A young person was brought into ER following an MVA with these problems,
Don't know if any of you remember the Minister of Health's message to private centres, especially regarding patients who can't afford treatment ... that we must not turn such patients away until the appropriate treatment is done or else the ministry can revoke the licence if any misappropriate or neglect is shown ... particularly based on financial grounds.
Please give your sincere opinion so that Dr. Ngun can present to the MAB & Administration.
Thank you.
1 of 3 Provision of Emergency care
From: bobbyphtan
Date: Mar 22 1999
Fine, we do not turn away patients who require first aid, resuscitaion etc.
There is no litigation I am sure which could result from any doctor trying his
best to resuscitate a critically ill patient in the ER of a hospital such as
SJMC.
The point in contention is: are anaethetists going to be the sole and primary
doctor in this case. I would think not, and logically, there should be an attemt
to get a primary doctor (depending on the diagnosis, a physician or surgeon Etc
) and get him to make the proper referral.
After all as anaesthetists, nearly all the time we are service providers, not
primary care physicians.
If a primary doctor can be and should be, obtained to write the necessary
referral to (GH in this case), I see no problem with the intial resuscitation.
2 of 3 Two Worries
From: gasline
Date: Mar 24 1999
Submitted by Mary
Should have been seen in ER by the primary physician -I'd be concerned about 2 things-level of care to the patient i.e. whether anything could be done before transfer to enhance his survival,and the medicolegal aspect.
3 of 3 Once Contacted, We Are Responsible
From: gasline
Date: Mar 24 1999
As anaesthetists, when we are called, we have little choice but to respond to the call, especially if it is a dire emergency. If we choose not to respond, because the primary physician has not personally seen the case, in the event that something untoward happens, we would be liable to a suit of negligence.
If the Medical Officer in ER sees a case and decides on his own to refer the patient away, without referring to a consultant first, then the MO, and the hospital, takes responsibility for the case.
If the MO has referred to a consultant but the consultant chooses not to see the patient himself, then he will be responsible if anything happens. Once he has been contacted, he will have to take the responsibility for his own actions.
Whether the primary physician sees the patient or not, we in the same way would have to be responsible for our own decision to see or not to see the patient.
Personally, I think we should,
1 See the patient,
2 Provide any and all necessary anaesthetic care,
3 Give an opinion on whether the patient is stable enough for transfer to the
other hospital, and
4 Give orders on how the patient should be transferred (like whether the MO
should accompany or what equipment may have to be brought along).