Madam, - I was disappointed to read Miriam Donohoe's article headed "New A&E faces same old chaos" (Health Supplement, February 21st). My disappointment is for the lack of appreciation shown to the medical and nursing staff involved in her daughter's care. We have sought and received Ms Donohoe's permission to publish the following details.
A sick 14-year-old child with a high temperature, high pulse rate and low blood pressure was brought to the emergency department at 3am on a Sunday morning. The cause was uncertain. Fourteen hours later she went home well with a normal temperature, pulse and blood pressure on continuing treatment.
In the interval she had been seen and assessed by the triage nurse, monitored regularly by the nursing staff, examined by two senior doctors, and her care was discussed with two emergency medicine consultants.
She had urine tests, blood tests and X-rays. She was given intravenous fluids and two doses of intravenous antibiotics and the response was monitored. She was put on treatment for a definitive diagnosis and given a letter for her general practitioner outlining her investigations and treatment. I am surprised that this level of clinical attention led to the article as published, causing distress to the staff involved in her medical care.
I believe that, in any walk of life, if people were to know that their overheard conversations would be reported this would lead to an artificial impediment to good interactions. The staff in the emergency department have an entitlement to privacy as well and this has been breached by the article. The relaying of overheard snippets of consultations between medical staff and patients created a distorted impression of the level of care that was being provided. I cannot elaborate due to patient confidentiality.
Like other major emergency departments, at times we have to see more than 100 patients in a day and deal with more than 30 emergency admissions. This can lead to problems of overcrowding and lack of privacy that cause distress to patients, relatives and staff. However, on average 50 per cent of patients are discharged within approximately two hours of presenting. Patients' care commences from the moment they are assessed, which usually happens within minutes of arrival.
To publish an article implying that patients routinely have to wait eight hours is misleading and only discourages patients who really do need to attend early for medical care. - Yours, etc,
ROBERT McQUILLAN, Director, Emergency Medicine, St Vincent's University Hospital, Dublin 4.