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12 hours in a WA Emergency Department
1points
I am often asked about my work, and what is it exactly that goes on behind those magic sliding doors of an Emergency Department. The following is an accurate account of the patients I was directly involved in caring for between 8am and 8pm in one of the 6 major Emergency Departments in Perth, Western Australia. As a locum I have worked in each of them this calendar year on several occasions.
To protect patient confidentiality the exact day and date will not be mentioned, also the patients will be identified by their age and sex only. On this particular day statistics show that the Department involved had 174 patient presentations and on average there were more than 160 presentations to each of the major Emergency Departments in Perth. That is more than 960 people went to an Emergency Department between midnight and midnight on this day, which is not an atypical occurrence.
Handover from the night shift occurred at 0800 hours and the following 9 patients became my responsibility. At the end of each patients story will be an identifier code to show that by the time I finished my shift they were either AW = Admitted to ward, AED = Admitted but remains in the Emergency Department, DC = Discharged home or to another hospital, DE = deceased, or AO = Assessment ongoing
8.00am
18yo M Diagnosed with quinsey and awaiting a ward bed AW
15yo F Intoxicated, awaiting parents to collect DC
38yo F Intoxicated, awaiting psychiatric review once sober AW
26yo F Methamphetamine overdose AED
36yo M Witnessed seizure, first ever seizure, admitted and awaiting a ward bed AW
77yo M Referred to hospital with haematuria, admitted and awaiting a ward bed (over 24 hours waiting) AW
96yo F Brought to ED by family as not coping with her cares, admitted and awaiting ward bed (over 24 hours waiting) AW
84yo F Fall 2 days ago in Nursing home, fractured NOF (Neck Of Femur), admitted awaiting surgery or ward bed (over 24 hours waiting) DE
46yo M Collapse, unknown cause, waiting for CT later today DC
The following people presented throughout the shift and again are only the ones I was directly involved in.
Between 8am and 9 am: No new patients
Between 9am and 10 am
70yo F Collapse, unknown cause, loss of consciousness for greater than 2 min, has been unwell for past 2 weeks AED
Between 10am and 11am
48yo M Central chest pain, previous cardiac history DC
Between 11am and 12pm
87yo F Unwell for 4 days with a productive cough, referred by GP DC
81yo F Arrhythmia complicated with shortness of breath AW
36yo M Laceration to right arm requiring sutures DC
61yo F Short of breath, known asthmatic, ran out of medication 3 weeks ago, has not been to her GP DC
73yo F Nausea and vomiting, dehydrated, referred by GP AED
66yo M Severe shortness of breath DE
Between 12pm and 1pm37yo F Pain in L) eye and Double vision post visiting chiropractor AED
18yo M Pilonidal sinus for excision and drainage, referred by GP AED
76yo F Allergic reaction to contrast during outpatient CT DC
19yo M Infected thumb, referred by GP, oral antibiotics not effective AED
26yo F Nausea and vomiting, referred by GP after being given injection for nausea DC
92yo F Family request admission and reassessment, discharged from another hospital this morning. DC
28yo M Short of breath since 4am unable to get to GP, is on antibiotics for past 4 days AW
Between 1pm and 2pm37yo F PV loss, 8 weeks pregnant DC
16yo M For x-ray of hand, referred by GP DC
22yo F Purulent infection in R) groin DC
86yo F Chest pain for x-ray, referred by GP DC
42yo M Suicidal due to situational crisis AED
99yo F Found unconscious, BSL 2.9, now stable AED
77yo M Urinary retention, from Nursing home, GP unable to catheterise DC
Between 2pm and 3pm
31yo F Injected crystal meth 2 days ago, now unable to feel or move L) side of her body AW
93yo F Worsening shortness of breath, known history of congestive cardiac failure, referred by nursing home AED
58yo M Severe abdominal pain, ? diviticulitis, referred by GP AW
27yo F Multiple injuries, fell from horse at full gallop, not wearing a helmet DE
53yo M Deep penetrating wound to R) hand from electric grinder AW
Between 3pm and 4pm
26yo M Multiple injuries, Motorcycle accident, spinal injuries, no movement or sensation in L) leg AW
Between 4pm and 5pm: No new patients
Between 5pm and 6pm
85yo F Tibia and Fibula fractures, referred by GP AW
65yo M Sudden onset central chest pain, associated with sweating and nausea AW
88yo F Fall this morning, now confused and incontinent AED
Between 6pm and 7pm
25yo M Fall while playing Lacrosse, R) shoulder dislocation DC
40yo M Intoxicated and fell over, multiple abrasions, attempted suicide, for psychiatric review when sober AED
22yo M Deep Laceration on R) foot, intoxicated and stood on glass without shoes DC
54yo F Nurse with needlestick injury, used needle DC
33yo M Violent and aggressive, handcuffed, bought in by Police DC
35yo M Central chest pain radiating to neck and arm, AO
Between 7pm and 8pm
32yo M Accidental drug overdose, took too many in attempt to get rid of chronic back pain AED
39yo M Severe crush injury to lower limbs, caught between bobcat scoop and brick retaining wall AO
28yo F Severe suprapubic pain, ? ectopic, referred by GP AO
Handover to night shift 15 patients either admitted and awaiting ward beds or requiring further assessment
Comments
phew!!!!
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