In message <008301c0d426$56360340$c7517ad5@afogarty>, Adrian Fogarty
<[log in to unmask]> writes
(in response to colles tweaks and gas-board availability)
>It's about time A&E folk recognised their
>considerable expertise and stopped asking other people's permission to do x,
>y and z!
We used to do Bier's on a regular (2-3 x a week?) basis, following BAEM
guidance on same (see their web site). As you correctly point out, this
is 2-3x a week more often than most anaesthetists perform them.
Apart from the luke-warm support from the gasboard, we rarely do our own
Bier's these days because of serious constraints on time and space. For
one of us to do a Bier's uses up easily 45-60 minutes of senior A&E
staff time (from finding the keys to the drugs cupboard to assessing the
patient after cuff-deflation). During this time we are tied to the one
patient. This does not seem justifiable when there is a 7 hour wait for
minors and the anaesthetists are free because routine surgery has been
cancelled again for the nth day running due to a "one-off" bed crisis.
The self-same "unavoidable" bed crisis means we invariably have 1 or
even 2 medical patients lying on beds in our small plaster theatre
waiting for ward space. Shunting such victims of the system in and out
of corridors and cubicles to accommodate the ever deepening lack of beds
is NOT acceptable IMHO.
All non-urgent surgery should be cancelled whilst there is even 1
patient waiting for a bed in A&E, so the orthopods and anaesthetists
should be doing these time and space-consuming procedures while we're
prevented from providing a proper service due to overflow of non-A&E
patients.
Yes, I know they're busy people too.
Dr G Ray
Staff Grade
A&E
Sussex
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