All entries for Friday 13 March 2020

Accidents and Emergencies

For the last two weeks, I have been on placement as part of the ‘Acute Block’. I have been excited to experience as much as possible during this block as I’ve always considered ‘Acute Medicine’ as a potential career path after graduation. The block includes a variety of placements including A+E, the Intensive Care Unit, Anaesthetics, etc. There’s something I find exciting about the challenge of not knowing what’s going to come through the door and having to work quickly to make the patient better. (This may just be because I’ve got a short attention span, but I’ll let you decide!)

Last week I had two shifts in Warwick Hospital’s A+E department. One shift was in ‘See and Treat’ from 1.00pm - 9.00pm and another in ‘A+E Majors’. ‘See and Treat’ is where patients have problems that can be treated on the spot without need for lengthy hospital admission. I thought that I would be shadowing at first and then may be able to see some patients later, however I was immediately told to go and see patients. Having just come out of the 6 week ‘Psychiatry Block’ I was quite apprehensive as it had been some time since I’d put my knowledge of physical medicine into practice. Quickly enough, though, I was able to remember how to examine a suspected broken foot and I knew what questions to ask to rule out a bleed on the brain after a head injury. Most of the patients had suspected fractures, so I also got a fair helping of X-ray interpretation. One of the Advanced Nurse Practitioners was keen on teaching and went through some good radiology revision with me, as well as the criteria for a head scan after trauma.

This week I have also had shifts on ‘A+E Majors’ at UHCW, our main teaching hospital, and also a regional Major Trauma Centre (MTC). I didn’t really know what a MTC was before this block, but it basically means that it is a centre of excellence for dealing with major traumas such as car crashes, stabbings, shootings etc. Not all hospitals are MTCs, so it’s sort of neat that our main hospital is. It also means that patients are brought in from all over – so if you had a car accident outside for example Warwick Hospital, even though there is an emergency department at that hospital, the ambulance service would drive you all the way to UHCW. The theory is that because UHCW is used to dealing with these major traumas, the survival rate is better. I think I saw a research paper that showed that structuring services like this does save lives every year, so it does work. Because of this, during my time in A+E Majors, I have seen several traumas, along with heart attacks, pneumonias, sepsis and many other things.

During my second shift, Majors was busy, so I went over to the “Rapid Assessment and Treatment” unit, where they assess patients and decide where they need to go next. Up until now I had only done 3 cannulas and failed 2 of them so I was feeling less than confident. However, in the Rapid Assessment unit, almost all of the patients need cannulas – so this was my chance to get some practice in. I managed to try and do 3 more and managed to get all of them, massively improving my overall success rate. Towards the end of this shift I went back over to Majors and was told that there was a patient having a heart attack. I was able to go over and see the patient and observe while they got their treatment. In the media, you only ever see negative stories about our NHS – for example how the targets aren’t being met, or when it failed to give good care. Today, however, I saw how the NHS does work when it matters – for example, someone can have a heart attack, have the paramedics turn up, be taken to a specialist hospital with a specialist cardiac unit, be seen in A+E, and then be taken to the catheter lab to have the clot removed within an hour and a half. This saves their life. The NHS isn’t perfect by any means, and there are lots of inefficiencies. However, when someone is really sick and in need, the NHS delivers, and it delivers the best standard of care imaginable. To make it even sweeter, it costs patients nothing at the point of care.

Hattie Trigg : 13 Mar 2020 16:34 |  Tags: Jordan Mbchb Student Warwick Wms |  Comments (0) |  Close comments |  Report a problem