emergency department – Michmutters
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Australia

E-scooters help Australia’s net-zero goals, but medics warn about long-term injuries

Traumatic brain injuries, severe dislocations, and broken bones are some of the injuries Graeme Maw has seen come through the Townsville University Hospital from electric scooter (e-scooter) accidents.

Emergency physician Dr Maw says staff would support a ban on the two-wheeled devices, as new research shows half of the riders are making potentially life-threatening decisions on Queensland roads.

He said approximately one person per day was presenting to the hospital with injuries ranging from skin abrasions to significant head trauma.

“Lots and lots of soft tissue injury, extensive grazing and abrasions. Lots and lots of lacerations that require suturing up,” Dr Maw said.

“Often, these patients go on to suffer relatively significant long-term impacts from these sort of injuries.

“There was one young man who came off a scooter after drinking. He came in deeply unconscious and was sent to intensive care. He went from being a functioning member of society with a job to spending months and months in hospital and rehabilitation.”

A serious looking middle-aged man with slicked back hair, standing in hospital ward with equipment, wearing blue scrubs.
Dr Maw says about one person per day presents with an e-scooter injury.(Supplied)

The Townsville University Hospital has been collecting data on the frequency of e-scooter accidents since the ride-sharing devices arrived in the city in 2020.

Dr Maw said about 50 per cent of patients presenting to an emergency were not wearing a helmet, and more than 75 per cent were under the influence of alcohol when an incident occurred.

The data showed 70 per cent of patients presenting to the hospital with e-scooter injuries were male, with the majority in the 18–30 age group.

Man rides e-scooter down a tree-lined street.
The data shows 70 per cent of patients presenting to Townsville University Hospital with e-scooter injuries are male.(ABC North Queensland: Rachael Merritt)

But Dr Maw said the true extent of cases was being under-reported.

“It’s not just the people riding the scooters. We’ve had a few innocent bystanders knocked over,” he said.

“Not everybody who comes off an e-scooter ends up going to the emergency department.

“A lot of patients head to GPs, private hospitals, and some may not seek medical attention at all.”

Calls for help becoming ‘more frequent’

Queensland Ambulance Senior Operations Supervisor Wayne Paxton, from the Townsville district, said paramedics were responding to an e-scooter crash at least once or twice a week.

“It’s starting to become more and more frequent over the weeks and weekends,” Mr Paxton said.

“The types of injuries we deal with can vary from a small cut or abrasion to something like a head injury or fractured leg or shoulder injury.”

Purple e-scooters lined up in front of palm trees with helmets.
Doctors say they have seen cases of traumatic brain injury in Townsville since the scooters were introduced.(ABC North Queensland: Rachael Merritt)

Amid the rising cost of fuel, Mr Paxton said more regional Queenslanders were choosing the cost-effective mode of transport.

He said their popularity would likely continue to rise but warned riders to be aware of the risks.

“I’ve been to accidents where the helmet has been on, but they haven’t done the strap up, and it has come off during the fall,” he said.

“If we don’t have the right education and don’t wear protective equipment … it can certainly lead to serious injuries and, worst-case scenario, more deaths.”

Safety not being taken seriously

With more regional Queensland cities such as Mackay, Rockhampton and Bundaberg taking part in the e-scooter rollout, a recent survey by the state’s peak motoring body found half of the riders admitted to reckless driving behaviour.

Andrew Kirk, principal technical researcher at RACQ, said a crackdown on non-compliant e-scooter users was needed to improve safety, as well as a stronger education campaign.

“Nearly one in 10 riders have had an accident, and over half of those have been injured,” he said.

“That comes down to lack of safety equipment, going too fast and riding in the wrong areas.”

Close up of red safety sign on e-scooter saying ride safely, park responsibly, don't block path, with figures depicting action.
A statewide survey of e-scooter users by RACQ found only a third of riders were aware of the road rules.(ABC North Queensland: Lily Nothling)

Mr Kirk said RACQ had been in talks with e-scooter rental companies to incorporate new technologies, such as onboard cameras, to improve user safety and did not want to see them pulled from the streets.

“It’s getting cars off the road, so it’s reducing vehicle emissions and reducing traffic congestion,” he said.

“They do have a big role to play in Australia’s net-zero goals.

“Most bike riders have adapted to the fact you have to have a helmet on, but for e-scooters we just need to change that mentality to get people to do the right thing.”

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Australia

Fixing weekend discharge key to improving capacity at South Australia’s hospitals

A senior doctor at Adelaide’s biggest hospital says the health system is under “siege” and pinpoints Mondays as the busiest day.

SA’s struggling health system was again in focus this week due to the death of a 47-year-old man while he waited for an ambulance in suburban Adelaide on Monday.

Problems around ramped ambulances, overcrowded emergency departments and full inpatient hospital beds, trouble doctors and nurses on any day of the week.

But each Monday a perfect storm of complications aligns, cranking up pressure on health staff and patients.

So, what makes Monday the busiest day in SA’s hospitals, and what can be done about it?

Headshot of Dr Peter Subramaniam at an Adelaide hospital
Dr Peter Subramaniam says having fewer doctors working and community services unavailable on weekends leads to lower discharge rates.(ABC News: Ethan Rix)

A weekend hangover

As medical lead of the surgery program at the Royal Adelaide Hospital and chair of the Australian Medical Association Council, Peter Subramaniam knows South Australia’s health system well.

He says it is under “siege”.

“The system is under pressure and there is a significant demand and our capacity to meet that demand is not working,” Dr Subramaniam said.

The qualified vascular surgeon pinpointed Mondays as the busiest days for hospitals.

“You can see from the data we have that ours are lower on the weekend compared to weekdays,” he discharge said.

“So that contributes to the log jam that occurs on a Monday.”

A masked nurse adjusts their blue plastic glove in an operation room.
Experts say more resources are needed every day of the week, including weekends.(Rawpixel: Chanikarn Thongsupa)

Dr Subramaniam said fewer doctors working to patients over the weekend had an impact discharge.

“Most acute care hospitals operate on reduced staffing,” he said.

But that’s not the only thing bringing down discharge numbers.

“We rely heavily on community services to be available and accessible over weekends and often that’s difficult to organize,” Dr Subramaniam said.

“You might need a rehab bed or a step-down bed or a community nursing service to be able to manage the patient once they’re discharged.

“Once we’ve discharged the patients, they need to go somewhere.”

Elizabeth Dabars stands outside a hospital in Adelaide
Elizabeth Dabars says a criteria-led discharge policy was never fully implemented.(ABC News: Michael Clements)

monday blues

Chief executive of the Australian Nursing and Midwifery Association’s SA branch Elizabeth Dabars said the “absence of senior clinicians” on the weekend was driving up ramping times.

Professor Dabars wants to see nurses, allied health professionals and junior doctors able to discharge more acute patients under something called criteria-led discharge (CLD).

“It’s a win for the people wanting to go home and it’s a win for the broader community who would have better access to hospital beds,” the qualified nurse said.

CLD has been hotly debated for decades and was a policy directive issued by SA Health in 2019.

A car drives past an emergency department building
The state’s emergency departments have been under extreme pressure.(ABCNews)

Professor Dabars said it was never fully implemented.

“That has not really seriously been put in place and that is a blocker to people being discharged,” she said.

“It doesn’t actually make sense for it not to be enabled.”

But the former president of the South Australian Salaried Medical Officers Association, Dr David Pope, said the number of patients that would fit the CLD criteria was small.

“Item [CLD] works quite well in some areas but I defy anyone to go around and find patients sitting around in the hospital for want of a doctor to come in on a Monday morning,” Dr Pope said.

“That just doesn’t happen.”

Headshot of Doctor David Pope
David Pope says elective surgery admissions make Mondays busier than other days.(ABC News: Ethan Rix)

He said a crowded start to the week was a side effect of elective surgery.

“That worse effect on a Monday is purely a function of when elective surgery patients arrive,” he said.

The doctor said the idea that senior clinicians were unwilling to provide care on weekends was damaging to an already stretched workforce.

“Doctors are in the hospitals 24/7, so if there’s a need for a doctor to be in the hospital they will be there if they exist,” he said.

What will change?

The state government said it was looking to make criteria-led discharge “a regular part of hospital operations.”

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Australia

A grieving family says South Australia’s health system is broken after man’s death while waiting for ambulance

The family of a South Australian man who died while waiting for an ambulance on Monday night says the state’s health system is ‘broken’.

The 47-year-old father of two, Andrew, died from cardiac arrest on Monday evening in a Plympton car park, where he had pulled over and called an ambulance after experiencing chest pain.

At the request of the family, the ABC has decided not to publish a picture of him or use his last name.

His family remembers Andrew as a “much-loved” partner, friend, family man and colleague.

Nathan Hutchison, the brother of Andrew’s partner, read a statement on his behalf.

“My partner Andrew was my soul mate and loving father to our children, my heart has been torn in two and I feel broken,” the statement said.

man standing in vest with checkered shirt and glasses
Nathan Hutchison says the health system needs to be fixed. (ABCNews )

“He’s going to be deeply missed, but will always be remembered and very much loved.

“We are devastated he’s been taken so soon.”

Mr Hutchison said that the system needed to be fixed.

“It’s just devastating for us,” he said.

“It’s very hard to put it in words, clearly there’s a system that’s broken and needs to be fixed.

A divided road with palm trees in the median strip, along with directional signs.  Only one car is visible and its parked
The man suffering chest pain called triple-0 after pulling over on Anzac Highway at Plympton. (ABC NewsEvelyn Manfield )

“It’s tearing up my family. Fix the system.

“We do appreciate the work the first responders did when they arrived, and the community members did when they were there.”

Central Adelaide Local Health Network chief executive Lesley Dwyer described the “awful” incident as “an absolutely tragic outcome” and said a full investigation would take place.

TAFE SA chief executive David Coltman said Andrew had been a well-loved member of staff.

“[He] was a highly regarded manager at TAFE SA and we are deeply saddened by his sudden passing,” he said.

“TAFE SA is providing support to [his] colleagues during this difficult time and we extend our heartfelt condolences to [his] Familia.”

A woman with short brown hair wearing a beige scarf and a black top
Lesley Dwyer says discharging NDIS and aged care patients to free up hospital beds remains a priority.(ABCNews)

Acting Health Minister Tom Koutsantonis said the man’s death was “horrific” and said he would also want his elderly father to call him if he had a medical episode.

“I’ve got an elderly father and I say to him, ‘if something happens, call an ambulance and call me’,” he said.

“But that’s not the solution you’d expect in a first-world country.

“In a first-world country, we expect an ambulance to come on time when it’s [a] life-threatening situation.”

A man in a suit standing behind microphones with a road overpass behind him
Tom Koutsantonis urges the public to still call triple-0 in an emergency. (ABC News: Shari Hams)

Mr Koutsantonis said there had been a “whole-of-government” approach to address the health crisis, which included hiring more doctors and nurses, opening private beds, and moving aged care and NDIS patients out of hospital and into care.

“You gotta have faith. We still want people calling triple-0,” he said.

“In three months we’ve done a lot but in three months you can’t fix it.

“Right now there’s no-one in South Australia who’s thinking about this in political terms, they are thinking about in terms of ‘if I call an ambulance will it come in time to save my father, my mother, my child?'”

‘extreme pressure’

Ms Dwyer said the health system was “under extreme pressure on Monday afternoon with large numbers of triple-0 calls.”

“The hospitals themselves had come off a weekend where we’d been extremely busy,” she told ABC Radio Adelaide.

A white hospital building with blue and green windows, with green trees in front of it
Ambulance crews were ramped up at the Royal Adelaide Hospital for three hours on Monday, the union says.(ABC News: Che Chorley)

“And so you had two of the major metropolitan hospitals, being Flinders and the Royal Adelaide, that were really struggling to get people into the emergency department in a timely way to free up ambulances.”

SA Best MLC Frank Pangallo said he was unsure what a government inquiry would achieve “because we all know where it’s going wrong.”

“The system is broken and more people are likely to die unless something happens,” he said.

Mr Pangallo said Andrew’s death was a “tragedy, and most likely was an avoidable one”.

“We’re likely to see instances like this again,” he said.

“Waiting times have blown out to unacceptable levels.”

A man sitting behind a microphone points.  There is a bottle of water next to him and a name tag
Frank Pangallo wrote to Health Minister Chris Picton last week about a different patient.(ABC News: Lincoln Rothall)

Mr Pangallo said he wrote to Health Minister Chris Picton last week about a different patient who had waited two hours for an ambulance after suffering a heart attack.

“There was another tragedy that was averted,” he said.

Mr Pangallo said his office had been told by a member of the public yesterday that a taxi had been dispatched when a triple-0 call was made.

“A family member had called for an ambulance and it wasn’t considered a high priority so a taxi was dispatched,” he said.

“I’ve heard of this happening previously as well.”

Plan alternative options, says union

SA Ambulance Employees Association secretary Leah Watkins said yesterday that South Australians should consider planning alternative options in the event of lengthy ambulance delays.

SA Ambulance Employees Association secretary Leah Watkins.
Leah Watkins says South Australians should prepare a plan for what to do in the event of a lengthy ambulance delay.(ABCNews)

“In the vast majority, people are calling triple-0 because they’re in a point of crisis and they have no other option and they should still do that if they do feel the need,” she said.

“But the ambulance service and the health system is completely overwhelmed at the moment and so if they are concerned that there is going to be a delay for them, to get help early.

“If you’re home alone, call a neighbor or a friend just to let them know what’s going on so that there’s perhaps someone that could come over and wait with you or someone that can drive you to hospital yourself.

Lesley Dwyer said while “there was nothing wrong” with Ms Watkins’ advice, “people should not be frightened of ringing” triple-0, and it should be the “first port of call” in an emergency.

“We’d certainly not advocate people hopping in a car or a taxi if they thought they had a life-threatening condition or one that was going to deteriorate on the way,” she said.

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Categories
Australia

SA government to use former aged care home to help transition NDIS patients out of hospital

A former aged care home will be used to transition NDIS patients who no longer need acute medical care out of hospital in a bid to free up capacity across South Australia’s overwhelmed health system.

The state’s hospitals continue to face unprecedented pressure, with 341 patients currently hospitalized with COVID-19, including 11 who are in intensive care.

There have also been 984 people hospitalized with the flu this year.

The new 24-bed community care facility will open next week at the former site of Uniting SA’s Regency Green aged care home.

Health Minister Chris Picton said the new facility would provide transitional care to NDIS patients with a psychosocial disability while they received mental health support.

“It’s going to give a much more peaceful and calming environment for them, the appropriate care that’s going to be provided by CLO (Community Living Options) but also making sure we are freeing up those beds,” he said.

A woman wearing a purple blazer and purple lipstick with a serious expression
SA’s Human Services Minister Nat Cook says some NDIS patients have been waiting in hospital for over a year. (abcnews)

There are currently 127 patients in public hospital beds who are eligible for NDIS support services and ready to be discharged.

“These are people who it has been difficult to find elsewhere because they do need appropriate supports,” Mr Picton said.

“These are people who have NDIS clearance, are medically cleared to be discharged from hospital but there simply aren’t places for them to go.”

The facility will cost $1.2 million to open and will initially only take patients from Central Adelaide Local Health Network (CALHN).

It will be run by CLO in partnership with Wellbeing SA, Uniting SA, CALHN and the Office of the Chief Psychiatrist.

Human Services Minister Nat Cook said for some NDIS patients, hospital could worsen conditions and escalate behaviours.

“These people, some of them have remained in hospital not just for weeks and months but for over a year,” she said.

“They have been stuck in other step-down facilities as well without pathways or coordinated journeys for discharge to home.”

A woman with short brown hair wearing a beige scarf and a black top
COVID acute commander Lesley Dwyer says 230 patients have been moved out of hospital and into aged care facilities. (abcnews)

Acute System Response COVID Commander Lesley Dwyer said in the last few weeks, 57 NDIS patients had been discharged into more appropriate accommodation.

“Accommodation that is much more home-like gives people a chance to really experience independence that they probably haven’t had while they have been in the acute system,” she said.

“In addition to that, we have also discharged 230 people into aged care beds.”

The latest data from the SA Ambulance Service shows ambulances spent 3,647 hours ramped outside hospitals during July.

The previous month, SA recorded its worst ramping times on record with 3,838 hours lost waiting for beds to become available.

The state recorded 2,421 new cases of COVID-19 today and eight deaths of patients ranging in age from their 60s to 90s.

There are currently 17,647 active cases in the state.

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