Senior medical official says hospital can do more to manage ER

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In the wake of public criticism over long waiting periods at the Casualty Department/Emergency Room at the Mount St. John’s Medical Centre (MSJMC), Dr. James Knight has said more can be done to better manage/triage those who go to the state-owned facility for care.

Knight, who has on numerous occasions filled in as Antigua and Barbuda’s Chief Medical Officer, said medical staff can take a minute or two to interact with those who are waiting for medical attention to find out their needs, let them know there are alternative places offering care for non-emergencies, and even to ask them for their patience while serious emergency cases are being dealt with.

Yesterday, speaking with OBSERVER media, he said one of the instances where this was needed was the recent situation in which a young man, Terry Viville, went to the hospital after being beaten on the head with a baseball bat during a robbery.

Dr. Knight said it could have been handled better and the patient should have been assessed, told that his injury isn’t life threatening – if that were the case – and be reassured of the services he would get.

On Saturday February 9, the 19-year-old Belmont youth went to MSJMC

for medical care on the advice of the police after the mugging, which left his head badly swollen and in a lot of pain.

He waited from 11 a.m. until after 7 p.m. without receiving any care. Fatigued and unable to bear the pain and discomfort he was in all the time, Viville left, but continued using pain medication he had acquired on his own.

He was however forced to return to Mount St. John’s on Monday February 11 when the head pain and swelling worsened – with the additional troubling symptom of blurred vision. Viville again waited more than five hours without being attended to and, as before, decided to leave.

He explained that although he was not getting the required medical attention at Mount St. John’s, he was left with no other choice as he could not afford a private doctor’s visit.

He only got care the Wednesday when police escorted him to the hospital where it was determined his head injury was not life threatening and he was placed on medication to manage the pain, swelling and blurred vision.

Dr. Knight – no longer in the government’s medical service, having retired – also spoke about the matter on Saturday during an appearance on Pointe FM alongside Prime Minister Gaston Browne.

He described it as an “unfortunate” case.

There, he said, “The triaging is not always efficient, and sometimes people wait longer than they should and all that. But it is much better now than it was a year or two ago; there is constant improvement.

“I have had bad experiences there in terms of waiting and it was a question of the triaging.”

Meanwhile, yesterday, Dr. Kinight told OBSERVER that out of the 20-plus community clinics in Antigua, five of them are opened all day and they offer quality care and services.

These are the clinics in Grays Farm, All Saints, Johnson’s Point, Browne’s Avenue and Clare Hall.

Residents are being encouraged to use the clinics within their communities as the MSJMC continues to struggle with numerous non-emergency cases that could be dealt with at the community level.

He said the “heavy use of emergency rooms for routine medical services is nothing unique to this time or to Antigua” but it should not be encouraged.

“We have five clinics in the communities in Antigua with a doctor there daily, then you have a district doctor who spends a day in each particularly clinic; in all of the 25 or so clinics where the chronic care patients go, especially the elderly, for their treatment,” he said.

Every since the incident with Viville, the Cabinet has said more staff would be hired to further improve operations at MSJMC.

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