An introduction to St George’s A&E

An introduction to St George’s A&E

The A&E department at St George’s is made up of four key areas. The staff in each section specialise in treating a different group of patients who arrive at the hospital, either by themselves or by ambulance or helicopter. Here is a brief guide to each area and thoughts from a key member of staff in each on what they specialise in and what the day to day running of their section is like.

Urgent Care Centre (UCC)
Becky has been an Emergency Nurse Practitioner (ENP) at St George’s for five and a half years. ‘The best thing about working in the Urgent Care Centre (UCC) is the wide diversity of people and health problems that you have to deal with,’ says Becky.

Although the UCC is one of the smaller areas in the Emergency Department, it probably has the highest turnover of patients, with forty percent of reception admission and over half of all adults passing through the unit.

The area is for patients with less serious complaints and therefore the flow of patients is managed mainly by ENP’s like Becky rather than doctors.

These specially trained clinicians bridge the gap between nurses and doctors and are able to assess, treat and discharge patients independently. In Urgent Care, staff will see a wide variety of cases and can be plastering a broken arm one moment then extracting foreign objects from a patient’s ear the next.

Paediatric Department
Consultant Rhys announced at the age of eight that he wanted to be a paediatric doctor. ‘Treating children requires a whole different set of skills, specifically when it comes to communicating to them, ‘ says Rhys. I really enjoy that challenge though and getting on their level. They have such a sweet and naive outlook on life that really makes me smile.’ Rhys now spends roughly half of his time dealing with children in his role as a consultant in Emergency Medicine.

St George’s has an additional mini-emergency department dedicated to patients under 16. This area, which is connected to the main Emergency Department, has its own waiting room, triage and paediatric assessment unit. All children are assessed and treated in the Paediatric Department unless they arrive as a trauma call or as a red phone emergency. There is a dedicated bay for paediatric trauma cases in Resus. The staff in paediatric A&E deal with between 80 and 90 cases each day, from babies to teenagers.

Majors
‘Controlling Majors is the top priority. By about 3 o’clock in the afternoon it’s the craziest place to be in the whole department,’ says Team Leader Daryl who is one of the senior nurses in charge of the department.

Majors is the busy epicentre of the Emergency Department at St George’s. Staff in Majors deal with serious medical needs that are non life-threatening. Most of the patients in the department are adults over 50 years old and about half of them will have arrived by ambulance. Majors is the largest area in the whole department. There are 21 beds in the unit and a team of 15 staff on for each shift. Overseeing Majors is the Nurse in Charge, who has to manage the flow of patients and the allocation of staff to ensure that the walking wounded are seen in a timely and efficient manner. The Majors area is also home to the porters’ station and the kitchen, both key to the smooth running of the whole Emergency Department.

Resuscitation
Jai is one of a team 18 consultants who oversee care at St George’s. When he is in the Emergency Department he spends a majority of his time treating patients in Resus. ‘I think you gravitate towards the red phone because you want to see what is coming in and you’re keen and enthusiastic about it,’ says Jai.

The Resus area sees approximately 10 % of the patients who come through the Emergency Department. Patients here will have arrived in a critical condition via ambulance or HEMS (Helicopter Emergency Medical Service). The department has a dedicated helipad which is located on the roof of St Georges. There is a direct lift from the helipad straight to Resus. The ambulance bay is immediately outside the doors to Resus too.

Paramedics or HEMS doctors announce new patients by calling the red phone while they are en route to the department. The red phone rings in Resus where St George’s staff first get news of cases that are arriving. The phone goes on average 15to 20 times a day. The Resus unit has eight beds and can go from being very quiet to incredibly crowded in a matter of minutes. At busy times the area is full of paramedics, Hems doctors, trauma doctors, police and patients. Crucial decisions are made in Resus that can mean the difference between life and death.