The Straits Times
Published on Jan 25, 2013

Train nurses to ease A&E load


SECONDARY monetary considerations aside, the crux in relieving the crush at accident and emergency (A&E) departments lies in medical staff manpower issues and public education on what constitutes a necessary visit to such facilities ("Why lower A&E fees for referred patients won't work" by Dr Oh Jen Jen; Wednesday).

Contrary to what Dr Oh opines, all general practitioners know the signs and symptoms of life-threatening conditions that warrant an immediate visit to the A&E department.

These mainly include sudden, severe chest pains or breathlessness; choking or difficulty in breathing; loss of consciousness; head injuries with bleeding, drowsiness or vomiting; drug overdose or poisoning; traffic or worksite accidents; broken bones or dislocation; sudden abdominal pains that do not subside; and deep cuts with uncontrollable bleeding.

To allay the fears of Ms Ada Chan Siew Foen ("Visiting GPs first may mean loss of precious time"; Wednesday), there is little need to rush to the A&E department for seemingly troubling but trifling conditions like mild fever; coughs and colds; small cuts or bruises; superficial burns or scalding; localised rashes or insect bites; minor nosebleeds; chronic aches and pains; and mild diarrhoea and vomiting.

In the Singaporean context where the more public medical institutions are established, the more people avail themselves to them, manpower issues will never be satisfactorily resolved.

A&E departments are swamped by a majority of patients with non-life-threatening conditions despite public education efforts.

To alleviate this situation, many countries have adopted a system whereby very experienced and specially trained nurses do triage and manage these patients, so that the truly urgent cases are attended to expeditiously.

Yik Keng Yeong (Dr)