"This featherweight volume packs a heavyweight punch. It's a how-to guide to emergency general medical practice, which omits no important subject - the most practical book ever for general practitioners...the ideal book to keep by your side when on call." Update, 1997 Here is the fully revised fourth edition of this unique book that provides general practitioners with an easy-to-read, easy-to-use guide to the management of the vast majority of emergencies. The first contact a GP has with an emergency case is almost always a telephone call, and the advice given here by the doctor is of paramount importance in the subsequent management of the case. A unique feature of the book is that each topic begins with advice on how to handle the initial telephone call. Each presenting problem is then approached logically with concise notes on assessment, advice and management necessary when the patient is seen. The emphasis is on practical primary care, with discussion of differential diagnosis taken as far as is needed to decide the best immediate course of action. Tables are used liberally to summarise useful information.For each emergency, the ultimate advice and strategy is emphasised within heavy horizontal lines. Emergencies in General Practice is an indispensable book for the practising GP, whether in the practice, on call, or working for the co-op or deputising service. It is also a valuable teaching text for GP registrars.

This book has been written to provide general practitioners with an easy to read, easy to consult guide, to aid in the management of the large majority of practice emer gencies. Each presenting problem is approached logically with telephone assessment and advice followed by the assessment and management necessary when the patient is seen. The emphasis is on practical primary care with discussion of differential diagnosis only taken as far as is needed for deciding the best immediate course of action. Words are kept to a minimum though tables are liberally used to summarise useful information. For each situation the final management advice is highlighted by being presented within a heavily lined box. Our guiding principles for emergency care, which this book naturally reflects, are: (1) Visit first - argue or educate later. (2) If in doubt - see the patient. To use this book for ready reference by the telephone, in the car, or at the bedside: (i) If the patient is a child, look at the contents list at the beginning of chapter 4 and then turn to the relevant pages. (ii) If the patient is an adult, first decide the system involved then look at the contents list at the beginning of the appropriate chapter before turning to the relevant pages."

The original Beecham Manual for General Practice was produced by Dr Selwyn Carson, of Christchurch, New Zealand, whose objective was a set of instructions for patient care for his practice team. Beecham Research Laboratories published and distributed it. Dr Ed Gawthorn of Melbourne, Australia, edited an Australian version again published and distributed by Beecham Research Laboratories. We were invited to adapt the New Zealand and Australian editions for British readers -but we decided that we should produce an entirely new Manual. This was done and it was published and distributed to general practitioners by Beecham Research Laboratories. This latest edition has been revised and updated. The Manual is a ready reference on planned care of certain age groups and situations; specific procedures and emergencies; and clinical care in general practice of important conditions. We have intentionally adopted a concise didactic style that should be helpful for trainers, trainees and members of the practice team. We thank Beecham Research Laboratories, and especially Ed Stanford and Bill Burns, for their support and help over many years. John Fry (Editor) June 1982 viii Section A PLANNED CARE Family Planning A1 Discuss with the individual patient the advantages and disadvantages of all the methods. Keep in mind individual needs, wishes and religious beliefs. In Great Britain * 2.5 million women are registered with their G.P.'s for contraception. -100 per G.P. * 95% of G.P.'s provide contraceptive services.

The Membership examination of the Royal College of General Practitioners has evolved and matured as a seal and a test on completion of vocational training. More than 1000 candidates are taking the examination each year and an increasing majority are trainees who have completed their three year training period. The whole concept and philosophy of the MRCGP has been questioned by critical cynics who refuse to accept general practice as a field of medical practice worthy of recognition as a specialty with its own core of know ledge, skills and expertise and with its own special epidemiology, pathology, clinical presentations and management. These cynical critics are being answered by the growth of the examination and its recognition within the profession as an important and necessary goal to be achieved. The MRCGP exam has arrived, it is here to stay and it will continue to grow and evolve. The exam is no easy obstacle to negotiate. It has a regular failure rate of I in 3 and it requires special preparation and study of its examinees if they are to understand its aims, contents and methods. It must not be assumed that even the brightest trainee can walk off the street, enter the examin ation hall and be confident of passing. It requires a few months of careful and guided preparation.

JOHN JOHN FRY FRY All All examinations examinations create create problems problems and and stresses stresses in in examinees. examinees. The The examination examination for for the the Membership Membership of of the the Royal Royal College College of of General General Practitioners Practitioners is is no no exception. exception. Although Although the the examiners examiners state state that that their their objectives objectives are are to to pass pass candidates candidates wherever wherever and and whenever whenever possible, possible, nevertheless nevertheless the the failure failure rate rate remains remains con sistently sistently at at 30% 30% plus plus of of those those taking taking the the examination. examination. The The reasons reasons for for failure failure fall fall into into a a number number of of groups. groups. The The candidate candidate may, may, through through over-confidence, over-confidence, not not have have prepared prepared for for the the examination. examination. He He may may have have assumed assumed that that it it is is not not necessary necessary to to read, read, learn learn and and digest digest data, data, facts facts and and experience experience on on general general practice. practice. How How wrong wrong that that is, is, he he will will discover discover when when he he sits sits the the exam. exam."