Notes for Medical Staff working in the ED

  • The Department must be staffed at ALL times.
  • Do not alter the rota or swap shifts without permission of the Duty Consultant. All rota swaps must be organised via the ED Secretary.
  • It is essential that you keep full, adequate and legible notes for both clinical and medico-legal reasons.
  • Every time you write on the ED card, SIGN it and WRITE YOUR NAME IN CAPITALS, the time, date and your MCRN under your signature. Your clinical notes constitute a legal document.
  • As far as possible, the Doctor requesting an x-ray should interpret it. If you request an x-ray, and then go off duty, please "hand over" the case to a colleague who will then interpret the x-rays.
  • There are great dangers in interpreting x-rays of a patient that you have not examined.  If you have any doubts you must re-examine the patient yourself, as it is your responsibility when you discharge the patient.
  • If you are unsure about interpreting an x-ray, ask advice from the Middle Grade or Consultant working on the shop floor. During working hours further advice may be sought from a Radiologist.
  • If you request routine blood tests, whose results will be reported on the same day (eg FBC, routine biochemistry, D-dimer, CRP), it is your responsibility to check the results (and to record these in the notes).
  • As a general principle, patients should not be referred from the Emergency Department to the Outpatient Clinics, other than following trauma (usually # Clinic). A patient requiring an outpatient appointment should usually be referred back to their General Practitioner to arrange this.
  • All patients who register at the desk must be seen.  If a patient has a chronic problem, they should be referred back to their own GP for treatment. Urgent treatment should be given if thought necessary. 
  • From time to time, guidelines on the management of certain conditions will be issued, and these should be read.
  • Please inform one of the Consultants of any problem which arises in the running of the Department.
  • If you want advice on any problem, there is always a Middle Grade Doctor in the ED and there is always a Consultant on call. Where the Guidelines state: "Ask Advice", do this from the duty Consultant/ Registrar in the Emergency Department.
  • If in doubt about anything, ASK. Remember the nursing staff may well be able to assist – don’t be afraid to ask them for advice.