for the doctor’s bag will depend on the practice’s location and the type of clinical conditions likely to be encountered
  • The doctor’s bag needs to be stored securely.

Security

Doctors’ bags must be kept secure in accordance with state and territory legislation.

Equipping the doctor’s bag for use

All GPs in the practice require ready access to a doctor’s bag. Bags should always contain core equipment, medications and stationery so when they are required the GP can simply add equipment in regular use (eg. auriscope, ophthalmoscope or stethoscope) to make the bag ready for use.

Medicines for the doctor’s bag

Practices need to consider what general medicines they should keep in their doctors’ bags. In general this will be determined by the location of the practice, the health needs of the local community and the type of clinical conditions likely to be encountered. The shelf life and climatic vulnerability of various medicines needs to be accommodated.

To ensure patient safety, it is important that GPs are familiar with the medicines that are included in their doctor’s bag, including the general usage, suggested dosage and possible side effects.  It is recommended that GPs seek appropriate and ongoing education on these as required. Amended in May 2013.

Suggested emergency medicines include:

  • adrenaline
  • aspirin
  • atropine sulphate
  • benztropine mesylate
  • benzylpenicillin
  • chlorpromazine or haloperidol
  • diazepam
  • ergotamine maleate
  • frusemide
  • glucose 50% and/or glucagon
  • glyceryl trinitrate spray or tablets
  • hydrocortisone sodium succinate or dexamethasone
  • metoclopramide hydrochloride
  • morphine sulphate or appropriate analgesic agent
  • naloxone hydrochloride
  • prednisone
  • promethazine hydrochloride
  • salbutamol aerosol.

PBS emergency drugs for doctors’ bags

Through the Pharmaceutical Benefits Scheme (PBS), certain medications are provided to prescribers without charge.  Prescribers can, in turn, supply them free to patients for emergency use.

A review of these medications was undertaken in December 2012 and a comprehensive and up-to-date list of PBS medications available for doctors’ bags is available at www.pbs.gov.au/browse/doctorsbag.

The Emergency Drug (Doctor’s Bag) Order Form is available from Medicare. Amended in May 2013.

Emergency drugs for children

Paediatric emergency drugs and dosages can be found in the Royal Children’s Hospital Pharmacopaecia, available at www.rch.org.au/pharmacy/dev/index.cfm?doc_id=11341.

Australian prescriber article on emergency medicines for the doctor’s bag

The 2007 article by Andrew Baird, ‘Drugs for the doctor’s bag’, provides a useful explanation of PBS and other medicines for the doctor’s bag. The article is available at www.australianprescriber.com/magazine/30/6/143/6/.

Standard 5.2 Equipment for comprehensive care

Our practice provides medical equipment and resources that are well maintained and appropriate for comprehensive patient care and resuscitation.

Criterion 5.2.2

Doctor’s bag

Our practice ensures that each GP has access to a doctor’s bag.

In a nutshell

A doctor’s bag should be available at any time, to each GP, fully equipped and stored securely. In remote settings, a doctor’s bag may be interpreted as a combination of the special packs in common use in ACCHSs.

Key team members

  • Health service manager
  • Clinic manager

Key organisational functions

  • Equipment register
  • Doctor’s bag

Indicators and what they mean

Table 5.5 explains each of the indicators for this criterion. Refer to Criterion 5.2.2 Doctor’s bag of the Standards for general practices for more information and explanations of some of the concepts referred to in this criterion. 

Table 5.5 Criterion 5.2.2 Doctor’s bag
IndicatorWhat this means and handy hints
▶ A. Each of our GPs has access to a fully equipped doctor’s bag for emergency care and routine visits and the bag contains:
  • auriscope
  • disposable gloves
  • equipment for maintaining an airway in both adults and children
  • in-date medicines for medical emergencies
  • ophthalmoscope
  • practice stationery (including prescription pads and letterhead)
  • sharps container
  • sphygmomanometer
  • stethoscope
  • syringes and needles in a range of sizes
  • thermometer
  • tongue depressors
  • torch.
Each of your health service doctors has access to a doctor’s bag, fully equipped with the contents listed, for emergency situations and routine out-of-clinic visits. The bag should be kept secure, and in accordance with each state and territory’s legislative requirements.

In remote settings, a doctor’s bag may be interpreted as a combination of the special packs in common use in ACCHSs, together with any additional pieces of equipment that make up the full complement of equipment described in this criterion.

Different communities’ health needs mean that the medicines kept in the doctor’s bag would reflect those needs.

The shelf life and climatic vulnerabilities of medicines need also be taken into account when deciding how your health service stores the medicines required for the doctor’s bag.

Case study

Below is a description of the ways in which an Aboriginal community controlled health service can ensure that each of its GP has access to a doctor’s bag. Not all of these good practices are required by the Standards, but they illustrate the many practical and creative things that ACCHSs can do to ensure they deliver services of high safety and quality to their community.

The health service has a doctor’s bag (or a combination of packs and any additional equipment) containing the required equipment, and the doctor’s bag is readily accessible to the doctors. It contains the necessary medicines to enable doctors to treat patients appropriately wherever they are.

The doctor’s bag is kept in a locked cupboard and is checked weekly at the same time that the equipment is checked, and these checks are recorded in a log.

Health services should ensure that GPs are familiar with the medicines contained in their doctor’s bag, including the general usage, suggested dosage and possible side effects.

It is recommended that GPs seek appropriate and ongoing education on the medicines contained in their doctor’s bag. Amended in May 2013. 

Showing how you meet Criterion 5.2.2

Below are some of the ways in which an Aboriginal community controlled health service might choose to demonstrate how it meets the requirements of this criterion for accreditation against the RACGP Standards. Please use the following as examples only, because your service may choose different forms of evidence to show how you meet the criterion that may be just as good or better.

  • Through the use of direct observation.
  • Maintain a doctor’s bag contents checklist.
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