ABSTRACT
Rural ambulances are now normally crewed by paramedics who are well trained in pre-hospital care. Although the injuries sustained in rural road traffic accidents are similar to those sustained in towns, access can be restricted by narrow roads, and definitive treatment may be delayed because of the distance to hospital. Fish farming, a relatively new rural industry, has its own occupational health problems. Many GPs will have spent 6 months or more working in an accident and emergency department as part of their vocational training for general practice. Make sure the patient's airway is patent and secure. If there is any possibility of neck injury, the cervical spine should be stabilised manually, then secured by a rigid cervical collar and neck blocks on a spinal board. A cardiac monitor can make management of ill patients much easier. Thrombolytic or 'clotbuster' therapy administered within 12 hours of the onset of a myocardial infarction significantly reduces the risk of the patient dying.
