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Culprit Cancer



Joined: 06 Feb 2003
Location: Port Melbourne

PostPosted: Wed Nov 23, 2016 5:21 am
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^^Many people attend emergency wards with problems that can be addressed at their local doctor. With the Federal Government keen to remove bulk billing to save $$ emergency departments will be busier. Throw in people with mental issues are dumped into emergency wards as there are no longer facilities for these patients. Unless you have sat in a public hospital emergency ward on any given night you are oblivious to these situations.
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think positive Libra

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Joined: 30 Jun 2005
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PostPosted: Wed Nov 23, 2016 7:51 am
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John Wren wrote:
just read about hope and the other young chap who passed away. terribly sad situation but, without fully understanding the challenges and circumstances faced by the ambulance services, it is difficult to condemn them so early in the piece or even at all.

no doubt the opposition will be baying for blood and the families of the deceased will be anguishing no end and wanting answers. lessons need to be learned but there needs to be a measured enquiry into the handling of things.

here's the numbers affected:

By the numbers

Two people died, including 20-year-old Hope Carnevali

At least 30 people in intensive care

1900 calls to Ambulance Victoria in five hours

Royal Children's Hospital: 500 children taken to emergency, normally 300 in a day

Royal Melbourne Hospital's Emergency Department: a record number of 335 patients in 24 hours, more than 215 people with thunderstorm asthma.

Northern Hospital: 383 patients, normally 170.

Western Health: at 1am Tuesday morning, 230 patients across the two emergency departments of Footscray and Sunshine Hospital.

St Vincent's: 216 in 24 hours to 2am. Normal day is 120.

Monash: 512 emergency patients overnight across its three emergency departments, compared with an average of 250.

Austin Health: 197 patients overnight, compared to an average of about 50. About 75 per cent had respiratory problems.

The Alfred Emergency Department: 110 more patients than an average Tuesday night

Sandringham Hospital Emergency Department: 90 more patients over an average Tuesday night

Frankston Hospital: 260 patients in 24 hours, normally 200.

University Hospital Geelong: 108 people arrived at the Emergency Department between 6pm and midnight., normally 200 people in a day.

Eastern Health: On Monday, 147 people arrived at Angliss Hospital's emergency department, 211 people arrived at Maroondah Hospital's emergency department.

Box Hill: On Monday, 230 patients presented to Box Hill Hospital's emergency department.

what i find is striking are the numbers seeking medical attention on any given night. i guess it's a numbers game.


Yeah I read the family is upset about the time the ambulance took, but it just happened, they probably, hopefully, just need to lash out. It was a very different situation, and living through it for that brief moment, when the weather hit, it really was just BAM. I was just glad it happened after both my kids were home safe and off the roads. I just can't imagine, (I knew hubby was still in his workshop) with all the trees and fences flying around. Very lucky no one was killed by flying crap. Emergency workers were going out to calls in their own cars when the ambulances ran out, that's nobody's fault.

Nicole's mum was really crook apparently, something about a silent chest which is only good if you don't have asthma. She took her to the doc but two hour wait so she went to Willi hospital, and she screamed up to the door, someone came out to help and the doc saw her inthree min flat. That's the way emergency should work, but it's hard sifting through who's urgent.

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watt price tully Scorpio



Joined: 15 May 2007


PostPosted: Wed Nov 23, 2016 10:07 am
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One thing I don't think people quite understand is just how busy Emergency Departments are, indeed just how f*cking busy ED's are generally speaking. The acuity has increased a hell of a lot of the year that is, more sick people coming to the ED more often. Where I work it's almost always busy so to get more than a 55% increase in presentations 2 days ago is incredible and staggering. The ED I work in is a major trauma hospital & I have a lot of admiration for my colleagues for medical issues.

I think it's quite astonishing in many respects that only 2 people died in the circumstances. This was a "perfect (thunder)storm of unexpected & unplanned medical emergencies arising at the same time.

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stui magpie Gemini

Prepare for the worst, hope for the best.


Joined: 03 May 2005
Location: In flagrante delicto

PostPosted: Wed Nov 23, 2016 6:22 pm
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^

Yep. The numbers presenting at ED's have increased in general and it's not all minor shit that should go to a GP. That's always a component but while the number of presentations has increased, so has the number needing admission which causes access issues.

I reckon the system coped bloody well considering.

Normally you either get some notice (like in a pandemic) or the impact is localised to a geographic area (natural disaster, significant incident) and the system allows for preparation or overflow.

In this case there was no notice, no warning (and not even anything that could be reasonably anticipated) and the geographic spread hit everywhere at once. It was a fluke event.

The thing that hasn't been mentioned is that this fluke event is likely to bugger access across the whole system for days (by access I mean getting a patient from the ED into a bed if they require admission) as this temporary overload means that once normal business resumed at the shop front (ED), the back of house is clogged and unable to take the normal volume until those people all get discharged.

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Morrigu Capricorn



Joined: 11 Aug 2001


PostPosted: Wed Nov 23, 2016 8:15 pm
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^ Correct!

And with so many needing crit care beds especially ICU/HDU for respiratory support including NIV and mechanical ventilation it means that elective surgery where the patient is pegged for ICU post op have their surgery cancelled.

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stui magpie Gemini

Prepare for the worst, hope for the best.


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PostPosted: Fri Nov 25, 2016 5:55 pm
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Question, why don't people prone to asthma carry a ventolin inhaler for emergency?

Too expensive ? Expire to quickly?

I'm allergic to bees. I don't carry an epipen because they cost too much and I did an immunity course decades ago so I have time if I get bitten. If I do get bitten anywhere I just need to keep an eye on my throat in the mirror. If I see red lines like claw scratches starting to work their way up, get thee to a doctor. If that doesn't happen within an hour or so, all good.

But ventolin isn't as expensive as epi pens, is it?

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HAL 

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PostPosted: Fri Nov 25, 2016 5:59 pm
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Too what?
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watt price tully Scorpio



Joined: 15 May 2007


PostPosted: Fri Nov 25, 2016 6:02 pm
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stui magpie wrote:
Question, why don't people prone to asthma carry a ventolin inhaler for emergency?

Too expensive ? Expire to quickly?

I'm allergic to bees. I don't carry an epipen because they cost too much and I did an immunity course decades ago so I have time if I get bitten. If I do get bitten anywhere I just need to keep an eye on my throat in the mirror. If I see red lines like claw scratches starting to work their way up, get thee to a doctor. If that doesn't happen within an hour or so, all good.

But ventolin isn't as expensive as epi pens, is it?


Some times ventolin doesn't work as was the case with quite a few in the recent storm.
Sometimes people who have never had asthma before became asthmatic as it were, as was the case in this episode
Sometimes it can be one hasn't had an episode for quite some time so people don't feel the need to carry it
etc.

I bought a ventolin a few months ago when I had man-cold, sorry mad-flu, sorry man-bola & I had trouble clearing the airways & I'm not an asthmatic

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Morrigu Capricorn



Joined: 11 Aug 2001


PostPosted: Fri Nov 25, 2016 7:04 pm
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stui magpie wrote:
Question, why don't people prone to asthma carry a ventolin inhaler for emergency?

Too expensive ? Expire to quickly?

I'm allergic to bees. I don't carry an epipen because they cost too much and I did an immunity course decades ago so I have time if I get bitten. If I do get bitten anywhere I just need to keep an eye on my throat in the mirror. If I see red lines like claw scratches starting to work their way up, get thee to a doctor. If that doesn't happen within an hour or so, all good.

But ventolin isn't as expensive as epi pens, is it?


Its not that expensive and most do but in an acute attack the inhaler often doesn't do the trick they need to have the salbutamol via a nebuliser and usually steriods and for kids they need a spacer (although most would have one).

Such an acute trigger would have resulted in compromised airways very quickly rendering an inhaler in many circumstances of little value.

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stui magpie Gemini

Prepare for the worst, hope for the best.


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PostPosted: Fri Nov 25, 2016 7:09 pm
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Yet the chemist shops had a run on people buying ventolin, many more than presented at ED's so it obviously helped a large number of the effected, if not all.
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Morrigu Capricorn



Joined: 11 Aug 2001


PostPosted: Fri Nov 25, 2016 7:42 pm
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^ True but an awful lot of the people who went to chemists were not asthmatic per se or were people who had in their earlier years suffered asthma or asthmatic like respiratory disorders that had resolved.

Interestingly there were a few presentations who went and got ventolin ? Dr Google - who then presented with palpitations and headaches ( and O\E many had very high B\Ps) - maybe overdose related - still can't breathe take more.

I recall stats I saw not that long ago that showed around 8-9 deaths a week from asthma - can go pear shaped real quick.

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John Wren Virgo

"Look after the game. It means so much to so many."


Joined: 15 Jul 2007


PostPosted: Fri Nov 25, 2016 10:05 pm
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i only learnt that ventolins don't require a prescription anymore. i haven't used one in over ten years but have often thought it'd be helpful to have one as a standby. don't know if a ventolin would have significantly fixed things for me the other night.

8,500 were reportedly counted as being treated at the hospitals.

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stui magpie Gemini

Prepare for the worst, hope for the best.


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PostPosted: Sun Nov 27, 2016 5:37 pm
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Death toll up to 6 now.
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watt price tully Scorpio



Joined: 15 May 2007


PostPosted: Sun Nov 27, 2016 7:13 pm
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What it was like in an ED on the day in question from the Director of ED at The Royal Melbourne Hospital:

"...The first thought I had when I arrived at The Royal Melbourne Hospital emergency department on Monday night was that I could be in a war zone..."

http://www.theage.com.au/victoria/thunderstorm-asthma-it-was-like-a-war-zone-emergency-doctor-says-20161126-gsy442.html

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John Wren Virgo

"Look after the game. It means so much to so many."


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PostPosted: Wed Jan 04, 2017 4:13 pm
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got invited by the alfred to do some follow up testing and a consultation. they tested my lung capacity and did a skin allergy test. they also provided me with an action plan and will be monitoring my health over the next 12 months. i consented to being a volunteer subject to support any research needs they may have in trying to better understand thunderstorm asthma.
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