--- "Dunn Matthew Dr. (RJC) ACCIDENT & EMERGENCY -
SwarkHosp-TR" <[log in to unmask]> wrote:
> Thank you for posting this one, Danny. This has
> always been one of my
> concerns with trick or treat- with existing
> resources it seemed impossible
> to combine senior doctors assessing minors with
> senior doctors being
> directly involved with all critically ill patients
> in the ED. As you say,
> however, it is unlikely to alter practice (if a
> patient attends with a minor
> or self limiting disorder and is seen and treated by
> a consultant within 15
> minutes of arrival, they go away thinking the NHS is
> being well run; if as a
> result of the consultant being tied up in minors
> they don't see a sick
> patient and that patient dies, it is the clinicians
> not the managers who are
> criticised).
I'm not sure this case illustrates that fact though.
Most of the problem seems to have been lack of
adequate review once the patient had been admitted
although at least he was seen by a consultant
physician before he died. Lack of adequate involvement
of senior physicians in medical admissions is an
ongoing problem.
With respect to see & treat this weekend we reached a
point where the see & treat wait was getting to 2
hours, majors was busy and I was fully occupied
sorting out seriously ill and injured patients so not
able to queue bust the see & treat. I told the staff
to abandon it and go back to triaging so at least they
got some sort of assessment quickly. Wrote to the
chief executive to tell him that we only had the
resources to run see & treat when it was quiet!
Cheers Fred.
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