Hopefully my last word.
I have just finished my weekend on call so I shall use it as an example.
Home at 6pm on Friday, 2 phonecalls about a neutropenic post-chemo patient
septic but improving with treatment. Called in at 10pm after patient crashed
and required RSI and ITU consultant attended. Home by midnight. Overnight
fatal cardiac arrest - not called, maximum treatment possible from SHO III.
. Back in Saturday afternoon to allow staff grade to go to CT with a young
patient with headache agitation and hemiparesis (found to be SAH) and did
some shovelling (including helping with a difficult shoulder reduction).
Overnight fatal young arrest - not called. Sunday afternoon went in at 2pm
and did some shovelling including removing 2 stone rings from someones
finger when the fire brigade had failed - I kid you not!). No calls
overnight and today is a day off - Hoorah!
I could have avoided some of the shovelling but Sunday afternoons are the
most depressing time of the week in A&E, everything goes slower, the
specialties misbehave, the waiting times are quite long. Blitzing the
waiting room down to nothing even once every couple of weeks pays back
massively in terms of morale and anectodally the it makes the SHOs work
faster the rest of the time as they get the impression thats what is
supposed to happen! If I had been in overnight I would have not gone in
during the day.
The rest of the stuff sounds suspiciously like what we are trained for. PS
we have 58 ISS>16s per year (20% penetrating), 200 helicopter transfers and
cover the 4th and 8th most deprived areas in the UK.
ps Just up the road is the Faculty President's department which sees 72K new
patients per year with an average waiting time to medical staff of 15
minutes!
People who arent in A&E to deal with emergencies should QUIT. There are
loads of trainees coming through just now who want to do true "emergency
medicine".
Phil Munro
A&E Glasgow
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