> -----Original Message-----
> From: Accident and Emergency Academic List
> [mailto:[log in to unmask]] On Behalf Of Coats Tim -
> Professor of Emergency Medicine
> Sent: 28 September 2005 09:02
> To: [log in to unmask]
> Subject: Re: A&E On - call Rota
>
>
> No experience of cross speciality cover. I don't think that
> an orthopod is able to practice emergency medicine (and an
> orthopod that thinks that they can just doesn't understand
> and so should certainly not be allowed to).
>
> I have some good experience of cross Department cover - very
> dependent on Geography (all of the hospitals in the East
> London A&E Consortium are a couple of miles apart).
>
> Even if long distances are involved, it might be better for
> an ED to have more distant cover from an emergency specialist
> rather than close cover from someone who is not a specialist
> in Emergency Medicine. Maybe an agreement from the local
> orthopods / surgeons that they would support the ED by coming
> in for major trauma (which they probably could cope with)
> might assist this system.
I suspect that this and also the requirement for consultant to
consultant requests is the true use of the other speciality senior
covering an Emergency Department
>
> To go one step further. My guess is that on-site late shifts
> followed by consortium on-call overnight (ie. one, or two,
> A&E consultant shared between several hospitals) will be a
> future pattern for emergency service provision. Closer
> integration with the pre-hospital care services would enable
> the night shift consortium consultants to focus their time in
> the right areas. Do we need to start taking a Regional rather
> than a Departmental view of the provision of nightime
> Emergency Care, to develop a more flexible system?
>
> (Puts on flame proof suit and hits send)
>
> Tim. Coats.
Makes a lot of sense , also if it's tied together with cross department
cover for a (supernumerary to the A+E shop floor) properly equipped,
practiced and drilled pre -hospital response team rather than requiring
everyone to maintain the PPE and equipment but get littlepractice due to
resistance from the 999 services to ask for inexperienced staff to come
to scene, who might not actually be bringing a great deal of extra
skills knowledge and experience to scene ,who have been released from
department duties grudingly because of a DoH circular...
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