General practitioner preparedness to respond to a medical disaster. Part II: Ability and training

Part I of this paper looked at the availability of 18 individual skills in two rural Victorian divisions of general practice, one with hospitals, and the other without. It looked at the deskilling of rural general practitioners and highlights a direct relationship between skill and equipment availability, and in particular, the effect of a local hospital.

By analysing the data in Part I, this paper looks at the availability of rural GPs with the ability to perform a range of 15 pre-hospital skills and analyses the effect of retraining in selected skills.

Part I identified needle and surgical cricothyrotomy as weaknesses requiring retraining in both divisions. Refreshing these led to a modest improvement only. In addition to the cricothyrotomies, retraining in one skill (as chosen by the GP), will increase to over 50% in both divisions, the percentage of GPs with the first nine skills only.

We found that neither division currently has adequate numbers of GPs with the required range of skills to allow for a GP based response to a disaster. Retraining the GP in both the cricothyrotomies and two self-nominated weakest skills resulted in adequate numbers of skilled GPs. The former can be provided by mass training and the latter requires a more personalized training. A 'travelling circus' format is described as a suitable means for this retraining. It also improves networking among health professionals likely to be involved in a disaster, and offers infrastructure support for GP involvement in emergency management, a public education vehicle, and a research vehicle for the study of critical and emergency care to rural areas.