Trauma unit is a big step forward

The level of care available to Island patients within the Emergency Department of St Mary’s Hospital, Newport has taken another significant step forward.

The department, which currently deals with some 45,000 admissions a year, has recently been given status as a trauma unit, and as such now stands alongside the likes of Portsmouth and Bournemouth in that particular area of hospital care.

The Emergency Department was officially designated as a trauma unit as of April 2011, although the Emergency Department’s dedicated team of highly-trained professionals have been working towards the achievement for the past two years with the development of a Trauma Team and 24 hour on site senior clinicians.

The advent of the Trauma Unit also means a heli-pad will be in place on site in the near future. Feasibility studies have been taking place, and funding, partly from a national charity and partly from the trust, is currently being discussed.

Maria Lynch is one of four consultants in Emergency Medicine at the unit, and is also Foundation Programme Director for foundation trainees on the Island. She explained: “We have recently achieved trauma unit status, and as such we are recognised for our expertise in dealing with major trauma incidents.

“Our status as a trauma unit means we are being invested in, and the standard of care which we deliver is high. We went through quite a degree of scrutiny to see that we met the standards required. When a patient comes in following a serious accident, for example, a team from the unit, including an emergency consultant, anaesthetist, surgeon and nurses, will be there awaiting their arrival.

“The trauma unit is something we have been working towards for a while and is a big step forward. The South’s main trauma centre is at Southampton. Our status as a trauma unit shows that we are committed to continually improving the care which we deliver to our patients. We are going through the process of training all our staff in high quality trauma care.

The heli-pad will be available for helicopter transfers of anyone with head injuries who may need neuro-surgery or further specialist care.” The St Mary’s Emergency Unit is what was commonly known as A&E, but the name has been changed. Maria said: “The specialty has changed its name nationally. The college is now called the College of Emergency Medicine. As a result, Accident and Emergency departments have been re-named as Emergency Departments.

“The changes were made because they were felt to be more accurate in terms of describing what we do. The word ‘accident’ didn’t seem to relate to medical conditions or medical well-being. So it was felt Emergency Medicine was a better description.”

Dr Maria Lynch

There is always debate as to whether some patients actually need the Emergency Department. But Maria says: “I am of the opinion that the Emergency department is being accessed more appropriately than ever. With all the advice lines that are available these days, such as NHS Direct, people are better informed about the best place for them to be seen.

“Also, because we are co-located with the Beacon Centre, once a patient is seen at reception, they will always be directed to the right area with the guidance of a triage nurse. Within seconds it becomes very clear whether someone should be in the Emergency Department or be seen by a GP in the Beacon Centre. This has streamlined the whole process of someone who comes into the department being seen.” The two departments work very closely together, with the patients’ best interests at heart. If a GP feels their patient has become less well during a consultation, the patient can be immediately referred on to the Emergency Team for more intensive monitoring and treatment. Likewise, we can hand over patients with minor ailments to the GPs when we are very busy.

The Emergency Department comprises four consultants, eight foundation doctors, five middle-grade doctors, and forty four nurses. Because the team has expanded in recent years it is anticipated it could deal with any major incident on the Island, and specialist training for such incidents regularly takes place.

Although the heli-pad will be available for helicopter transfers to the mainland, it is anticipated the existence of the trauma unit will mean more patients being cared for at St Mary’s.

A very clear training programme exists for anyone who wishes to undertake a career within Emergency Medicine. When someone begins the training programme they are based within an Emergency Department and are seconded to specialist areas. These secondments are in surgery, medicine, orthopaedics, paediatrics, intensive care and anaesthetics.

Becoming a consultant is a long and complex process which includes having to pass a Fellow of the College of Emergency Medicine (FCEM) exam at the end of training. Earlier in training there are also professional exams (MCEM); the actual training programme takes five years.

However, even to get on to an Emergency Medicine Specialist training programme, the doctor would have initially had to do two years at Foundation level, followed by Acute common stem core training for about a further two years. So usually anyone entering this particular field of medicine would become a consultant in around nine to ten years after qualifying as a doctor from Medical School.

Naturally the Emergency Department team sometimes witness horrific injuries. Maria explains: “Often in the cut and thrust of resuscitation situations, one is faced with some very traumatic images, but being professional, we are trained to think in a very systematic and special way so that the patient receives the best possible treatment.”

Naturally the Emergency Department does have its busier times, and activity increases massively during the summer with the influx of tourists. The staging of the annual Isle of Wight Festival is a particularly hectic time with a full team, including a consultant around five other doctors and five nurses, in attendance at the Seaclose site.

“We deliver an emergency medical team for the Festival and the Bestival. We provide all the emergency medical care at the Festival, said Maria. “There are full facilities on site, including resuscitation bay with ventilators and defibrillators as well as x-ray, and a mini pharmacy – everything you would need in a resuscitation situation, so it is quite complex.

“We care for a fair number of patients at the Festival, so being on site makes it easier for festival-goers to access healthcare very quickly. It also means the Emergency Department at St Mary’s does not get clogged up with admissions from the Festival. Being on site proves to be an enjoyable, exciting and inspiring experience for the Emergency medical team.”