Many junior doctors do not know the signs that a patient is critically ill,
according to a report. 
The survey of just under 200 recently-qualified doctors highlights
"significant gaps" in their knowledge and understanding of basic
life-supporting care. 
The study, published in a specialist medical journal, makes alarming reading
for patients. 

Its authors recommend an urgent overhaul of the training provided by medical
schools, 

The researchers found almost a third of doctors failed to answer a question
on how to deal with someone who was unconscious. 

None of the trainees identified all of the steps involved in using an oxygen
mask, and a fifth did not understand how it worked. 

The revelation comes just days after the leak of a pilot study into accidents
and error in the NHS caused a storm. 

One of the co-authors of the latest study says patients should be reassured
by the fact that steps are being taken to tackle medical errors. 

Education call 

The move towards a no-blame system of reporting mistakes is bound to lead to
more known errors initially but should ultimately improve things, says Dr Gary
Smith of Portsmouth Hospitals NHS Trust. 

He told BBC News Online: "We're going through a phase in medicine now where
we are acknowledging our limitations and where errors occur. 

"Hopefully with better education and better recognition of these errors the
incidence is going to go down." 

Dr Smith and a colleague at the trust asked 185 junior doctors to complete
a questionnaire on basic aspects of critical care. 

The group comprised 108 pre-registration house officers and 77 senior house
officers. 

In the UK, most patients admitted to hospital wards following surgery or
because of illnesses like heart attacks are assessed initially by junior
doctors. 

Typically, they have one or two years of experience following medical school.


The questions included: 


A dozen about the signs of critical illness, including how to recognise total
airway obstruction and normal levels of blood oxygen 

How to use an oxygen mask 

The tests needed for an unconscious patient 

Who can legally authorise surgery in those circumstances.
The doctors found: 


Only five senior house officers correctly identified the signs that airways
are blocked while almost half the pre-registration house doctors gave an
incorrect answer. 

Only one in five trainees knew the correct levels of maximum blood oxygen.


Almost a third of trainees failed to answer the question on how to deal with
an unconscious patient 

There was poor recognition that unconscious patients should have their blood
glucose tested. 
The report authors say an overhaul of medical school training is particularly
necessary in view of the fact that medical students are getting less and less
experience of medical emergencies and surgical procedures. 

'Worrying' 

They write in the Postgraduate Medical Journal: "Our study demonstrates that
trainee doctors, many of them having just completed medical school training,
have significant gaps in their knowledge and understanding of the signs of
acute illness and the basic, but potentially life-saving, care required to
support life." 

Mike Stone of the Patients Association described the findings as "worrying".


He told BBC News Online: "It's worrying that this report identifies that
junior doctors are going on to the ward without being able to identify serious
conditions within patients. 

"We have to look at the training that they are getting in the first place to
make sure it lets them identify those specific areas that have been identified
in this report." 

Trevor Pickersgill, chair of the junior doctors committee of the British
Medical Association, said knowledge of signs of critical illness was an
absolute requirement for any doctor. 

"Assessment of emergency patients is something that doctors need at their
fingertips," he told BBC News Online. 

"Many of the errors we've been hearing about this week could be prevented if
postgraduate medical training was better supervised." 

6 responses total.

polytarp is teapot!

Ya think?  It's not like it's a difficult posting style to copy.

polytarp is a teapot copycat!

Who's teapot?

More proof that polytarp is teapot!

Teapot = There's A Penguin On Telly

Response not possible - You must register and login before posting.

- Backtalk version 1.3.30 - Copyright 1996-2006, Jan Wolter and Steve Weiss