2. Prevention and practice preparedness

Medical history and risk assessment

Most in-practice emergencies are preventable, or their severity can be reduced, through good preparation:

• Take and regularly update a comprehensive medical history at every course of treatment, including allergies, current medications and significant past medical history.
• Identify patients at higher risk (e.g. poorly controlled diabetes, asthma, cardiac disease, epilepsy, known allergy) and plan treatment and anxiety/pain management accordingly.
• Minimise patient anxiety and pain, which are common triggers for vasovagal syncope and can exacerbate underlying conditions.
• Ensure patients have eaten normally and taken regular medication before appointments, where relevant (e.g. diabetic patients).

Practice preparedness

• A written, accessible medical emergency policy, with defined team roles.
• Emergency drugs and equipment immediately available in every treatment area, checked and logged regularly.
• A clear, rehearsed process for calling for emergency ambulance assistance, including how to give the practice address and access details.
• Regular, practical, whole-team simulation drills.

ABCDE approach

For every emergency, assess using an ABCDE approach (Airway, Breathing, Circulation, Disability, Exposure), call for help early, and continuously reassess the patient’s response to treatment.