Protocol for the referral of emergency medical cases to
Singleton SAU via WAST
Protocol for the referral of emergency medical cases to Singleton SAU
via WAST
Introduction
Since January 2009 the A&E Department at Singleton Hospital has become a
General Practitioner led Minor Injuries Unit (MIU) which does not accept
undifferentiated 999 emergency cases. The majority of 999 type cases are
taken to Morriston Hospital which is the major receiving unit within the
Swansea Locality.
Singleton is the main receiving Hospital in Swansea for GP medical
admissions which arrive at the hospital via the assessment unit (SAU). In
some circumstances, however, medical patients who receive an initial 999
response may be deemed suitable by the attending paramedics for direct
admission to Singleton. The aim of this protocol is to describe the process by
which such patients can be taken to Singleton ensuring that patients are
admitted to the most appropriate hospital and that available hospital capacity
in the Swansea Locality is used to best effect.
Key Principles
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Medical cases referred by General Practitioners within the Swansea
Locality will primarily be admitted to Singleton Hospital via the SAU
Emergency 999 patients will primarily be admitted to Morriston Hospital
via the A&E Department
Certain emergency 999 patients, as defined below, can be admitted to
Singleton Hospital via SAU, if agreed between the paramedic at the
scene and the medical registrar on call at Singleton.
All critically ill and unstable patients must be taken to Morriston
Hospital A&E Department.
The paramedic at scene should call the medical registrar within the
protocol guidelines by contacting the switchboard at Singleton on
01792 285000. The medical registrar will be alerted that a paramedic is
on the line via a bleep “voice over”.
Protocol for admission of 999 patients to Singleton Hospital
1. All emergency medical patients referred by a GP will be admitted to
Singleton Hospital. However GPs can admit the following patients direct
to Morriston Hospital:
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Patients with a strong reason to be admitted to Morriston Hospital
such as those under the ongoing care of a Morriston based
Consultant.
Patients with a suspected stroke
Chris Hudson Clinical Director Swansea Locality 27th July 2012
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Protocol for the referral of emergency medical cases to
Singleton SAU via WAST
2. Between 10pm and 9am all 999 medical patients will be admitted to
Morriston Hospital.
3. Between 9am and 10pm patients with the following problems can be
admitted to the SAU at Singleton if agreed between the paramedic and
the on call medical registrar:
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Patients who have taken a drugs overdose
consciousness level
Breathlessness
Transient loss of consciousness
Seizures
Falls and funny turns if no evidence of trauma
Headache
Diabetic emergencies – hypo and hyperglycaemia
Palpitations
Diarrhoea or vomiting
Chest pain (with the exclusion of ST elevation MI)
Chest infection and pneumonia
Acute confusion/delirium
Suspected sepsis
with
a
normal
The only reason a medical registrar should refuse a request from a paramedic
to admit a patient direct to Singleton is on grounds that the registrar does not
consider the patient clinically appropriate (when assessed against the criteria
above) to be admitted direct to Singleton. Issues of capacity within the
hospital should be dealt with by the Bed/Site Manager.
Chris Hudson Clinical Director Swansea Locality 27th July 2012
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