Thanks to HITH registrar Dr Pamela Anjara and ID physician Dr Cristina Mateevici for providing their presentation about HITH services at the end of last year.
HITH ED presentation
- HITH registrar is on extension 56309 – 24 hrs a day
- Admission conditions include
- IV antibiotics – cellulitis, multi-drug resistant TB, osteomyelitis
- anticoagulation – bridging clexane to warfarin
- complex wound management eg VAC dressing
- post operative care – drain tubes
- cardiogeriatric – IV frusemide
- Exclusion criteria
- complex infection eg. hand / head / neck / necrosis / bites
- unable to manage at home
- no consent
TRAUMA CALL AUDIT
Thanks to Steve Lee. Review his talk here.
Audit showed that there is a delay to review by the Surgical Registrar – in 68% of cases > 10 minutes, in 32% >30 minutes. ED team should maintain their role as team leader and coordinate the Trauma assessment – retain your skills and be confident in your role.
Please remember the trauma call criteria – and SPEED is no longer one of them! If you think the presentation warrants a Trauma Call, please initiate it.
In the future we would be keen to audit the outcomes of Trauma Calls – a project in cooperation with the Surgical Units so watch this space!
See below for the trauma call criteria:
Thankyou Michael Gibbons for reminding us of this rare entity.
Important messages included:
- look for the R-on-T in ectopics
- consider cardioversion for arrhythmias
- treat pyrexia aggressively as this may precipitate an arrhythmia
Review his talk
Available 24/7 – including public holidays
Contact registrar on x56309 (BH) and via switchboard (AH)
- referral to registrar
- complete drug chart and prescription
- discharge patient if safe – leave IV in-situ
- if not reviewed in ED – patient should return to 2South (Footscray) following morning for clinic review
- If admitting to HITH for DVT/PE – fax “HAEMATOLOGY CLINIC” referral
Things to tell patient:
- May need long-term antibioitics
- HITH team may insert long-term IV cannula in clinic
- Anticoagulation – discuss medication (Clexane/warfarin), risks, duration (1st below knee DVT – 3 months, PE or above knee DVT – 6 months, recurrent – life-long)