Drugs for the doctor's bag: 1-adults

In the past, GPs carried a range of medicines for acute or emergency visits, which is now less necessary where paramedics are trained and equipped, and where emergency transfers to hospital are rapid. Indeed, acute services and ambulance trusts in some areas may discourage GPs from attending emergencies as it could delay patient transfers. However, there is still a need for some GPs to carry a range of medicines for use in acute situations when on home visits. What to include in the GP's bag is determined by the medical conditions likely to be met; medicines the GP is confident and competent to use; storage requirements and shelf-lives of drugs; ambulance paramedic cover and the proximity of the nearest hospital. Here we suggest medicines suitable for GPs for emergency or acute treatment of adult patients, updating our previous advice and including the underlying guideline recommendations for their use. A later article will cover treatment for children. The intention is not to imply that every doctor should carry every drug mentioned. Instead, we aim to highlight some of the key treatments and suggest choices in some of the more common clinical scenarios that GPs may have to deal with in everyday practice, which may be prior to referral to secondary care. Each section ends with a list of drug recommendations for the doctor's bag; drugs may be referred to in several sections but are only listed in one section to avoid repetition. The article does not provide recommendations for drugs to be stocked for use in routine clinical practice in the surgery (e.g. for minor surgery) or for drugs to be held by out-of-hours primary care services. Separate guidance and advice is available on drugs suitable for use by those providing out-of-hours primary care services. For example, in England a national out-of-hours core formulary contains the minimum list of drugs that patients should be able to access.