A CORK emergency medicine consultant has suggested that the overcrowding being seen in emergency departments has come about partly because these departments have become “the single portal of access to the health service for everybody.”
Dr Chris Luke, an emergency medicine consultant in Cork said that while there had been significant decreases in the number of patients presenting to emergency departments (EDs) at the beginning of the Covid-19 outbreak, that people were returning to hospitals, with facilities now back towards the workload they had experienced prior to Covid.
On Wednesday, 44 admitted patients were waiting for beds at hospitals in Cork.
Cork University Hospital had the highest number of patients in the country waiting for beds at its emergency department with 36 people waiting there.
Dr Luke said that while people had been deterred from coming to the emergency room in recent months, people are beginning to return to the emergency departments for “all sorts” of reasons.
“It’s not always pure emergencies,” Dr Luke said.
“We would define an emergency as something which is unexpected and needs urgent input.
“Whereas what we’ve got in reality is many people with long-term problems popping in for a second opinion, or in despair because of waiting lists, or because they want to try and get a scan, or they’ve been referred by exhausted GPs or they have neglected their long-term disease and there’s been a flare,” he said.
The emergency medicine consultant said in some cases instead of people being referred for admission directly to wards, or being referred to outpatient or day case facilities, they’ve been sent to the ED to be initially assessed and processed.
Capacity is also a significant issue and Dr Luke said that while the Covid-19 outbreak had accelerated many improvements in emergency departments, this has also impacted how many people they can be accommodated.
“The hospital emergency department and other wards were significantly reconfigured. They were in many respects substantially rebuilt and that meant that the flow in the EDs around the place was changed, sometimes considerably for the better,” Dr Luke said.
The consultant admitted that heading into the autumn there are concerns about the challenges ahead.
“Heading into September/October, the anxiety would be that we’d have a second wave or we would have a series of spikes or clusters which will generate a lot of anxiety on all sides which will revive the extreme caution and wariness and then the need to use PPE for almost everybody, which slows down the managing and treating of everybody,” he said.