[log in to unmask] wrote:
> I ask for comments reluctantly as I expect many may not wish to see this
> topic aired too often. We are coming under considerable pressure to take over
> supervision of an MIU which has previously been under the care of General
> Surgeons. Based on the present attendances we find this hard to justify.
Hard to justify its existance or hard to justify it being supervised by those who
are trained to deal with minor injuries?
> If as has been suggested the unit is staffed by ENP's I would be gratful to
> know:
>
> is there any guidance on the issue of children attending such a unit - as
> compared to them attending an A/E dept.?
Not aware of any guidance from anyone. (But I bet the RCPCH would say if asked
that they must all have RSCNs)
Usually a high proportion of patients at MIUs are children.
My answers about ENPs are based on ENPs working in a unit with 24 hour medical
cover. I have some contact with colleagues who work in a nurse led MIU. It seems
as if they do more rather than less in such a unit.
Basically ENPs can deal with any injury that an SHO might deal with in the
"Minors" area of an A&E. It is a different debate as to whether this is cost
effective ethical etc.
> do / should ENP's treat eye injuries including corneal injuries?
Yes and yes.
> do ENP's treat all types of hand injuries?
What do you mean by treat. They see all types but generally they do not do tendon
repairs or anything that might be considered "operative surgery" but do simple
suturing.
> I have been told that in some
> instances protocols have excluded hand injuries?
Never heard of that one. It would take away a very high proportion of cases.
> What about hand injuries in children?
No problem.
> I presume all forms of penetrating injuries to limbs would be excluded -
> ? correct.
No. Incorrect.
> do / should ENP's assess head injuries including those sustained by
> children?
Yes and Yes. For example this is quite explicitly on the list of conditions to be
dealt with in NHS Walk in Centres.
> what is the experience of immediate referral rates from ENP staffed
> MIU's? I am informed that the overall referral rate can be 30 - 50%. This
> will depend of course on protocols I know.
>
Dont know.
> is there a critical workload at which such a unit is viable?
>
No. The continued existance of an MIU is an entirely political decision.
Andrew Hobart
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