Emergency Department Rundown
General
Contact person is Nikki Green. She is the person to speak to about leave, rostering issues, additional shifts.
There are usually 3 SMO’s on during the day and evening shifts. You will be allocated to one of the SMO’s. This is the SMO you should discuss all your patients with. The SMO’s wish to have the patients discussed with them as early as possible, but you can initiate simple treatment/investigation such as IVF, antibiotics, X‐rays, (CTs need to be discussed before ordering).
HOs are not allocated to resus but you will be asked to indicate your interest at the start of run and they sometimes put you on Tuesday morning to cover registrars during their teaching session (if you are interested). Otherwise, if you have particular interest in resus, it’s a good idea to speak with the Duty SMO for extra opportunities during your shift.
This run is a good opportunity to learn some procedures like suturing, lumbar punctures, ultrasound guided IV lines – just be sure to ask for help if you don’t know how to do these.
Shift times
Day shift – 0800 handover in Robin Mitchell Training room. Finish at 1800, but usually see and tidy up last patient around 1630-1700 and leave slightly early.
Afternoon shift – 1600 handover in Robin Mitchell Training room. Finish at 0100.
Night shift – 2230 straight to the floor, find the SMO in blue to say hello. Finish at 0800 with the handover. You will usually have one 30 minute break per shift.
Teaching
Tuesdays 2-4pm departmental teaching. Quite hard to actually attend as if you are on the day shift you can’t go. So only way to really attend is if you come in early for your afternoon shift. You can zoom into these teaching sessions from home too.
There are also case teachings after handover at 0800 and 1600 from the SMO.
Roster
Be prepared for lots of weekend shifts and night shifts. Most people do about 5 sets of nights in the 3 month rotation and lots of weekends. You will always have a minimum of 3 days off in a 7 day period.
These are usually during the week. Good to catch up on admin and life things. Not so good for your social calendar. Shift work can be very tiring. You’ll find that even though it’s less hours per week compared to other rotations it is quite draining. It is also continuous work, without the periods of calm in the day like other runs.
Patients and their presentations
You will see a full spectrum of patients.
Be careful to check for ED management plans for some patients – as these patients for the most part should not be seen by a HO
There are pathways in place to ensure that obvious gynae/psych patients are directly seen by those specialties – it will say gynae/wau pathway or psych pathway on the whiteboard next to their names
Be sure to ask for security or a support person for patients who are aggressive or under the influence
See patients in ambulatory for the simple lacerations if you want to suture – these are usually picked up quickly by the CNS
Admission notes are done online
Once discussed with your SMO, CT heads can be ordered under SMO ED protocol and do not need to be discussed with radiology. Other CTs, or CT-H that aren’t under this protocol need to be discussed.
Use the ED homepage on the intranet - it has lots of useful information
COVID
ED is the frontline for any COVID patients – any patients with respiratory symptoms are placed in the isolation rooms.
There are PPE donning and doffing stations around the area. Be sure you do this properly and get help/a watch to ensure you are doing this correctly.
If you have health conditions/immunocompromised or other reason you cannot be around COVID patients make sure you let your SMO/manager know.