Aust Fam Physician
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Epistaxis is one of the most common ear, nose and throat (ENT) emergencies to present to general practitioners (GPs). The management of epistaxis has evolved significantly in recent years, including the use of nasal cautery and packs. Successful treatment requires knowledge of nasal anatomy, and potential risks and complications of treatment. ⋯ Epistaxis can be classified into anterior or posterior bleeds, the former being the most common. Anterior bleeds can often be treated with cauterisation with silver nitrate sticks, provided there is good preparation, correct equipment and assistance close at hand. If there is a lack in any of these aspects, prompt use of nasal packing and referral to an emergency department or a specialist ENT service is recommended.
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Approximately 8% of the Australian population live with any one of about 10,000 known rare diseases. This is similar to the proportion of people living with diabetes or asthma. ⋯ Research from the Australian Paediatric Surveillance Unit indicates that people living with rare diseases face significant challenges, including diagnostic delays, lack of available treatment and difficulty in finding the right health service. Families feel isolated, under-supported, and often face economic hardship. All GPs see people with rare diseases and have a crucial role in making appropriate referrals, coordinating care, supporting families, and linking them with psychosocial and other supports. GPs require access to current, relevant resources to assist them to help patients with rare diseases. A coordinated national approach to rare diseases is also needed in Australia.
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A significant amount of attention has been paid to the increase in emergency department (ED) presentations in Australia. Questions have arisen regarding whether all of those presenting to the ED are actually in need of true emergency services. Under-standing the characteristics of those patients who may be cared for in non-emergency settings is important for future health system strategies. The aim of this study was to identify age-related variation in primary care type emergency department (ED) presentations over time. ⋯ There are marked differences by age in the proportion of triage category 4 or 5 ED presentations that met the criteria for primary care type visits. These results indicate it was primarily younger patients who presented to the ED with non-urgent conditions. Most might be able to safely receive care in a primary care setting.
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Same-sex-attracted women describe lower satisfaction with their general practice care, compared with heterosexual women. Yet, they have greater health inequalities, which requires effective care. A lack of disclosure of sexual orientation to general practitioners (GPs) may be one factor influencing these issues. ⋯ Facilitating disclosure should be a shared responsibility between same-sex attracted women and their usual GP. This must be accompanied by improved GP knowledge and affirming attitudes regarding specific health needs of same-sex attracted women.
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Virtual forms of communication (eg texting) can support patients and may contribute to better care. However, these informal communication methods may intrude on the doctor’s leisure time and undermine standards of care if they replace face-to-face consultations. Texting may cross boundaries in potentially unprofessional ways, especially when particular patients are favoured with this privilege. ⋯ This makes it important for practices to develop policies supporting the responsible use of virtual communication. Such policies should:clarify (for patients and GPs) when its use is appropriate accommodate doctors’ individual preferences regarding technology provide guidance regarding GPs’ duties, especially for interactions that do not allow full evaluation of patients. GPs may wish to have specific criteria for providing patients with this degree of access, set very clear indications and contraindications to its use, explain the potential pitfalls, and ensure that text messages augment good care rather than replace it.