- Ophthalmology cover their ward (4A) 08.00 to 20.00 with an ANP covering for the other 12 hours.
- All patients are admitted under a named ophthalmology consultant.
- There is agreement that emergencies are covered by the appropriate specialty if the ANP teams need help, mainly medicine via the MET team.
Raigmore Emergency ophthalmology admission protocol
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- Highland HSCP
- Primary and Secondary Care
- A&E Clinical staff, medical clinical staff, surgical clinical staff, Raigmore ANPs
The admission process needs to first consider the following:
Does the patient have a primary ophthalmology problem with no other acute medical / surgical problems?
- If yes admit to 4A under Ophthalmology 24/7
Does the patient with an ophthalmology problem have an acute surgical or medical problem (even if the ophthalmology problem is the major concern)?
- If yes, the patient should be admitted to the most appropriate medical or surgical admission area
- If a patient deteriorates while under the care of the ophthalmologists, unless this is entirely due to their ophthalmology disease, the patient should be escalated to:
- In hours: Ward 4A Junior Doctor
- OOH: ANP covering surgery
- At any time, if the nursing team are concerned about a deteriorating patient under the care of Ophthalmology, they should contact the medical emergency team (MET) team on 1999.
- If the reviewing ANP/Junior Doctor needs more support a senior MET call should be initiated: MET 1888
- In hours Monday to Friday: Acute Medical Consultant
- OOH: Medical Registrar with Consultant Physician on-call
- 24/7 The Senior MET doctor should review the patient and initiate treatment. If they need to refer to surgery this should happen.
- When the Senior MET is carried by a Medical Registrar their senior support remains the Consultant Physician on call.
- All need to be aware that there is no Consultant Ophthalmologist on-call between 20.00 and 08.00.
Although most Optometrists have closed, emergency eye patients can be seen by the following peripheral community Optometrists:
- Inverness - Deirdre Newcomen/Andy Carr (01463 241341)
- Dingwall – Gavin Wreath/Assara Shaban (01349 869850)
- Golspie – Colin Pettinger/Donald Goskirk (01408 633448)
- Orkney - Graeme Clark (01856 872857)
- Western Isles - Robert Doig/Ian Rough (01851 704200)
- Wick - Ian Morris (01955 609939)
- Fort William - Ian Fleming/Liz McGougan (01397 702973)
- Skye/Kyle - Craig Campbell (01599 530022)
|ANP||advanced nurse practitioner|
|MET||medical emergency team|