>John, do you know what they mean by "admission ward"?
>From my brief conversation with one influential person it seems that they
have'nt decided themselves what this is. As we know there seems to be quite
a few models of this phenomenon which varies from a ward remote from
diagnostic facilities and the emergency department and which tends to run as
a pseudo-emergency department, to the in-house ward within an A&E
department. I think they will plan on visiting centres of excellance that
have proven efficient programmes up and running and then advocate developing
these. A bit like a mobile A&E NICE really, I suppose.
But lets face it if we don't know for sure what the best model is how does
Frank and his men know ? But I hope no one is going to ram a Medical
admissions unit down our throats run by a host of emergency physicians
leading to a twin strand emergency service in the same hospital. You can
just picture it can't you? 2 people get severe blinding headaches at the
same time getting out of the shower. They vomit and are confused. One man's
wife calls an ambulance. Patient gets taken to A&E where he gets seen
promptly by senior A&E doctor. ANother man's wife calls the GP who phones
the Medical Admissions unit and the patient gets sent there by ambulance
where he is clerked by the house physician. Honstly who is more liklely to
have a CT quicker, get Nimodopine, analgesia and fluids and have transport
to a neurosurgical center booked sooner ? Or what about the 70 year old
chap with the epigastric pain going into his back that the GP did an ECG on
and thought might be having an infarct. Imagine sitting on a medical
admissions unit with a leaking AAA.
Dr John M Ryan
Consultant & Senior Lecturer in A&E medicine
Royal Sussex County Hospital
Eastern Rd.
Brighton
BN2 5BE
UK
Ph; 00 44 1273 696955
Fax: 00 44 1273 680627
http://www.pavilion.co.uk/users/ryanj/
http://www.rsch.org.uk/rsch/rschae.htm
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