Monkland's GP van service covers approx. 10% of Scotland's GPs, so we find
ourselves talking to the emergency medical service fairly frequently.
One Saturday, around lunch time, a very high glucose was phoned to the
deputising service and on the following Monday we heard the rest of the
story. The emergency doctor visited the home, failed to get an answer, so
left a calling card asking the patient to get in touch with our A&E
department. Later that day the occupant, who fortunately had not slipped
into a coma but had been shopping, came to A&E. She said she had not been
to the doctor for months and, although the name and address on the card were
correct, the date of birth was not. The A&E staff checked their computer
records and found the real patient with that date of birth and phoned her -
she was a known diabetic and really was not feeling very well. So I had the
delight of phoning the GP on the Monday to tell him that, despite giving us
all the wrong leads, his patient was doing nicely in our medical Receiving
Unit.
On another Saturday morning I phoned a set of impossible results to a
surgery. Later in the morning I was on the phone to them again and heard
that their doctor too had failed to get a response from the patient. It was
only after he'd called the police and they'd made a forced entry that a
neighbour arrived to say the patient had been admitted by ambulance to
hospital where she had died the previous evening. (Which confirmed my view
of the serious nature of the results.)
-----Original Message-----
From: p=NHS NATIONAL
INT;a=NHS;c=GB;dda:RFC-822=acb-clin-chem-gen-request(a)mailbase.ac.uk;
Sent: 28 June 2000 11:54
To: p=NHS NATIONAL
INT;a=NHS;c=GB;dda:RFC-822=acb-clin-chem-gen(a)mailbase.ac.uk;
Subject: Out-of-hours results
At the risk of re-visiting an old chestnut, what are the views of mailbase
members on contacting an appropriate/responsible clinical staff member
out-of-hours with urgent results (i.e. those exceeding the list of critical
limits we all have posted in the lab)in the following situations:
1. The closed GP Surgery.
2. The out-patient result where the Consultant / Med Sec have gone home.
The answers would seem to be to telephone the emergency GP number or the
Consultant via the Hospital switch-board. Do we all do this ?
I am concerned about the medico-legal issues here and wonder if anyone has
fallen foul of HM Crown Prosecution as a result of having been deemed to
have failed in one's duty in this area.
Many thanks for your input
Philip Hyde,
Pilgrim Hospital
Boston (UK)
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