Inside one of Australasia’s biggest and busiest emergency and trauma centres
The Alfred’s emergency department now treats an average 185 seriously ill and injured patients a day. Here’s the stories of survival we saw and heard during just three hours behind the dreaded front doors.
Inner East
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STAFF scramble, sirens blare, phones ring off the hook and still more patients are wheeled in attended by huddles of medics.
Families cling to one another. Somebody yells out — a paramedic runs left, something happens to the right … it’s the sort of chaos we normally associate with every hospital’s emergency department.
But this is not the case at the Alfred Hospital when the Leader visits.
It is 5pm on a Wednesday at one of Australiasia’s busiest trauma and emergency centres, and it is near capacity. But the department’s unique style means you wouldn’t know.
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“It is actually one of our busiest nights in a while,” associate nurse manager Angela Weber tells me.
“We have more than 60 patients in the department right now, but you wouldn’t be able to tell.”
There is a clear system to the department’s corridors — those walking along instantly move aside allowing passing staff members to easily manoeuvre through.
No one is shouting — instead, the nurse manager at front desk gives directions firmly, but steadily.
But countless stories of drama, survival and resilience are playing out behind those dreaded medical-green surgical blinds.
Chris Robertson was involved in a horrific accident only five hours ago.
He was delivering goods when his truck ploughed into a car on the corner of the Nepean Hwy and White St in Mordialloc.
“One side of the truck was wiped off,” he said.
“I slammed on the brakes, but I had no chance of stopping in time and just went straight into him.”
Mr Robertson was rushed to hospital with soft stomach and wrist injuries.
And if that ordeal wasn’t enough, this visit to the emergency department is his third in less than a year.
It also falls on his birthday.
But despite yet another accident and trip to emergency, Mr Robertson and his wife Raelene Draper are still able to have a laugh.
“I had a CAT scan to see if everything was alright up there, but I told the doctors I wasn’t sure there was anything there to scan,” Mr Robertson chuckled.
His wife chimes in: “When the results came back all good I questioned if the brain is what they found”.
“You’ve got to have a laugh,” Ms Draper said.
“If you don’t have a laugh in these places you’re just going to sit there and mope.”
Mr Robertson was discharged later that evening.
Over in the fast track ward, the Leader meets Ester Feldman.
Fast track services are designed for patients seeking primary care services for less serious illnesses and injuries.
Ms Feldman had never been to a hospital before — other than to give birth.
But tonight is her seventh visit to a hospital in three weeks.
She says she has been in hospital all day, her body probed with all sorts of medical equipment and she has lost count of the scans and tests she’s had.
But Ms Feldman still has energy left to tell me her story.
“Three weeks ago the whole family and I went to Mt Buller — they were all having ski lessons, every single one of them and I thought I’m far too old to have a lesson, I don’t want to break anything or sprain an ankle.”
But while walking around the village she went for a “slip and a half”.
“Both legs up both arms down and then I hit the ground — it was as if my arm was axed in half,” she said.
She had snapped her humerus bone (elbow).
But while undergoing treatment and surgery for that injury, something else much more sinister was happening inside her.
“Last night I couldn’t sleep, my arm was swelling and I noticed it was quite irregular so I came in and had an ultrasound and they noticed I had a clot,” Ms Feldman said.
“I don’t know what’s next, I will eventually be admitted, but I think I need to have more scans first.”
During our chat I notice Ms Feldman hasn’t stopped smiling once.
She is still in good spirits despite everything that has happened to her.
Next, we find Shannon Blines in the resuscitation wing.
His partner, Brodie Kendall, is huddled next to him.
Mr Blines has had a long history with cardiac problems, so as soon as he started experiencing tightness in his chest earlier that day, the couple jumped in their car and drove two and a half hours from their home to The Alfred.
“They’re looking at doing a heart transplant so I could be admitted tonight or tomorrow,” Mr Blines said.
The feeling is glum, but the concern Ms Kendall has for her partner is beautiful to see.
She places one hand on his chest and murmurs softly to him as I depart.
For seven years clinical nurse specialist Stephanie Riley has driven from Clyde North to treat patients such as Mr Blines.
“We get a lot of acutely unwell patients and seeing them improve keeps me coming back,” she said.
But, she warned, it wasn’t always positive.
“We see a lot of sad stuff, and a lot of people who die at a young age,” Ms Riley said.
“It is personally difficult for me not to take this job home.
“We’re really supportive here, especially when something bad has happened, but often we don’t have time to have a formal debrief — we will talk to one another, have a little cry and get ourselves together for the next horrible thing that is about to roll through the door.”
Ms Riley said she especially struggles while treating younger men because they remind her of her brothers.
“I find (treating them) really hard because they are often around my brothers’ age and they will do stupid things that my brothers do,” she said.
“It’s not because they are idiots, it’s because it’s just in their nature.”
Staff at the Alfred’s emergency and trauma department see about 185 patients on an average day.
And with this number set to climb the unit recently had a multimillion-dollar refurbishment to cope with increasing demand.
The old department was built for about 44,000 patient presentations, including 52 treatment spaces.
But 66,000 crammed through the centre’s doors last year.
Now the refurbished unit has 71 patient treatment bays.
Director of The Alfred emergency and trauma centre associate professor De Villiers Smit said creating an “order of chaos” was crucial to a successfully-functioning emergency department.
“It’s a really busy environment, anything can come through the door,” he said.
“The sickest of the sick come to The Alfred Hospital and about two thirds of all adult trauma patients in Victoria.”
Associate Professor Smit said the pressure was always high, but had complete confidence the team of doctors, nurses, pharmacists, allied health and security personnel were up for the challenge.
“Everyone has to know their place,” he said.
“We make a lifesaving decision every two seconds, so if you don’t get it right here then more often than not there isn’t a chance to fix it up later.”
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