ED Muskoka Physicians - Living the Dream

Hypertension in the Emergency Department

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suture/instruments

Hi all,

Friendly reminder… don’t throw out equipment that can be cleaned !! ( reusable suture kits, fine instrument trays, etc)

We are loosing instruments left, right and centre!!! Some for sure to the garbage!!

Also – based on the plastics session yesterday – I have asked for 3, 4,5 vicryl rapide in both sites all the time and more derma bond if you plan to use as a dressing!!

I will put my plastics protocol book in SMMH ER tonight as a reference book for anyone to use! Perhaps one of the other docs want to put theirs in HDMH ER?

NEW ED MD

Dr Tony Duarte is planning to join the HDMH group on the regular schedule ( to do 8-10 nights per month primarily) starting July 2020! He’s moving too Ontario! Tony is an experienced ER MD making the move from North Carolina.

Tony is happy to help in SMMH as able too! Is been years since he worked there but he is happy to help .

Plastics at MAHC

Dr Steve McCabe has had two clinics so far at MAHC – Huntsville Site -and next one is feb 14th. He hopes to soon be offering clinics q 2 weeks . As you know his speciality is hands. You can find out his next clinic by calling Switchboard at HDMH.

He is happy to have you text him or call his cell if you need advice about a plastics case involving the hand and /or next clinic/appropriate/question about what to do?/ or not?/etc…to help support us at MAHC and patients at MAHC.cell – 647-205-2243

Cell only for MD use and not for distribution! And I wouldn’t call or text maybe in the middle of the night!!

Dr Tony Yang (gen survey at HDMH) is also happy to help problem solve hand cases and support Dr McCabe presently – reachable by our contact list in ER or through switchboard.

Thanks Tony and Thanks Steve!!

Unattached patients in AFHT catchment

UPDATE: Patients with no primary care that want to be on the AFHT patient wait list need to sign up at algonquinfht.ca website -or if they have no internet they call 705-789-5966 who is the Wellness Hub at Summit Center and get on the list.

Only patients in catchment area or Huntsville, Port Sydney, Utterson, Dwight, Dorset, Baysville, Novar.

They are not accepting patients north of Novar as those patients should contact Burlks Falls or north.

We have no such model for geography south at present but I am gonna reach out to the Cottage Country FHT at ask again if they have a wait list.

masks

Just a thought I would suggest everyone consider – perhaps put your model of N95 on a sticker on your ID. Thats what I have done to remember as I get confused. Testing every two years is what is suggested to ensure no leaks with your style/model on your face!

Wuhan coronavirus

Infection control will be putting a memo out asap about the corona virus since it has now hit North America as we heard today all over the news. Please read it carefully when it comes out. We need not panic.

Officially the recommendation from WHO and the OHA is that droplet precautions should be taken. Our corporation in line with many other ontario hospitals ( I’m told) is gonna recommend airborne precautions at present.

Screening signage and triage awareness about travel to China (or contact with anyone who has traveled to China) is coming/started/starting.

In discussing at ED committee today we suggested to Infection control to seize this moment to perhaps review with staff PPE donning/use which I’m told will be coming. Using an N95 , eye protection , and gown/ gloves should be reviewed. Education links to come and in hospital huddles/support I’m told.

Tons of info about the virus if you google “Wuhan coronavirus and World Health Organization ” Under fifty deaths worldwide reported so still better odds of dying from things like the flu and driving to work. Not trying to minimize this but just a little perspective.

Expect updates as they come available by infection control and I will feed you anything that comes from the LHIN/other useful sources.

IM coverage

A memo will be coming out shortly outlinging the imminent holes in IM coverage.

Not just SMMH but both sites!!!

The hospital needs to share this information direct with providers before I can discuss dates with anyone.

The process to look for help when you need an internist for a patient ( to transfer, consult , or outpatient consult) that has been used at SMMH in the gaps before will be the same that is applied to HDMH gaps.

Lots of work has gone into trying to get coverage ( including more money offered) but the coordination of this work now falls under the new IM chief role of DR Salem. Since he started this role the short term and long viability IM coverage has been discussed at length. MAC again discussed it too this week at the MAC meeting.

I have been very clear that no internal medicine on call at either site is not an option in our current ER and inpatient models. I have been very open about the patient, provider , and corporation risks I think these gaps pose.

I also have vocalized how difficult this makes our ER work. How stressful it makes our ER work . How these holes are leading to physical burnout. And how we will be loosing ER providers should the this current model of IM coverage ( with holes in coverage) continues.

I have become a broken record with our COS, CEO, president of our medical staff, and chief of IM expressing these concerns.

Just thought I would let you know that advocacy has taken place repeatedly and while the hospital , IM Chief, and COS are each accountable to this problem no solution is yet forthwith. Happy to talk about with anyone one on one or at next group meetings.

Hand referrals

Just recirculating the memo about Dr McCabe who may be one option for some hand referrals. He has had two clinics here at MAHC so far. He is working out of huntsville hospital so far. His office will call the patient within two weeks to confirm appoitment. Switchboard/ER clerk should be aware of when his next clinic is at MAHC too.

Radiology

Please be sure to use the online schedule for identifying and contacting the appropriate radiologist if/when you need to contact them. It is available when you click on explorer and the MAHC homepage ( intranet page) pops up. It is on the right lower side.

When you hover over the initials of the radiologist you want to call you get their contact numbers pop up.

The schedule just changed this weekend and this is always the most up to date one to use!

THANKS