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CQC Essentials: Emergency drugs for GP practices

The emergency drugs that the CQC expects to be available to GPs in their practices and in the doctors' home visit bag, plus information about stock management and review.

This article relates to the CQC key questions: Is your practice safe? and Is your practice effective? 

CQC cannot be 100 per cent prescriptive around the exact emergency drugs that should be available to GPs because it depends on the situation.

One thing is for sure, GPs need the knowledge, skills, drugs and equipment for managing medical emergencies. Practices also need treatment rooms that enable emergencies to be managed while waiting for an ambulance.

The doctor’s bag

GPs need to carry a range of drugs for use in acute situations when on home visits.

Exactly which drugs they should carry is very dependent on the location of the practice. The drugs required by a remote and rural GP can be very different to drugs required by an inner city GP.

Therefore the choice of what to include in the GP's bag is determined by:

  • the medical conditions they are likely to face.
  • the medicines they are confident in using.
  • the storage requirements.
  • shelf-life.
  • the extent of ambulance paramedic cover.
  • the proximity of the nearest hospital.
  • the availability of a 24-hour pharmacy.

In the GP practice

Below is a suggested list of emergency drugs for GP practices. This list is based on current practice modified from a Drugs and Therapeutics Bulletin in 2005. 

This is not intended to be either exhaustive or mandatory and that final decision needs to be taken contextually so that choices/omissions can be professionally justifiable.

DrugIndication

Adrenaline for injection

Anaphylaxis or acute angio-oedema

Atropine for practices that fit coils or minor surgery is performed

Bradycardia

Benzylpenicillin for injection

Suspected bacterial meningitis

Chlorphenamine for injection

Anaphylaxis or acute angio-oedema

Glucagon (needs refrigeration) or Glucagel

Hypoglycaemia

Hydrocortisone for injection

Acute severe asthma, Severe or recurrent anaphylaxis

Salbutamol either nebules or inhaler with volumatic

Asthma

Antiemetic – Cyclizine or Metoclopramide

Nausea and vomiting

Opiates – Diamorphine or Morphine or Pethidine

Severe pain

Naloxone (dependent on if opiates are kept at the practice)

Opioid overdose

Diclofenac (intramuscular injection)

Analgesia

GTN Spray or unopened in date GTN SL tabs

Chest pain of possible cardiac origin

Aspirin soluble

Suspected myocardial infraction

Rectal diazepam and/or IV diazepam

Epileptic fit

We would want to see evidence that an appropriate risk assessment has been carried out to identify a list of medicines that are not suitable for a practice to stock, and how this is kept under review. There should be a process and system in place to check that drugs are in date and equipment is well maintained.

You may also find this article helpful as a reference guide.

  • Professor Nigel Sparrow is senior national GP advisor and responsible officer at the CQC

More CQC resources

Picture: iStock

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