SCGHED Newsletter 109 - Charlie's ED

Just to keep you all in the loop, you may have noticed the announcement of a major redevelopment last month.
We’re aiming to create a redesigned obs ward with 16 ‘visual’ beds and a separate 8 bedded Behavioural assessment Unit (BAU) that will allow us to look after patients that are currently NSFOW in a safer space.
This will also entail significant work to our triage area where hopefully we’ll be able to embed some more permanent PITSTOP beds.
It’s all pretty exciting and we’ll definitely need all of your help – when the time comes we’ll be looking for feedback and ideas as to how we make this work.
If we get to the end of this and we have NSFOW patients still in the main ED I think we’ll have failed.
The project architect should be appointed very soon and the tentative completion date is mid to late 2022.

If you’re putting on PPE please don’t bring the medical or nursing records into the patients cubicle
It seems likely that most cases of healthcare workers catching COVID are from surfaces in the workplace rather than via airborne transmission so wiping keyboards and mice and keeping notes away from patients etc are really good habits to get into now before COVID gets back into WA.

It’s really important that we keep up our donning and doffing skills at the highest possible level.
To that end our Staff Development nurses will be available after morning medical handover several days a week for the next few weeks to walk medical staff through it.

Hopefully you’ve noticed packs of alcohol wipes in green containers have appeared on the sides of the IV trolleys over the last couple of weeks.
Please get into the habit of wiping the top of the IV trolley before and after you use it.

We’ve had multiple people leave ED with their IV’s still in situ recently.
It’s everyone’s responsibility to make sure this doesn’t happen.
Please try and avoid putting cannulae in at all if you can.
Rough rule of thumb = only put them in if you’re 80% sure they’re going to be used.
Death to the ‘Just in case’ cannula!

A reminder to everyone that the plaster sink in fast track is the only safe place to dispose of your plaster water.
At risk of sounding like your mum, please make sure you rinse the sink after use also.

ACEM is looking for interested FACEMs or trainees to put their hands up for some of their policy-type committees.
You don’t have to be senior to get involved so new FACEMs and new trainees have a think.
EOIs close on Thursday so get your CV uploaded fast if you’re interested – EOIs here

We’ve had multiple clinical incidents related to prescribing fluids and medications on our nursing assessment form so it’s being changed in the next week or 3.
Once we have the new forms you’ll have to do all your prescribing on standard med charts and fluid charts.
This is what most of the other EDs in town do already so we’ll get used to it.

We don’t need to speak to Radiology prior to ordering CT C-spines but we should regard this as a privilege not a right.
We should always try and clear C-Spines clinically if possible first – SCGH ED guidelines here
If we’re requesting CT C-spines we need to make some justification for it on the CT request form.
Radiology have given me multiple examples where this hasn’t happened so please try and up your game people!