Criterion GP5.3 – Doctor’s bag

Why this is important

GPs must be prepared to make home and other visits, and must be available at short notice to help in emergencies that take place within the direct vicinity of the practice while they are at work.

A fully equipped doctor’s bag gives GPs immediate access to core equipment, medications and stationery so they can provide the necessary care in these situations.

Meeting this Criterion

Equipping a doctor’s bag

All GPs in your practice must have ready access to a doctor’s bag that they can take to a home or other visit, or use in an emergency.

If you are a small practice, you may only require one bag that is shared by your GPs. If you are a medium or large practice, you may require multiple bags so multiple GPs can simultaneously use a bag when required.

Storing a doctor’s bag

You must store the bag securely and in accordance with state and territory laws.

Deciding what to include in a doctor’s bag

Determine which medications you need to include in a doctor’s bag based on the:

• location of the practice
• local community’s health needs
• types of clinical conditions likely to be encountered
• shelf life and climatic vulnerability of each medicine.

To ensure patients’ safe use of medicines, you must store these products appropriately and securely, and not use or distribute them after their expiry dates.

Requirements relating to the acquisition, use, storage, and disposal of Schedule 4 and Schedule 8 medicines are contained in legislation, with which you must comply.

Suggested emergency medicines include:

• adrenaline
• atropine sulphate
• benztropine mesylate
• benzylpenicillin
• cephalosporin antibiotic
• chlorpromazine/haloperidol
• clonazepam
• dexamethasone sodium phosphate/hydrocortisone sodium succinate
• diazepam
• frusemide
• glucose 50% and/or glucagon
• glyceryl trinitrate spray/tablets
• hyoscine butylbromide
• lignocaine
• methoxyflurane
• metoclopramide hydrochloride/prochlorperazine
• midazolam
• morphine sulphate/appropriate analgesic agent
• naloxone hydrochloride
• oxytocin
• phytomenadione
• promethazine hydrochloride
• salbutamol aerosol
• tramadol.

Pharmaceutical Benefits Scheme emergency drugs for a doctor’s bag

Certain medications are provided to prescribers without charge through the Pharmaceutical Benefits Scheme (PBS). This means they can be supplied free to patients in emergencies.

A list of these medications  and the emergency drug (doctor’s bag) order form, from Medicare for eligible prescribers is available.

You must have:

• an up-to-date logbook that lists the emergency drug stocks in a doctor’s bag
• a system for checking expiry dates and replacing expired drugs.

Emergency drugs for children

A list of paediatric emergency drugs and their dosages can be found in the Royal Children’s Hospital Melbourne Clinical Practice Guidelines – Emergency drug doses. Consider the items in the list above when deciding which to include in a doctor’s bag.

GPs’ knowledge of medicines in a doctor’s bag

All GPs must be familiar with the medicines that are in your practice’s doctor’s bag, including their general use, suggested dosages and possible side effects.

The RACGP recommends that GPs seek appropriate and ongoing education on these medicines.

Personal protective equipment

PPE is used by staff to minimise the risk of infection. PPE refers to a variety of barriers used to protect mucous membranes, airways, skin and clothing from contact with blood and body substances. This might include gloves, water impermeable aprons/gowns, masks, protective eyewear and footwear.

The choice of appropriate PPE to include in a doctor’s bag is determined by the risk of infection and transmission-based precautions. At a minimum, your doctor’s bag requires PPE for standard precautions (gloves, gown, surgical mask and protective eyewear). Additional PPE could be provided if a pre-visit risk assessment indicates risk of transmission via the contact, droplet or airborne routes.

More information on the use of PPE is available in the RACGP Infection prevention and control guidelines at Section 3 – Personal protective equipment and Section 5 – Levels of precaution.

Meeting each Indicator

GP5.3 A Each of our GPs has access to a fully equipped doctor’s bag for routine visits and emergency care, containing the items listed under the Indicator

You must:

You could:

• educate GPs about the medicines included in the doctor’s bag, including their suggested dosage and possible side effects
• educate the clinical team members so they know how to properly equip the doctor’s bag
• maintain a checklist of the contents of the doctor’s bag
• perform a regular audit of the contents of the doctor’s bag.