Insights into Emergency Medicine Practices in Tasmania
Examining the healthcare landscape in Tasmania, this reflection delves into the operations of Royal Hobart Hospital as a major trauma and referral center, alongside the dynamics involving patient care, workload distribution, training protocols, and the influence of the private sector on patient outcomes. Noteworthy cases encountered by medical professionals further illuminate the challenges and unique experiences within the field of emergency medicine.
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Presentation Transcript
Is the grass really greener? Reflections on ST4 in Australia
Royal Hobart Hospital Population of 500,000 250,000 in Hobart Approx 500 beds Trauma and tertiary referral centre for just about anything Approx 160 presentations a day
Shifting targets The UK is not alone > 5% year on year increase in patient numbers Increasing social care needs Overcrowding in ED not acknowledged as a hospital wide problem
Workload and support Approx 40 hour week PENs - amazing! Roughly 8-16 patients a shift Aides but no HCAs less ENPs Consultant cover from 8am to 11pm every day EMAT Ultrasound Critical care CT in ED More procedures Lipase Certifying deaths BNP
There is only one emu in tasmania... 10 bed unit Aim to discharge within 24 hours <15% conversion rate Set proformas for common uses e.g. anaphylaxis Very popular with inpatient teams
Training and WBPAs 4 hours teaching a week Increasingly SIM focused Combined with departmental feedback Significantly less WPBAs Shift report similar to ESLE Dedicated registrar office
The dreaded private sector ED consultants and registrars Approx 60 patients a day More time with patients Less hostility Free lunch! Greater patient satisfaction
And a few cases that will stick with me
Cases 49 year old paramedic who rescues snakes in his spare time - bitten by snake 71 year old single gunshot wound to the face / neck. Arrested on route, required surgical airway 35 year old recreational diver with intense hip pain 45 year old set on fire by her husband, approx 40% and airway burns
