Doctors need to maintain their knowledge and skills and carry the right equipment and drugs

Life threatening emergencies do not occur every day in general practice: some conditions such as anaphylactic shock may occur only a few times in a professional lifetime. Rarity makes the task of keeping up to date a challenge. How should general practitioners respond?

Firstly, the use of protocols—regularly discussed and updated—should help maintain the essential knowledge. Secondly, regular attendance at practical courses helps sustain skills. The Royal College of General Practitioners has taken an important step by making it a requirement that candidates show their competence at cardiopulmonary resuscitation before they can pass the MRCGP examination. Nevertheless, more skills based courses are needed for established principals.

Thirdly, general practitioners need to be properly equipped for emergency care. The traditional black bag should now be accompanied by a range of items, …