Accident & Emergency

Casualty Unit Casualty/Emergency… Where Medicine Is Anything But Casual

Casualty UnitCasualty is probably the prime point of entry to any hospital where it is most vital for staff to be efficient, experienced and equipped to deal with any medical crisis. The patient arriving in the hospital’s emergency wing is likely to be distressed, possibly confused and often in pain.

The Avenues’ head of Accident and Emergency (A&E) and the Matron in charge of the department, are well aware of just how demanding their jobs are – as well as those under their supervision. For this reason they recently reinforced triaging in the clinic’s Casualty, a method used the world over to assess immediately the degree of urgency of each patient’s condition on arrival in the department.

“Triage is a French word that means ‘sorting out’. It is a procedure that was first used by Napoleon’s physician when he was faced with many casualties on the battlefields. Based on the method that women used to sort beans in a field – separating the good from the rotten – he looked at the wounded, the dying and the dead, and handled them with some medical order according to their condition.”

The Casualty/Emergency Matron said the advantages of the procedure included a reduction in the waiting period for new patients in critical condition. “ However,” she added, “it is important that we explain to those waiting patients with less serious problems, the life and death nature of why some patients appear to be jumping the queue,” she said.

“One of the most important aspects of Casualty/Emergency is communication: to explain to patients what is happening to them, to reassure those who are distressed, and to make sure that those who are waiting know what the situation is in the department. I believe that the principle in management should be that once you set standards, these are uniform throughout.”

The department continuously carries out an in-house training programme, which highlights the importance of life-saving cardio-pulmonary resuscitation (CPR). This makes the nursing staff alert to clinical changes in a patient, making them quick to act.

The A & E staff includes several part-time casualty officers (of necessity, all qualified doctors), a clinical matron, two charge sisters, four senior registered general nurses (RGN), twelve junior RGN’s, twelve nurse aides and eight Casualty Clerks.