When planning your local response, please consider the following:
Obligatory patients continue to require admission and surgical management, e.g. hip fracture. We must expedite treatment to avoid pre-operation delay and expedite rehabilitation to minimise length of stay.
A consultant must be designated as ‘lead consultant’. This duty can be for one day, a few days or even five days in small units. This is an essential role during crisis management. Ideally, they should have minimally conflicting duties, they must be free of clinical duties and the role involves co-ordination of the whole service from the Emergency Department (ED) through to theatre scheduling and liaison with other specialties and managers.
Patients with injuries that can reasonably be managed either operatively or non-operatively e.g. displaced wrist fracture. We must explore non-operative care first, especially if this avoids admission.
Trauma Assessment Clinics (TAC) will not reduce ED workload. Hospitals using this system may need to switch during the crisis to the system outlined above.
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