HSE publishes review of EDs and emergency care in Cork and Kerry

A review of emergency departments and pre-hospital emergency care in Cork and Kerry has been published by the HSE South today. The review contains recommendations on how to operate emergency departments and pre-hospital emergency care at all acute hospitals in the region, including Bantry General Hospital (BGH) and the West Cork area.
From the press release:
“We recognise that Bantry General Hospital serves a remote, rural population and it will continue to have a 24/7, 365 days a year service for patients with medical emergencies, e.g. a patient with serious pneumonia needing urgent admission. This service will be available at a medical assessment and admissions unit (MAAU) which will be opened at BGH,” said the Director of Reconfiguration, Cork and Kerry, Prof John Higgins.
“An MAAU is specifically intended for patients who show symptoms of acute medical illness and need immediate assessment and treatment or for patients about which there is a level of clinical uncertainty but who require further assessment and treatment. Examples would be symptoms such as abdominal pain, chest pain, rash or headache. MAAUs must be supported by good diagnostics up to and including X- Rays, CT scanning etc. If a patient requires admission, then a clinical decision will be taken as to whether that patient is admitted to the hospital where the assessment has been carried out or transported to a different hospital.
“An urgent care centre open up to 12 hours per day seven days per week, 365 days a year will also be established in Bantry. Urgent care centres are specially equipped and staffed to provide unscheduled care to patients with acute illnesses and minor injuries which are not anticipated to be life-threatening in nature e.g. lacerations and query fractures. Urgent care centres will be overseen by the regional emergency medicine consultant team with respect to standards of care, bypass protocols, qualifications and experience of staff. They will have access to diagnostics including blood tests as well as more complex diagnostic facilities such as x- rays, CT scanning etc. In essence, urgent care centres are specifically for patients who are likely, after expert assessment and treatment, to be discharged rather than admitted.
“An advanced paramedic (AP) team with a fully equipped rapid response vehicle responding to 999 calls was officially launched in West Cork last week. An AP is certified to perform advanced life support procedures including intubation, defibrillation and administration of drugs under a doctor’s direction. APs can perform additional life saving treatment at the emergency scene which previously had to be done in a hospital. The APs are additional to the existing ambulance service in West Cork. While at scene, the APs have a direct link via a dedicated emergency number to the Emergency Department at Cork University Hospital (CUH). This ensures the APs can liaise directly with an ED doctor for consultation and decision making around patient care.”
Prof Higgins outlined the review’s other main recommendations on the services in West Cork: “A telemedicine (computerised) link with Cork University Hospital (CUH) will facilitate access to prompt 24/7 surgical and other specialist opinion if and when required.
“Radiology and laboratory services will continue. We will soon be able to have x-rays and CT scans carried out at BGH, transmitted digitally and read by consultants based in Cork city. This will provide a prompt radiologist opinion and rapid diagnosis if and when required.
“Intermediate Care Vehicles (ICVs) will be acquired by the ambulance service to transfer patients between BGH and Cork hospitals without drawing on the acute ambulance service. This service will enable the acute ambulance service to focus on emergency pre-hospital care which will improve ambulance response times.”
He also said that “staff skills and competency requirements for a reconfigured emergency service will be assessed to ensure that changes are supported by appropriate education and training.”
-Gary Culliton