SOUTHMEAD EMERGENCY DEPARTMENT,
NORTH BRISTOL NHS TRUST
North Bristol NHS Trust is the largest hospital trust in the South West of England, providing hospital and community healthcare to the residents of Bristol, South Gloucestershire and North Somerset. Southmead Hospital is also a specialist regional centre for a number of services including neurosurgery, renal (kidney) medicine, plastics, orthopaedics and major trauma.
The redevelopment of the new state-of-the-art Brunel building at Southmead Hospital Bristol is now completed, and it is fully open with all teams and services in place. The hospital teams from Frenchay and Southmead have been brought together onto one site where they provide the very best of healthcare in facilities
the patients deserve.
THE EMERGENCY DEPARTMENT NORTH BRISTOL TRUST (NBT)
The Emergency Department (ED) and Major Trauma Centre was designed to
meet our specific needs, and comprises-
- A 6 bay resuscitation area, including a Paediatric bay
- A CT scanner sited within the resuscitation area
- A 14 bay Majors area
- A large minors area including dedicated eye room, procedure room and plaster room
- A completely separate, specially designed, dedicated Paediatric minors area, with its own waiting room and facilities.
Immediately next to the Emergency Department is the ED Observation
Unit, run and staffed by ED staff. This area comprises 14 reclining chairs, a procedure room and 3 private rooms.
The NBT ED comprises an Adults ED, and an Adult and children's Minor Injury Department. The ED sees almost 100,000 patients per annum, of which approximately 10,000 are children. Analysis of patient presentation indicates a high level of patient acuity, with the ED seeing a large number of sick, complex, medical patients, together with a high number of severely injured patients.
STAFFING
The ED provides a high level of senior shop floor presence. It is staffed by shop floor Consultants until 2400, together a Resident Consultant Trauma Team Leader, 24/7. The Junior and Middle Grade tier provide a 24/7 shop floor service, with a separate junior and senior registrar rota.
In addition, there are a number of allied professionals working in the ED; including advanced care practitioners, physio practitioners and emergency nurse practitioners. The ED is also well supported by a Front-Door Frailty Service, Mental Health Liaison, Alcohol Liaison and Domestic Violence Services.
SERVICES
MAJOR TRAUMA CENTRE (MTC)
Southmead is the Major Trauma Centre for the Severn Region, serving as the MTC for a Trauma Network stretching from Cheltenham in the north, to Taunton in the south, and Swindon in the east. The Trauma Teams are led by a dedicated, resident, Consultant Trauma Team Leader (TTL) 24/7. Weekdays, the TTL is an NBT ED Consultant; at weekends, the TTL is provided by a consortium of Consultants from both NBT and the Trauma Network.
The ED and the Trauma Service invests heavily in education and training, of both TTL's and Trauma Team members. An ED trainee is a regular member of the Trauma Team. There is a robust Clinical Governance structure, with regular M&M meetings. As the MTC for the Severn region, the department is required to report all treatment results of manor trauma patients to the National Trauma Audit and Research Network (TARN).Results for 2015 showed that the ED at Southmead Hospital had the best survival rate of any MTC in England and Wales.
ED SERVICES
The ED provides cutting edge, evidence based Emergency care, at the forefront of Emergency Medicine. It delivers 24/7 Stroke Thrombolysis, with an excellent “straight to CT” service for pre-alerted FAST positive patients. In addition, Southmead is one of only an handful of ED's in the country, in conjunction with Interventional Radiology, to provide an dedicated clot retrieval service.
Primary Percutaneous Coronary Intervention Services for the management of AMI is available on site during weekday hours, together with the ability to liaise with, and transfer patients to,the Bristol Heart Institute at BRI.
The ED medical staff provide a wide range of patient care, managing a large number of medical conditions in-house. This includes the management of cardiac arrests, patient sedation, RSI, cardioversion, delivery of noninvasive ventilation, and a number of rule out pathways.
The ED has two Ultrasound machines for FAST scanning and vascular access. The ED Consultant body is able to provide support for USS training in line with meeting College requirements.
The latest April 2016 CQC report rated the ED as “good”, highlighting leadership, , patient safety and effectiveness as particularly good areas. It noted the Major Trauma service as “outstanding”.
ICU website for doctors
https://www.nbt.nhs.uk/clinicians/services-referral/icu-clinicians
EDUCATION, RESEARCH AND TRAINING
The ED has a well established, excellent weekly teaching programme. The includes a monthly, multi-disciplinary Clinical Governance meeting. SpR's are released to attend the monthly, Regional Training programme, which is also delivered by Southmead at regular intervals.
Southmead ED has a long, well established,national reputation of being at the forefront of research in Emergency Medicine. There are always a number of high profile research projects being undertaken at any one time, supported by dedicated research nurses. All trainees are encouraged, and expected, to become fully involved in current research projects, as well as taking an active part in the Department's extensive audit projects.
All new medical staff receive a comprehensive, protected Induction Programme at the start of their post.
All trainees are supported throughout their post by an Educational Supervisor. The Consultant body have a wide range of interests and expertise, and actively support the trainees in achieving their necessary portfolio requirements. Study leave for appropriate learning opportunities and development is actively supported.
The ED has students on attachment from Bristol University at regular intervals. In addition, there are often Military personnel undertaking placements.