Recent postings have raised questions about the role of our specialty-
Between 11.30 and 0200, 31/12 - 01/03 our department dealt with a
respiratory arrest due to asthma ( pH 6.6 pCO2 25), a collapsed pregnant
woman who underwent immediate section to deliver the baby, an axillary stab
wound with shock and an ischaemic arm, and an anterior MI who received
thrombolysis in A&E - later on there was an acute subdural transferred to
the neurosurgical unit. All except the ~30/52 baby have survived so far. I
haven't include the numerous drunks +/- HI etc.
I don't claim this is "normal for Norfolk" or wish to start a "if you think
that was bad, we saw..." thread. My point is that while some colleagues
will claim to be better at treating asthma, obstreticians can perform neater
c-sections, anaesthetists can resuscitate, surgeons can manage the stab
wounds etc., it is the unique combination of skills, knowledge and
attributes of those who practice A&E medicine (medical and nursing staff)
that allow us to move seamlessly between these cases and deal with them as
they come through the door. Of course we are grateful for the support we can
call upon from the other specialties, but those first few minutes and the
breadth of our abilities ( if not always the depth of our knowledge) are,
for me, what defines the core of our specialty.
It was a hell of a night and it is helpful, to me, to be able to share it
with you - thanks.
Happy New Year!
Mike Lambert
A&E Consultant
Norfolk & Norwich University Hospital
Tel 01603 287316
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