Department of Emergency Medicine: University Hospital Limerick

 

About Us

The Emergency Department, University Hospital Limerick provides emergency care for adult and paediatric patients with a core focus in the diagnosis, treatment and management of acute and urgent injuries and illnesses.

The Emergency Department is open 24 hours a day, 365 days a year and provides service to in excess of 60,000 patients a year, in the catchment areas of Clare, North Tipperary, and Limerick. It is staffed by doctors and nurses who have specialized training in Emergency Medicine and is supported by multi-disciplinary teams, allied health professionals, porters and clerical staff. Approximately 20-25 % of emergency department attendances are admitted to inpatient beds.

The Emergency Department is the major referral centre for the Mid-West Region and access protocols are in place ensuring patients with acute medical/surgical problems, cardiac emergencies, stroke, multiple traumas, paediatrics and specific orthopaedic injuries are brought by the ambulance service directly to the department.

Patients may present to emergency department via ambulance of self present. They may be referred from their GP or from another hospital/LIU.  On arrival all patients are required to register in order to generate an attendance and a medical record. Patients are then assessed by the triage nurse and assigned a priority rating. This determines the urgency in which they will be seen.

While priority is given to patients with life threatening illnesses or injuries, emergency department staff endeavor to see all patients in a timely manner.

The Emergency Department also acts as a referral source for the SAU and the AMAU, rapid access clinics and also community based services such as the CIT and COPD outreach services. It provides a large number of services that complement the core work of the department, providing access to social work, physiotherapy, and radiography.

An integral part of the ED is REDSPOT (Retrieval, Emergency and Disaster Medicine Research and Development). Set up by Dr. Fergal Cummins in 2010 and subsequently taken over by Dr. Damien Ryan, this group is tasked to establish a robust research infrastructure promoting multidisciplinary engagement with a collective commitment to improving patient outcomes.

Contact Details:

Emergency Department General Enquiries
Phone: 061-482120 or 061-482011
Fax: 061-482493

Emergency Clinical Decision Unit
Phone: 061-482394

Contact Details: Emergency Department
Title Name Phone Email
Business Manager Jim Gallagher 061482095 Email
Directorate Nurse Manager Medicine Mary O’Brien 061482113 Email
Clinical Nurse Manager 111 Joe Cassidy 061485218 Email
Advanced Nurse Practitioner (Emergency) Evan Wallace 061485275 Email
Advanced Nurse Practitioner (Emergency) Mary Ann O’Grady 061485275 Email
Clinical Research Nurse Sarah Watkins 061482567 Email
Clinical Facilitator Ann Scanlon 061482567 Email
Administration Staff Officer Marina Rankin 061482338 Email

 

Contact Details: Emergency Department Consultants
Title Name Phone Email
Dr. Gareth Quin Consultant in Emergency Medicine 061482775 Email
Dr. Damien Ryan Consultant in Emergency Medicine 061482775 Email
Dr. Cormac Mehigan Consultant in Emergency Medicine 061482775 Email
Dr. Catriona Mularkey Consultant in Emergency Medicine 061482775 Email
Dr. Anthony O’Carroll A/Consultant in Emergency Medicine 061482775 Email

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Attending the Emergency Department

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Registering

All patients attending the emergency department are required to register in order to generate an attendance and a medical record. Essential details such as Name, DOB, Address, NOK and GP’s name are required. This information will also help in expediting the retrieval of previous medical records. Once registered the patient will await review by a triage nurse.

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Triage

Triage is a systematic process of prioritising patients ensuring the most urgent life threatening illnesses/injuries are seen first.

The emergency department, University Hospital Limerick uses an internationally researched and validated tool for triage called the Manchester Triage System and all triage nurses have received specific training in its use.

All patients presenting to the emergency department are assessed by a triage nurse and a triage category assigned.

Triage categories range from 1-5 and are dependent on the nature and severity of the presenting illness/injury.

Triage 1 red immediate reviewTriage 1 red immediate review
Triage 2 orange target time 10 minutes Triage 2 orange target time 10 minutes
Triage 3 yellow target time 1 hour Triage 3 yellow target time 1 hour
Triage 4 green target time 2 hours Triage 4 green target time 2 hours
Triage 5 blue target time 4 hours Triage 5 blue target time 4 hours

Once assigned a triage category, patients are streamed into the area within the department most appropriate to their presentation and triage category. Triage categories 1 and 2 will be transferred to appropriate areas immediately, Categories 3-5 will be directed to the waiting room if assessment areas are not available.Please note patients are seen according to triage category and not on time of arrival

On occasion the emergency department may become overwhelmed due to severity of illnesses/injuries /large volumes of patients As a result target times for review are extended and often prolonged. Please note during these occasions all emergency department staff are working hard to reduce waiting times as efficiently and quickly as possible.

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The operational sections of the Emergency Department are

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Walking Area

This area sees and treats patients with stable illnesses and minor injuries. It is very busy with a high turnover of patients and all patients streamed to this area are mobile and should only require a trolley for treatment purposes and for short periods of time only. It is staffed by advanced nurse practitioners, doctors and nurses. As with the major’s area, nursing staff often review patients and perform certain tests prior to review by emergency doctors.

Treatments offered in this area include

  • Injury assessment
  • Wound care
  • Plaster/Splint application

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Majors Area

The Majors Area is for stable patients with major illnesses and injuries who require a trolley. This area is predominantly very busy, and caters for patients with a wide range of medical and surgical problems such as chest pain, shortness of breath, headache and abdominal pain. Many will require further investigation and possible admission.

In order to expedite patient flow through the department patients may have certain tests performed by nurses such as blood tests, x-rays and electrocardiographs prior to review by an emergency doctor. Following review patients may be referred to specialty teams for admission and further treatment or to the Medical or Surgical Assessment Unit, or may be discharged following treatment to their general practitioner.

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Stepdown Area

This is a 4 bay assessment area for category 2 patients and for patients requiring close observation and monitoring.

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Resus Area

The resus area has 3 assessment bays- 2 Adults and 1 dual purpose (adult and paediatric).Patients with life threatening illnesses or injuries are assessed, stabilized and treated in accordance with best evidence practice.

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Paediatrics

There is a new dedicated Paediatric Treatment Area for the treatment of children (under 14 years). At present this area has 3 assessment bays and will see all paediatric patients (triage category 2 or greater) for assessment, treatment and management of their injury/illness. It will also facilitate reviews by specialist teams and where necessary, organization of admissions to paediatric wards. It has its own waiting area and with a small play area and television.

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Clinical Decision Unit

The Clinical Decision Unit (CDU) is an 8 bedded short stay facility in the E.D. where patients requiring investigations and treatment for specific conditions are managed by the emergency medicine team. The target length of stay is < 24 hrs.

Specific care pathways have been developed and include

  • Asthma
  • Anaphylaxis
  • Back Pain
  • Cellulitis
  • Chest pain-low risk
  • Deliberate self harm
  • Head Injury
  • Overdose and Poisoning
  • Pain relief
  • Renal Colic
  • Seizure
  • Simple Pneumothorax
  • Social Intervention
  • Soft tissue Injury
  • Stable upper GI bleed
  • Tonsillitis

 

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Patients Under 16 Years of Age

Please note that patients under the age of 16 years must be accompanied by a parent or guardian as consent for treatment is required.

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Visiting the Emergency Department

A visiting policy of one visitor per patient is currently in place at University Hospital Limerick and includes visiting patients in the Emergency Department.

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Clinical Support Services

  • Physiotherapy
  • Social  Work
  • Diagnostics