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The message <005801c1d438$d81caea0$44e82ac2@eayqwndo> from Dr Philip T Munro <[log in to unmask]> contains these words: > What experiences do members of the list have? Is this a common > problem? Do patients quickly start triaging themselves away from MIUs > as has been suggested? Are we asking for trouble if we have nurse-led > MIUs at stand alone sites in an urban area? The local nurse-led units don't seem to get some of the problems we get at Edgware. We are what was left when they closed the A&E and Edgware became a Community Hospital, having been a DGH beforehand. We have a doctor present for 24 hours (shortly to end). Amongst the problems I have seen whilst working here (3 years on 1/4/02) are MIs (many) Complete pneumothorax Severe stridor in an adult Fitting febrile floppy baby* (yesterday) CVAs Old people off legs Pelvic fractures Severe abdominal pain (needed opioids; advised to attend by ambulance service) Some of our more severely sick patients have been advised to attend by the ambulance staff, (we have complained formally) some by NHS Direct (formal complaints also), some because the local A&E departments are reputed to have a long wait and patients feel they would be seen sooner in Edgware. I know things are somewhat different here. *Mother foreign. Could not give address in English. -- Helen D. Vecht: [log in to unmask] Edgware.