Dealing with office emergencies. Stepwise approach for family physicians.
OBJECTIVE
To develop a simple stepwise approach to initial management of emergencies in family physicians' offices; to review how to prepare health care teams and equipment; and to illustrate a general approach to three of the most common office emergencies.


METHODS
MEDLINE was searched from January 1980 to December 2001. Articles were selected based on their clinical relevance, quality of evidence, and date of publication. We reviewed American family medicine, pediatric, dental, and dermatologic articles, but found that the area has not been well studied from a Canadian family medicine perspective. Consensus statements by specialty professional groups were used to identify accepted emergency medical treatments.


RESULTS
Family medicine offices are frequently poorly equipped and inadequately prepared to deal with emergencies. Straightforward emergency response plans can be designed and tailored to an office's risk profile. A systematic team approach and effective use of skills, support staff, and equipment is important. The general approach can be modified for specific patients or conditions.


CONCLUSIONS
Family physicians can plan ahead and use a team approach to develop a simple stepwise response to emergency situations in the office.
Sempowski
Ian P
IP
Department of Family Medicine, Queen's University, Kingston, Ont. sempowsk@post.queensu.ca
Brison
Robert J
RJ
D000554:Ambulatory Care Facilities; D000707:Anaphylaxis / Q000628:therapy; D002170:Canada; D004630:Emergencies; D004864:Equipment and Supplies; D005194:Family Practice; D006801:Humans; D017202:Myocardial Ischemia / Q000628:therapy; D010360:Patient Transfer; D011787:Quality of Health Care; D014218:Triage; D014754:Violence