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Emergency Medicine Trainees Emergency Medicine Trainees Orientation and Policy Guidelines October 2019 1 Index Section 1 Organisation Section 2 Medical Staffing Arrangements Section 3 ACEM related information Section 4 Education Section 5 BMDH General Information Section 6 Role of the ED registrar Section 7 Allied services Section 8 Trauma / AMI / Stroke/PE etc Section 9 Outpatient’s clinics Section 10 Paediatrics Section 11 ED ward Transfer form (T- form) Section 12 Other policies Section 13 Investigations Section 14 Radiology Section 15 Emergency Short Stay Unit Section 16 Policy for Accepting referrals to the ED Section 17 Deaths in the ED Section 18 BMDH Stroke Thrombolysis Protocol Section 19 Sepsis pathway Section 20 Contacting the ON-CALL ED CONSULTANT Section 21: Commonly used phone numbers at Blacktown ED 2 Section 1: ORGANISATION Senior Medical Staff Director of Emergency A/Prof Reza Ali Deputy Director of Emergency Dr David Melvin Directors of ED Training (DEMT) Dr Karina Hochholzer Dr Ponnuthurai Jeyaruban Dr Jannatun Nayim JMO coordinator Blacktown – Dr David Melvin Mt Druitt – Dr Shaila Islam Staff Specialist / Toxicologist A/Prof Naren Gunja Dr Dushan Jayaweera Dr Gopi Mann Dr Satish Mitter Dr Richard McNulty Ultrasound coordinators Staff Specialist Dr Michael Hession VMO Dr John Shirley Staff Specialist Dr Kenny Yee WBA coordinator Dr Chamila De Alwis Staff Specialist Dr Anj Amarasekera Dr Harry Elizaga Dr Daya Jeganathan Dr Susie Stapledon Dr Fernando Pisani Dr Greg Robinson Dr Liaquat Sheriff VMO Dr Irshath Abdul Raheem Dr Rasel Ahmed Dr Nina Dhaliwal Dr Waseem Hassan Dr Ravinder Jassal Dr Richard Lennon Dr Vijay Manivel Dr Janina Usenko Dr Behzad Vasfi Dr Faryal Waqar Dr Payam Yahyavi 3 Nursing Unit Manager Blacktown ED Ms Camille Dooley A/Mt Druitt ED Ms Tahlia Strickland Clinical Nurse Consultant Ms Helen Zaouk Clinical Nurse Educator Ms Zoe Clarkin Clinical Nurse Educator Mr Jonathon Hamilton Administration Staff Executive Assistant Ms Joan Brown ED Clerical Manager Ms Di Lyons ED Data Manager Marty Bodsworth Trauma Service Australasian College for Emergency Medicine (ACEM) affiliations Dr Jannatun Nayim - ACEM Primary exam VIVA working party Dr Kenny Yee - ACEM Examiner - ACEM Fellowship exam committee (OSCE subcommittee) Coordinators of ACEM Emergency Medicine Certificate / Diploma Dr Chamila De Alwis ANY QUESTIONS OR CONCERNS? 4 Section 2: MEDICAL STAFFING ARRANGEMENTS JMO total per shift (i.e. Intern / RMO / SRMO): Weekdays and Weekends Day: 6 – 7 Evening: 6 – 9 Night: 3 - 4 Registrar total per shift: Day: 3 Evening 3 Night 2 - 3 The registrar numbers on Day / Evening may vary during times of increased leave due to exams. Emergency Physicians provide direct clinical cover from 8:00am to midnight seven days a week, every day of the year. There are 2 ED consultants on call overnight. Staff Specialist/VMO total per shift: Day (Mon – Sun): 2 - 3 Evening (Mon – Sun): 2 – 3 On Call nights (Mon-Sun): 2 Rostering The registrar roster is written by the ED Deputy Director. The SRMO roster is written by the ED Executive Assistant. The registrar roster is usually written in 13-week blocks. The roster process has flexibility to accommodate requests. You will be asked for your next terms roster request in the middle of the preceding term (this will allow you to request leave dates and specific rostering shift dates if required). We pride ourselves on being very flexible with our rostering and try to accommodate most requests. In general terms, registrars and SRMO’s are usually rostered for 80 hours per fortnight (eight 10-hr shifts). Unless you request that you want to save your ADOs (Accrued Day Off), an ADO will be rostered in once per month. All rosters are made available on Google Sheets which can be viewed via a smartphone or computer There are five shift types: Day (D) 0800 – 1800 (Registrar) / 0800 - 1800(JMO, SRMO) Evening (E) 1400 – 2400 (Registrar) / 1400 - 2400 (JMO, SRMO) Night (N) 2230 – 0830 (Registrar) / 2230 – 0830 (JMO, SRMO) Sick relief(S) for night shift ONLY The load of night shifts for each registrar over a 13-week term is approximately: 5 - Full time (12 - 15); pro- rated for part timers The number of nights can vary during periods of excessive exam leave. The number of night shifts per term is the same no matter the amount of leave taken in a term. Weekly Roster The weekly roster is generated from the most recent JMO/Registrar and Consultant rosters. The ED director, A/Prof Reza Ali, and the ED executive assistant are responsible for allocating your location for each shift. Every attempt will be made to ensure you get an equitable distribution of shift locations during your term. If you find you are getting a disproportionate number of shifts in one particular area, please speak with the ED secretary and politely ask her to even up the count. On the roster, medical personnel will be allocated to one of the following teams: Team A = Acute A (includes resus) Team B = Acute B (includes resus) Team UCC= Urgent Care Centre Team EDSSO = Emergency Short Stay unit (for JMO’s) SRMO’s will be rostered to these areas. Shift Swaps - Shift swaps can only be made with a Registrar of equal / greater seniority for night shifts – Any shift swaps need to be approved by Dr Melvin and a notification sent to the Executive Assistant to make sure floor rosters are up to date. Leave If you have accumulated leave and you wish to take it, the ED management will try its best to approve this leave. Most requests are in fact approved; however, the following must be borne in mind when planning your leave. Plan your leave well ahead, preferably at the start of the year. All other things being equal, leave will be granted on a first come first serve basis. As the roster is written up to 13 weeks in advance, it is not possible to process requests for annual leave for the period when the roster has already been written. This does not obviously apply for urgent leave required for sickness or other calamitous events. In the periods leading up to the College exams (primary and fellowship), preference will be given to those sitting for the exam. 6 Sick Leave If you are unable to work a shift due to an illness or other reason, then the following procedure needs to be followed. 1. Please call Prof Ali or Dr Melvin via the switch and notify the in-charge on the floor. Leaving messages with the secretary/nursing staff/JMO’s is not acceptable. When ringing the in-charge please ask them to make adjustments on the floor roster. It is the responsibility of the trainee to provide the ED with sufficient notice. This is especially important for the evening and night shifts. A medical certificate needs to be produced if you are sick for more than one consecutive day or for more than two days per term. The certificate can only be written by a non- hospital MO, preferably your own LMO and not a relative or close associate. Emergency Department on-call Consultant The ED has a 24 hour on call roster for Consultants. The on-call Consultant should be contacted by the senior doctor rostered on duty in the ED or the nursing Team Coordinator under the following circumstances: The following Criteria is a guide to calling the Emergency Consultant on call. This list is not exhaustive and the emergency consultant on call is always available to answer questions and give advice and support as required. Clinical: 1. Any clinical decision that requires consultant to consultant discussion 2. Expected difficult resuscitations (eg. pregnant OHCA or neonatal resuscitation, potential difficult airway) 3. Clinical advice on patient management or disposition 4. Significant adverse event or unexpected outcome (eg. unexpected death/SAC 1) Departmental: 5. Any major incident with multiple casualties/patient presentations expected, issues with staff safety, overwhelmed department with overwhelmed resources 6. HR, performance or staffing matter unable to be resolved by duty staff Attire - Trainees are expected to wear appropriate clothing and footwear - green scrubs - Medical staff wear green scrubs and nursing staff wear dark blue scrubs .Footwear needs to be sensible and comply with OH and S requirements - No sandals or non-protective footwear are to be worn. - No jeans - Remember use your common sense!! 7 Emails From mid 2017, NSW Health policy requires ALL employees to communicate using their health email for all work-related emails. You are automatically given a health email if you previously worked with NSW health. If you are new to NSW Health, then you will be given a health email when you start. Instructions on how to access your email can be found below. 1. Health email All correspondence regarding patients and work-related discussions must be on Health email. Do NOT use personal email for work purposes. Health email is available on any device at https://webmail.health.nsw.gov.au (login with Stafflink credentials) Health email is also available on your smartphone/tablet native email app or Outlook app – this needs to be activated. 2. Wifi All medical staff have Wifi access across the 4 acute hospitals (Westmead, Blacktown, Auburn, Mt. Druitt) on the “Clinical” network. To apply for Wifi access please complete an eForm on the ITS intranet. Setup instructions and username/password will be sent to your Health email. 8 Section 3: ACEM related information Any feedback or questions regarding your contract or training should be directed to the Directors of ED training. There is usually at least one of us available on most weekdays. Terms Rotations for each year are organized by the DEMT’s. When organising secondments, the department takes into consideration each trainees’ preferences, training requirements and availability Available rotations for Advanced trainees include: - Emergency Medicine .
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