Trolley chaos could cost 400 lives yearly, claims consultant

TROLLEY chaos could be costing up to 400 lives each year because patients are not receiving appropriate care amid the bedlam, a consultant in emergency medicine has warned.

Dr Chris Luke, who works out of two Cork city hospitals, said patients “are becoming ill quietly”, but that a deterioration in their condition may go unnoticed in the “congestion and chaos” of an emergency department (EDs).

He said colleagues in Galway had undertaken a study which found there were 20 avoidable deaths over the course of a year, and that on a national level, this could equate to 400 avoidable deaths annually.

“Chaos is really bad for care,” Dr Luke said, adding the trolley problem was “no better than it ever was”.

Speaking at the AGM of the Irish Medical Organisation (IMO) in Killarney over the weekend, Dr Luke said staff working in EDs were partly to blame for the national trolley crisis.

“Most of the people on trolleys every day are not particularly ill and it drives me mad. You have young healthy boys playing Nintendo, or patients who are waiting for an MRI scan who have to be admitted because the VHI insists they be admitted. Much of the trolley problem is created by staff, much as I hate to say it,” Dr Luke said.

Overcrowding in EDs also led to increased risk of infection. “If you look at SARS, that began in an overcrowded ED in Toronto,” Dr Luke said.

He said if consultant colleagues working on the wards agreed to take one patient extra “and dispense with the ludicrous health and safety arguments raised in some quarters”, it would help solve the trolley problem.

Dr Hugh Bredin, retired consultant urologist, said he did not support placing patients on trolleys in wards, that it had been the practice during his early days of medicine and the wards were “not created for that”.

Prof John Higgins, consultant obstetrician at Cork University Maternity Hospital, said the problem of trolleys was “systemic” and the only way to get rid of them was to throw them all in “a big yellow skip”.

He said elderly people coming into EDs were now “genuinely afraid of trolleys” instead of feeling that they had reached somewhere “safe and secure”.

“We’re all part of the process to turn that around,” Prof Higgins said.

The debate centred on a motion calling on Health Minister Mary Harney and the Board of the Health Service Executive to acknowledge that 500 patients are being treated on trolleys in EDs “which is inappropriate for a variety of reasons” and calling on them to address the situation urgently.

Dr Luke said he objected to blaming ‘bed blockers’ – elderly people awaiting long-term care beds – for the trolley crisis.

“It’s got nothing really to do with 800 bed blockers, it’s partly the way we do things” Dr Luke said.