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Whilst restrictions are being lifted in most public places on 19 July 2021, strict Infection Control needs to be followed in hospitals and healthcare settings, to stop vulnerable people from being placed at additional risk.
The Emergency Department is sometimes known as ‘Accident and Emergency’, or A&E. We treat people who have suffered a recent injury or accident, or who have developed a sudden illness. All emergency departments use a priority system where the sickest people are seen first. This is called Triage.
Our emergency department in Plymouth sees over 100,000 people every year. That’s the same as filling up Home Park stadium six times over! We see all people in our department, but we are also a specialist hospital for severe injuries, strokes, heart attacks and neurosurgery (brain and spinal problems).
Initial Triage and Assessment
After meeting our reception team, you will be directed to the initial triage area and you will meet some of our senior doctors and nurses. This team will find out about your problem, and try to answer any questions you have. They will provide you with pain relief and other emergency treatment. Tests and treatments will be tailored to your needs, but some examples include:
Blood pressure, heart rate, and oxygen check (observations)
Heart tracings (ECG), x-rays, blood tests
Pain relief, antibiotics, anti- sickness medicine, or a drip
We know that our triage area is sometimes quite noisy, and sometimes conversations can be overheard. Let us know if you would rather be assessed in a private area. If you find hearing difficult, please do let a member of staff know.
This initial encounter might seem brief, but don’t worry—you will be seen again in more detail later on, once your initial tests are back.
What happens after my initial assessment?
After the initial assessment, you will usually wait for a more detailed assessment from a doctor, or one of our other specialists. These include advanced clinical practitioners and emergency nurse practitioners. All of our staff are highly trained and experienced at dealing with emergency problems.
Sometimes, we may identify that another department or specialist is better placed to treat the problem you have attended with. In this case, we may refer you directly to an alternative place of care. We will always let you know if this is the case.
If you have attended with a minor problem, it may be more convenient for you to see your GP or a community pharmacist. We will advise you if this is the case.
What are the areas of the emergency department?
You may receive care in different areas of the emergency department, depending on the nature and severity of your condition. These areas include:
Ambulatory Emergency Care area
Our doctors and specialists see people with a range of problems in our ambulatory area, provided they are able to wait on a chair and do not require a bed.
‘Majors’ is the term we use for the bedded area of our emergency department. Here our doctors and nurses see people with a range of problems, who require a bed or constant observation, monitoring or treatment.
‘Minors’ is the term we use for the area of our department staffed by our emergency nurse practitioners, who are experts in treating people with a wide range of minor injuries and illnesses, such as broken bones, bites and stings and falls.
Our resuscitation room has seven fully equipped beds for monitoring people who are either very unwell, or are undergoing certain procedures which require constant observation. If needed, we can provide intensive care support for the sickest people in the resuscitation room.
Paediatric (Child) area
We also have a specially equipped area for children and young people, which is usually staffed by our childrens’ nurses. We see children and young people with all problems in this area.
How long will I wait?
There will usually be a wait following your initial assessment. This will depend on the number of people in the department as a whole, and how sick they are. We will try to keep you informed about the length of waiting times. Waiting times can change if new emergencies or very sick people arrive in the department.
We know that waiting can sometimes feel frustrating, and if you are worried about your length of wait you can let us know. Our staff work very hard to see everybody as quickly as possible.
Please be kind to our staff. Violence and aggression is not only very unpleasant for our staff, but it is frightening for other patients. Violence and aggression will not be tolerated and may lead to criminal prosecution and exclusion from the hospital in the future.
People are being seen before me. Why is this?
Sometimes people may be called to be seen before you, even if they have arrived after you. This may be because they have a more urgent medical need, or they can be seen by a different specialist. If the waiting room appears quiet and you are still waiting, this often means we are busy treating very sick people in other parts of the department.
I feel like my condition is getting worse whilst I am waiting. What should I do?
If you feel that your condition worsens while you are waiting please do let a member of staff know so that we can provide a review. We can provide additional pain relief whilst you are waiting, if this is needed.
Can I take my own medication?
If you wish to take your own pain relief or any other medications, please inform the doctor or nurse who is assessing you before you take these.
Some conditions, such as insulin dependent diabetes, epilepsy or Parkinson’s disease, require medication at very specific times. If you have such a condition, please let us know and we will try to obtain essential regular medication for you.
Who is who in the emergency department?
Many different people work in the emergency department. We work as a team and everybody has a very important role to play in your care. All staff you encounter should introduce themselves to you by their name and job role, but please don’t hesitate to ask them if you are unsure.
Staff can also be recognised by the colour of their tunic. You can see some examples below:
Are visitors allowed in the emergency department?
Due to COVID-19, no visitors are routinely permitted in the ED. This helps us protect you, our other people and staff. We hope you understand. Sometimes, there are special reasons you may require a visitor—for example, if you have genuine difficulty communicating with others. This may be permitted by the nurse or doctor in charge where appropriate.
What happens once my emergency department assessment is complete?
Once your emergency department assessment is complete, you will either be discharged home or we will recommend admission to a hospital ward or assessment unit for further tests or treatment. Your doctor or nurse will always let you know where and why you are being admitted. If you have any questions, please ask.
Sometimes, we need to wait for further test results or for a specialist opinion whilst you are with us in the emergency department. In this case, we may direct you to a seated area on our Clinical Decision Unit (CDU). This provides a safe and comfortable place to wait. We may also admit people to CDU for overnight observation and treatment.
Are visitors allowed if I am admitted to hospital?
Due to COVID-19, wards are unable to allow visitors. However, visitors are welcome to bring items in for their loved ones, which can be left with the ward clerk/receptionist. You can contact any hospital ward via switch board on 01752 202082.
Sometimes, there are special reasons you may require a visitor—for example, if you have genuine difficulty communicating with others. This may be permitted by the nurse or doctor in charge where appropriate.
What happens if I am discharged home?
If you are discharged home, you should be provided with information about your condition and any further steps that are required, including any follow up appointments either in hospital or with your GP. If you are required to follow up with your GP, you may need to arrange this yourself. If you are due to be seen in a hospital clinic, the hospital will arrange this for you.
We will usually provide your GP with a letter about your visit. This may take a few days to arrive with them.
It is vital that you know what to do if your condition worsens, once you get home. Please listen carefully to the instructions from the doctor or nurse and let them know if you are unsure, or if you have any questions. They may also be able to provide you with some written information, such as a leaflet.
You may be provided with a prescription or given a course of medicine to take away. The doctor or nurse seeing you will provide you with information about any new medicines.
What if I wish to leave the emergency department before my assessment is complete?
If you wish to leave the department before your assessment is complete, please do discuss this with a member of staff. Staff may still be able to offer some advice that means you are able to keep safe. Staff will also let you know any risks of leaving, in a way that you can understand so that you can make an informed choice about what to do.
If you choose to leave, you can return to the emergency department at any time, for example if you feel your condition worsens. You may also contact NHS 111, Community pharmacist or your GP for further advice.
Once you have booked in, please try not to leave the emergency department without informing a member of staff.
Providing us with feedback
Friends and Family Test - We ask all people who attend the emergency department and are discharged home to provide us with feedback via the Friends & Family test. This gives you, the patient, or your relatives or carers the opportunity to voice your concerns/ praise of your experience of the ED. You are welcome to individually name staff.
While you are in the department, if you have any concerns regarding care or communication and you would like to discuss this, please raise your concern with a staff member at the time so that we can try to rectify the problem or concern.
Please also note that you can also visit the Plymouth University Hospitals NHS Trust website to report positive experiences. This feedback is collated and can be presented to a specific person or the entire department, in the form of a card: Saying Thank You (plymouthhospitals.nhs.uk)