Welcome to the Emergency Department

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Welcome to Milton Keynes Hospital Emergency Department (ED). Our aim is to provide safe, effective, patient-focused care. Our busy department provides 24-hour care to an average of 240 patients every day. We recognise that attending the ED can be a stressful time, so we hope it will be helpful to understand how the department works. This leaflet aims to provide information explaining your journey through the ED from arrival to discharge.

Do you need the Emergency Department?
The role of the ED is to treat patients who have serious medical conditions, life-threatening illnesses/injuries and limb-threatening problems. If you condition is not an emergency, staff will advise you of the most appropriate or suitable services for your needs. Other services are listed below.

• Patients should first contact their GP surgery at all times when they require a doctor.
• If you need advice or are not sure which NHS service you need, you can call 111.
• Milton Keynes Urgent Care Centre is open 24 hours a day, 365 days a year and no appointment is required. Main services include:

– coughs, colds and flu-like symptoms
– minor cuts and wounds – dressings and care
– muscle and joint injuries – strains and sprains
– skin complaints such as rashes, sunburn and head lice
– stomach ache, indigestion, constipation, vomiting and diarrhoea
– treatment of minor infections

• You may be advised on how you can look after yourself at home and/or be advised to visit a pharmacy.

What happens when I arrive at the ED?
1. Booking in: unless you come in by ambulance your first contact will be the ED receptionists. They will take some details necessary to your care (e.g. address, GP, next of kin etc.) and create an ED patient record. Arrival by ambulance does not always mean you will receive immediate attention.
2. Triage: Most patients attending the ED are assessed by a nurse. This is known as triage. The assessment may include checks such as blood pressure, pulse, ECG, X-rays, etc. Doing these tests early means that the results are available to the doctor or nurse practitioner when it’s your turn to be seen.

The purpose of the triage system is to ensure that patients are seen according to their need, not their time of arrival. We operate a streaming system where our ED is divided into ‘Majors’ and ‘Minors’. Major deals with serious and life-threatening conditions while ‘Minors’ deals with non-life-threatening conditions. The triage nurse will decide which area you will be seen by. Painkillers can be made available by the nurse at triage.

Once you have been triaged, you will wait to see an ED doctor, a specialty doctor or an Emergency Nurse Practitioner (ENP). ENPs are nurses who have specialist training and are able to see and treat patients independently. If you are the victim of an assault, you may be asked extra questions. This information will be anonymous so your name will not be given out. We use this information to work with the community, including the Police, to try and reduce alcohol-related assaults.

How long will I have to wait?
We aim to ensure that all patients are seen as soon as possible, but it is very difficult to predict how long you will have to wait. The triage system ensures that patients requiring immediate attention are seen before other patients, whose problem may be distressing, but who are safe to wait for treatment. Waiting times vary and depend on the number of patients waiting, as well as the severity of their conditions. The triage nurse will inform you of approximate waiting times. This information can also be found on the board in the waiting room.

The waiting time may increase suddenly when seriously ill or injured patients arrive or when patients’ conditions worsen which will require immediate attention. We will try to keep you updated of such changes in waiting times. At times, it may appear quiet in the waiting room, but this does not reflect activity within the department. Many unwell patients arrive by ambulance at the side entrance. For patients who are waiting to see a specialty doctor (e.g. orthopaedics, general medicine), the waiting time is different and the triage nurse will inform you of this.

What happens next?
You will be called through to either Majors or Minors. Here, you will be assessed and, if necessary, given treatment based on your condition. After seeing the ED doctor or ENP, you will either be discharged or referred to a specialty team for further assessment. For some patients, it may seem that you have waited a long time and only see the doctor or ENP briefly. This does not mean you are unimportant but that many conditions or injuries are easily assessed and relatively simple to treat.

Admission to Hospital
If it is necessary to admit you to the hospital for further treatment, this could be to a ward or to the Observation Unit in the ED. Staff will explain what will happen and will be happy to provide further information. Unfortunately at times, there may be a delay before your bed is available. We will try to keep you informed.

Going home
When you are discharged from the ED you may be prescribed medications. The nurse treating you will give you advice and you may also be given information leaflets regarding your condition which will help you look after yourself at home. Your GP will be sent a letter with details of your visit to the ED. Information regarding your visit may also be sent to your health visitor, district nurse, social services or school nurse.

Review Clinics
It may be necessary for you to come back to a follow-up clinic. This will be arranged by the ED receptionists before you leave the department. Please be punctual and remember to cancel your appointment if you can’t attend. Refer to your appointment letter for cancellation details.

How do I get home?
Patients are expected to arrange their own transport home. Please speak to a nurse regarding any difficulties. The hospital is well-served by public transport and bus timetables are available at ED reception. There is also a Freephone taxi facility in the waiting room for your convenience.

Children’s ED
During the day, we have a separate Children’s ED with its own entrance. There is a pleasant waiting area with toys and books where children can play while waiting. Parents/carers must supervise children at all times.

For your comfort
Your comfort is our concern. Please do not eat or drink before being seen by the Triage nurse. Refreshments are available from the vending machines in the waiting room, the Friends’ shop, the Eaglestone Restaurant and also from catering outlets in the main entrance. ED staff can direct you to these. Toilets are located in the waiting room. Please inform staff if you find them in an unacceptable condition. Baby-changing facilities are available. Please ask one of our staff if you require an area for breastfeeding.

We ask information about you so that you can receive proper care and treatment. This information remains confidential and is stored securely by the Trust in accordance with the provisions of the Data Protection Act 1998.

Your views on our services
Your views are important to us. If you do have any concerns, compliments or complaints, the nurse in charge will be happy to discuss these with you. You can also express your views in other ways:
• Complete a Friends and Family questionnaire. Collect from the Emergency Department reception desk.
• Complaints and Patient Advice Liaison Service (PALS) team. Telephone 01908 995954, email: [email protected] or text 07773 577923.

Please note, any physical or verbal abuse towards our staff will not be tolerated.