Best place to be when there is an adverse reaction
BY DR RICHARD KIDD, CHAIR, AMA COUNCIL OF GENERAL PRACTICE
Vaccination is one of the most successful and cost-effective health interventions. GPs know that while vaccinations are generally safe, very occasionally a patient will have an immediate adverse reaction. This occurred recently in my practice and highlighted why general practice remains the best place to receive a vaccination.
Best practice dictates that vaccination should be provided by a medical practitioner or by a nurse under the supervision of a medical practitioner. However, the efforts of other health professionals, such as pharmacists, to get involved in providing vaccinations, leaves me concerned at the potential consequences for patients. Opting for convenience, patients may not understand the benefits of care from a medically trained practitioner, who has the facilities and clinical capacity to identify and manage a rapidly evolving adverse reaction.
In my example, a child who had received their 12-month immunisation experienced facial redness and swelling at the injection site within two minutes of receiving the vaccine. We were well equipped to respond accordingly.
The speed of the reaction had us monitoring for the development of any breathing difficulties, which thankfully did not arise. However, had the child gone into anaphylaxis we were equipped and skilled to immediately respond. The child was administered 2ml orally of a corticosteroid and monitored.
The adverse reaction was also promptly reported and the child’s parents provided with information and a plan of management, including what this might mean for future vaccinations. Now that the reaction has been recorded in the child’s medical record, we will ensure even closer medical supervision is provided at the 18-month immunisation.
As GPs, we owe it to the parents of the children we care for to ensure that questions they have about immunisation are answered honestly and backed up with scientific evidence such as that provided in the Australian Academy of Science’s The Science of Immunisation/Questions and Answers.
As family doctors we are the most trusted source of advice for parents, see the vast majority of children a number of times per year during their first six years and deliver almost three-quarters of all their vaccinations. We have significant opportunity during this period to embed within the family construct the value of having a regular GP.
Last month the AMA’s Family Doctor Week highlighted the important role GPs play in caring for the community. Immunisations, in many cases, provide important opportunities to check in on our patients and see how they are faring. Not only is immunisation an important part of preventive health care, it provides the opportunity to speak to people about their other health care needs
Despite what must have been a very worrying experience for the young child’s family, I know the standard of care we delivered was best practice. They saw the value of GP care first hand and I have little doubt that this family will be back to see me again, safe in the knowledge that quality is at the heart of everything we do as GPs.