Emergency care
As an OOH doctor you are likely to encounter emergency situations. You may wish to demonstrate that you are up to date in this area (eg resuscitation course etc), to identify learning needs or to demonstrate your skills in practice. The recording of a significant event would be an alternative when demonstrating your practice.
You may download a simple template here.
The two examples below show both training and application in practice:-
Description of event
I attended a resuscitation course organised by the OOH provider, this included training in the use of the new resuscitation kit and defibrillators.
What happened? What was learned/demonstrated?
The OOH service has recently updated its resuscitation kit, with new oxygen bottles, resuscitation bags and defibrillators. I updated my knowledge of basic life support and am now aware of latest guidance from the Resuscitation Council UK. This information alone was important, as there have been changes since my last update. More importantly I gained two major learning points. : -
- I found out that there are now two valves on the particular oxygen cylinders used. I was amazed that none of my colleagues had been given this information either. Initially I struggled to get the oxygen to flow. As a group we have asked the OOH provider to have stickers made pointing this out to potential future users.
- The use of the new defibrillators – this was vital to my work in OOH as the new style machines are very different to the ones I have used before. This training session allowed me to have supervised instruction in their use and indeed they do appear to be foolproof.
I have a certificate of satisfactory completion for inspection.
Reflection on event, are there further learning needs?
Previously I have found resuscitation updates a bit boring with very little or no new information imparted. This session did however impart some vital knowledge and practical skills. I would not have attended this event if it had not been mandatory to continue working in OOH as I have regular updates in my own practice. If I had not attended then I am sure that at a subsequent resuscitation thins would not have run so smoothly (please see significant events). I will now make an effort to attend the annual updates arranged by the OOH provider.
Description of event
I was working in the base surgery when a 57 year old man attended, he had a PMH of type 2 DM and had been feeling light headed and sweaty for 4 hours. On arrival it was plain that he was experiencing some sort of cardiac event and I immediately asked the receptionist to call a 999 ambulance and ask the other base doctor to join me. The patient then arrested and the two of us started resuscitation.
The resuscitation pack was complete, an appropriate size airway easily found. Both my colleague and myself had attended a resuscitation update organised by the OOH provider (certificate available for inspection) and had been trained in the base defibrillator. We successfully resuscitated this patient and he was conscious when the ambulance arrived. I later discovered he left hospital 10 days later.
What happened? What was learned/demonstrated?
I feel this demonstrates a number of issues
- Appropriate training
- Appropriate use of equipment
- Teamwork
- Personally acting quickly and efficiently in an emergency
- Recognising a sick patient immediately
Reflection on event, are there further learning needs?
My immediate reaction was one of relief that my colleague was also present at the base which made the resuscitation more effective and a deal less “scary” for me. Looking back now I am able to see the importance of regular updates in training, these events do not happen often but when they do the appropriate training is vital.
I will attend annual updates and training days and hope it never happens again!