Here in Cornwall we have a network of eleven MIUs based around the county in
what are essentially the old cottage hospitals. For a variety of reasons,
A&E took over clinical responsibility for them about four years ago. The
Nurse Practitioners all undergo the same training and adhere to protocols
written by the A&E Consultants. They can contact the department for advice
from a senior A&E doctor via a designated line, and most of them also have a
telemedicine link to the department and digital X-ray reporting. By and
large it works very well and is popular with the patients who can be seen in
"their" unit. It certainly helps us to cope with the huge seasonal influx of
people we have in the summer, most of whom are indeed suffering from "minor"
conditions which can adequately be dealt with by nurse practitioners. We
gained an extra half consultant. I could go on at great length about the
relative risks/benefits. Serious things do turn up occasionally, but the
Nurses simply call 999 meanwhile administering what they can (oxygen,
aspirin, IV fluid etc) much as a GP would. Happy to answer any further
questions. We have been at the forefront of this but very remiss about
writing it up....we need the other half consultant.
Sue Barton
RCHT Truro
Cornwall
----Original Message-----
From: Dr Philip T Munro [mailto:[log in to unmask]]
Sent: Monday, March 25, 2002 20:06
To: [log in to unmask]
Subject: MIU problems
In Glasgow we are generating more heat than light over the idea of creating
minor injury units as part of restructuring our A&E service. One very
legitimate concern that has been raised is what happens if something
serious/major turns up by mistake at one of these units.
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?
Unable to find much to inform this debate.
Phil Munro
A&E Consultant
Glasgow
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