Irish medical journal
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Irish medical journal · Apr 2008
Patients presenting to an Ophthalmic Emergency Department after 5pm.
We analysed the attendance after 5pm at the Ophthalmic Accident and Emergency department of Royal Victoria Eye and Ear Hospital, Dublin over a period of 34 days. 345 patients attended, 203 (73%) were considered non urgent by the duty ophthalmologist. 12 (3.4%) required immediate admission. 245 (71%) self referred without an accompanying letter. There is a disproportionate amount of non emergency presentations to the RVEEH ophthalmic emergency department that leads to long waiting times and inefficient use of resources. By implementing a multifaceted educational and publicity programme and by improving access to daytime ophthalmic services we will eliminate the need for patients to attend our A&E with non-acute complaints after 5 pm. A new Accident and Emergency department policy is required to prevent inappropriate use of the service after 5 pm.
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Timely management of pain in paediatric patients in the Emergency Department (ED) is a well-accepted performance indicator. We describe an audit of the provision of analgesia for children in an Irish ED and the introduction of a nurse-initiated analgesia protocol in an effort to improve performance. 95 children aged 1-16 presenting consecutively to the ED were included and time from triage to analgesia, and the rate of analgesia provision, were recorded. The results were circulated and a nurse initiated analgesia protocol was introduced. ⋯ Pain score documentation was very poor throughout, improving only slightly from 0% to 19.3%. No child had a documented pain score, which slightly improved to 19.3%. We recommend other Irish EDs to audit their provision of analgesia for children.