Emergency care

PUBLISHED : Thursday, 03 April, 1997, 12:00am
UPDATED : Thursday, 03 April, 1997, 12:00am

The accident and emergency unit at a hospital is intended exclusively for cases which fall into that category. Patients are rushed there suffering from heart attacks, haemorrhages, crash injuries, and acute life threatening illnesses. Often, they may have only minutes to live unless skilled medical attention is immediately available.

Staff in these units work under pressure at all times. An 'A & E' department is open 24 hours a day, 365 days a year, and the patients who call upon its services fall into four categories. The first are genuine emergencies where lives are at stake; the second are urgent cases where prompt surgical or medical treatment is essential; then come non-urgent cases such as broken bones or cuts which require stitches. Finally, there are all the other patients who wander in with minor ailments ranging from the common cold to a bad case of acne.

Over Easter, the territory's emergency units were working flat out trying to cope with a flood of cases, 22 per cent of which fell into the fourth category. These are cases which do not require hospital treatment of any kind, but which are imposing a strain on the service and risk bringing it to breaking point.

It is clear that action must be taken to deter people from abusing the system, particularly during holiday breaks. The United Christian Hospital's record of treating 872 casualty cases on Easter Sunday is one world record we do not wish to retain. Many patients at the weekend were complaining of nothing more serious than colds and diarrhoea.

Medical staff are always reluctant to turn people away, even when they are patently not in need of attention. But they have to be realistic. Apart from wasting staff time and hospital resources, people with trivial complaints could endanger other lives by monopolising the attention of doctors and nurses in the critical moments when a genuine life-or-death case arrives.

The answer may be to open all the territory's 50 clinics at holiday times to ease a burden which hospitals say is becoming intolerable. Since this would only require funding three or four times a year, it should be possible for the Department of Health to find the money. But for the high proportion of patients present with ailments which even time or a bottle of proprietary medicine could cure sterner measures are justified.

Time wasters should be sent packing, when emergency wards are under stress. Perhaps the Government could run a publicity campaign to show the public the consequences of such selfish behaviour, and to spread the word that the title 'accident and emergency unit' means what it says - and making plain that those who can afford to wait for treatment will have to do so, often for many hours.