Toolkit may reduce number of admissions to hospital Ambulatory emergency care is said to be ideal for older patients who can recover in their own homes

Retrieval and transfer service will be first of its kind in UK A NEW emergency service to stabilise and transfer the critically ill and injured patients to hospital by road and air will be operational in Wales from April. The Emergency Medical Retrieval and Transfer Service (EMRTS) Cymru is the first national service of its kind in the UK. Its development has drawn on the latest evidence from military and civilian experience. It is estimated that EMRTS Cymru ‘could contribute to at least a 40% improvement in survival rates from major trauma’ and ‘reduce patient transfer times to specialist hospital care by more than 40%’. EMERGENCY NURSE

admissions and a reduction in the number of emergency bed days used. The toolkit sets out 11 principles to ensure the success of AEC, the four emerging AEC models and practical tips on setting up AEC services. It includes four questions that should be asked to determine whether or not a patient is suitable for AEC, and explains why hospitals, GPs and social care services should share information to ensure that the care of patients who have left hospital is not compromised by missing information. Principles Toolkit co-author and programme director of the Ambulatory Emergency Care Delivery Network Deborah Thompson said: ‘The creation of this toolkit has enabled us to distil learning from many sites across England. Using principles in the toolkit,

i Find out more The toolkit is free to download from

Thirteen-fold increase in queries about legal highs Science Photo Library

by Nick Lipley STAFF CAN identify emergency patients eligible for ambulatory care by using a toolkit published by the Royal College of Physicians (RCP). According to the RCP, the number of people attending emergency departments (EDs) who are subsequently admitted to hospital is rising, which puts pressure on EDs across the UK. The college proposes that these patients are treated in ambulatory care settings and discharged on the same day, thereby ‘offering benefits to patients, carers, support workers and NHS trusts’. Ambulatory emergency care (AEC) is said to be particularly well suited to older patients, who can fare better in their own homes than in hospital. Consequently, acute care services with ambulatory care units have reported high levels of patient satisfaction, avoidance of unnecessary

clinical teams can develop and improve AEC services rapidly, maximising this approach as an alternative to overnight admission to hospital for the benefit of patients and staff alike.’ Chair of the RCN Emergency Care Association Janet Youd said: ‘Ambulatory emergency care can be a safe and effective way of treating patients with conditions suitable for day-case-type treatment. This not only increases hospital efficiency but, more importantly, can improve the patient experience, particularly if they can avoid an emergency department or medical assessment unit and go home to sleep in their own beds. ‘However, as winter approaches, we must be clear that patients must not be sent indiscriminately from emergency departments to these units simply to ensure the four-hour standard is not breached while they wait for acute inpatient beds. I support the mandatory reporting of quality indicators, such as time to initial assessment, time to clinical-decision maker and length of stay, on these units.’ See also feature, pages 18-19

Some recreational drugs are sold legally in the UK

POISON SPECIALISTS have flagged up rises in the number of calls and online queries about treatments for users of psychoactive substances known as ‘legal highs’. According to the National Poisons Information Service (NPIS), there were more than 130 phone queries, a 13-fold increase, from clinicians treating users in the past year. There was also twice the number of queries from NHS healthcare professionals through the NPIS online database TOXBASE over the same period. Last year, the only illegal drug that was the subject of more questions by front line staff than legal highs was cocaine. ■ Details of the National Poisons Information Service Report 2013/14 are available at November 2014 | Volume 22 | Number 7

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Toolkit may reduce number of admissions to hospital.

STAFF CAN identify emergency patients eligible for ambulatory care by using a toolkit published by the Royal College of Physicians (RCP)...
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