Candidate Instructions
Who are you:
You are an FY2 in the GP surgery.Who the patient is:
Mark Simons, aged 49, has made an appointment to see you.What you must do:
Talk to him and address his concerns.
Patient Information
- He is about to go to Thailand for holiday.
- He wants to take antibiotics with him in case he develops infections while abroad.
- Last time when he went to Brazil, he was given antibiotics.
- He has plans of swimming while on holiday so he thinks that he may develop infections
- He is concerned that he could get a stomach bug or any infections such as chest infections.
Approach
Opening statement: I want antibiotic for travel
Tracel Hx
- Tell me more about your travel.
- When are you planning to travel?
- How long is travel? P: 10-12 days
- What sort of activities you plan to do during your travel?
Vaccination Hx
- Have you taken any vaccination so far? (Vaccination is taken one month before the travel)
- Who are you travelling with? Wife (Has she taken the vaccination?)
- Are you up to date with your vaccination?
Reason for requesting Antibiotic?
- Are you worried about any particular infection?
- Why you want to take antibiotic?
- Any particular kiind of antibiotic?
Vaccination required before travelling to Thailand
- Hepatitis A vaccination
- Hepatitis B vaccination
- Typhoid vaccination
- Rabies Vaccination
Needs Malarial Prophylaxis: Antibiotics such as doxycycline may be needed for malaria prophylaxis
Health risks in Thailand
- Rabies
- Zika Virus
- Dengue Virus
- Traveller’s diarrhoea: caused by virus (self limiting)
(Avoid insects bite)
Concerns
• Can I use probiotics? Yes
- Can I have antibiotics? Unfortunately, we do no prescribe antibiotics in that way. It’s against the national/expert recommendation
- Why was I given antibiotics last time I went to Brazil? It could be prophylaxis or maybe it was indicated. But I would not know exactly, What antibiotics were given?
- We don’t give antibiotics for diarrhoea and chest infection in advance.
• I have imodium, do you think I should use it if I develop diarrhea? Better seek medical advice before taking any medication to ensure that there is nothing serious going on. You can seek medical advice while abroad.
• Ask if he has got a medical insurance? if not have then advice to get one.
What other advice will you give me?
Make sure you get traveling medical insurance and under go all necessary vaccinations that are recommended before travelling to Thailand
Ask for:
• Ask if he is up to date with all immunisations?
• Medical insurance?
Advice
- Take measures to avoid insect bite.
- Dengue fever is common, but there is no prophylaxis.
- Avoid eating unwashed fruit from the street.
- Perform hand hygiene frequently.
- Advice his wife to do the same as well
NOTE:
- Do not offer unindicated antibiotics.
- A prescription pad will be availble in the cubicle, do not touch it!!