Paediatric General Surgery - Processes in ED

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Objectives

This document is intended to assist the general surgical team with specific ED processes

Accepting referrals
  • The paediatric general surgical team accept referrals from GPs. Where possible they should add the patient to the RHC ED Patient Expected List on Trakcare. If unable to do so they should phone the ED Nurse Coordinator 84585 or the ED Duty Consultant 84059. These patients will be seen for a first assessment by ED medical staff. If ED are under extreme pressure the general surgical team will be asked to assist.
  • In-patients being transferred from another hospital are accepted to an available in-patient bed as per the Inter-hospital transfer policy. The ED Nurse Coordinator 84585 should be phoned with the patient details.
  • Patients referred from other EDs accepted by the Surgical team will be seen in ED by the Surgical Team. The ED Nurse Co-ordinator should be informed.
  • Only patients transferred from other EDs with an isolated Head Injury will be seen by ED staff but they should still be accepted by the Surgical team and communicated to the ED Nurse Coordinator.
Trakcare in ED
  • Surgical staff should assign themselves to the patient on the Trakcare screen using the “Clinician pop-up” function. Any member of ED staff can assist with this.
  • There is a Nurse-in-Charge of each area and the Surgical Team should communicate their plan for the patient to them. The nursing staff use Trakcare “floor plan notes” for their documentation.
  • Every patient discharged from ED should have an ED discharge letter completed for the GP. This is a short letter that is found under Letters Discharge; ED Attendance Letter. Diagnosis and Discharge summary are the only mandatory fields.
Special Patient groups

The surgical team will be asked to see some patients directly without an ED doctor reviewing them first. These are:

  • Patients who attend with a post-operative complication from surgery performed by the Paediatric general surgeons.
  • Patients who represent within 48hrs of discharge from an in-patient surgical admission and have symptoms directly related to that admission.
Patients causing concern

If the nursing staff are concerned about any patient presenting to the ED they will ask ED medical staff to assist with their initial assessment and treatment irrespective of their planned pathway. This may because they have a high PEWS score, are in pain or need immediate intervention. The Surgical Team should attend ED as soon as possible.

Editorial Information

Last reviewed: 13 April 2021

Next review: 30 April 2024

Author(s): Dr Fiona Russell (Consultant in Paediatric Emergency Medicine, RHCG) & Ms Rania Kronfli (Consultant Paediatric Surgeon, RHCG)

Approved By: RHC ED Clinical Governance Group