Emergency Medicine deals with the diagnosis and treatment of acute illnesses or injuries which require immediate, or urgent medical attention – it is not able to provide care for chronic problems, or to provide second opinions. Emergency Medicine is key in the planning and preparation when dealing with major disasters and incidents.
Emergency Department Information
On your arrival to the Emergency Department (ED) you will first be seen by a streaming nurse who will take a brief history of your complaint and then determine the most appropriate area for you to be seen in. This could be Adult ED or Minor injuries, or if you are bringing a child, the Paediatric ED. Alternatively, if the streaming nurse feels your symptoms can be managed by a GP you will be streamed to the on-site GP Service. Some patients who need hospital investigation but not overnight stay, may be streamed after triage to the Same Day Emergency Care (SDEC) department. Following streaming you will then be asked to book in at one of the next windows by a receptionist.
You may have already been to see your GP who may have referred you to a specific speciality in the hospital such as medical, surgical, orthopaedics, paediatrics, gynaecology or the psychiatric liaison team. On your arrival these specialities will all be alerted that you are here. You may be seen in the ED or in the specialist’s own assessment area.
You may have been in contact with the NHS 111 before attending. In some cases you are given a time to arrive. You will still be seen by a streaming nurse and need to register at reception. The purpose of the arrival time is to help spread ED demand more evenly. You may still need to wait and will be prioritised in order of your clinical need.
Located within the Trust we have an experienced mental health team. If your presentation solely relates to mental health concerns you may be seen directly by this team.
Following registration to any of the ED areas you will be called for triage, which is an initial assessment to commence and prioritise care. Observations may be performed. You will also be offered analgesia if required. If you require initial investigations such as blood tests, urine test or heart tracing (ECG) this may be completed by one of the nursing/technician team.
The purpose of initial assessment (or triage), is to prioritise care. Following initial assessment the nurse may escalate your care into one of the trolley areas of ED as capacity allows. For this reason some patients may be seen out of time order.
Alternatively, following initial assessment (or triage) if all of your observations are in a satisfactory range, you may be asked to take a seat back in the waiting area to be called by the doctor. If at any time your symptoms become worse, please let the receptionist or streaming nurse know.
While you are in the waiting area, there may be other patients that are called before you. This does not mean you have been forgotten or you have missed your turn. Patients are called from multiple queues to different areas of the department. It is likely that you will have had to queue to enter the department and then had to wait to see the relevant team. We will try to
minimise this where possible.
When you are called for triage by a nurse for assessment please tell the nurse if you require any pain relief. The nurse will need to know what medication you have already taken, what your regular medication is and if you are allergic to any medications. To aid our assessment of your pain you will be asked to score your pain from 0 – 10, 0 being no pain at all and 10 being the worst imaginable pain.
Your pain score should be based on your pain on movement at that time. Should you find it difficult to respond to a scoring system, please ask the nurse who can provide alternative methods of scoring pain, such as a visual scale.
Following your assessment by a clinician, you may be required to remain in the hospital for further treatment and/or an inpatient stay.
Bedford Hospital Emergency Department (also known as Accident and Emergency or ‘A&E’)
The Bedford Hospital Emergency Department is is located at the Ampthill Road entrance to the South Wing site. It is open 24 hours a day, 365 days a year and provides a service for adult and paediatric patients who are brought in by ambulance, been referred by their GP or who have self-referred.
The department serves a catchment area with a population of 271000 people from north and mid Bedfordshire and sees in excess of 95 720 patients a year.
The ED is divided into six areas:
For the most seriously ill or severely injured patients (usually arriving by ambulance), highly equipped and allows advanced management of patients
Majors and Ambulatory Majors
For the majority of sick patients and provides a trolley based area for assessment and treatment
For all children under the age of 16 to be seen, assessed and managed.
Clinical Decision Unit
A clinical observation unit which has six reclining chairs.
A five bed 24 hour short stay observation ward situated within the ED. It is run by ED nurses with the majority of patients remaining under the care of an Emergency Medicine consultant. Visiting hours are between 0800-2000. Mealtimes are protected on this ward, visitors may be asked to leave during meal times and during doctors ward rounds. A restriction of 2 visitors per bed is requested and children under 12 should have permission from the ED shift manager in order to visit. It is currently closed in order to provide extra majors capacity during the COVID crisis.
Urgent Treatment Centre
Is based in the Cauldwell Centre, adjacent to the Emergency Department. This service sees patients sent by NHS 111 or those streamed by the Emergency Department between the hours of 1100-2300. It is managed by the Department of Emergency Medicine and staffed by ED doctors, GPs, Advanced Nurse Practitioners, Emergency Nurse Practitioners and Extended Scope Physiotherapists.
When should you use the ED?
If you are injured or seriously ill, you can self-refer (attend yourself or get a friend /family to take you) to the Emergency Department. In an emergency, dial 999 and ask for the ambulance service.
For non-urgent medical assistance: contact your GP, pharmacist or call NHS 111.
What to expect when you attend the ED
- You will be streamed by the streaming nurse as to which area of the Emergency Department you need to be seen in. If you have a GP letter, you may be sent directly to SDEC (on Victoria Ward) and will be registered there.
- You will need to register with the receptionist who will take your personal details and basic information about your illness or injury.
- A brief assessment will be carried out by a doctor or nurse to identify the severity of your condition. You may need tests and/or procedures and may be seen and treated by other health care professionals.
Please note: We see patients according to the urgency of their medical need followed by the order of their time of arrival.
- Many of you will be able to go home after treatment. Some may be admitted to a ward at Bedford Hospital or be transferred to another hospital to receive definitive care.
- On discharge we may ask you to see your GP for follow-up care or you may be referred to a specialist clinic. For example if you have a broken bone you will be followed up by the orthopaedic team (bone specialists) in fracture clinic.
The ED Team
Rebecca Pheby – General Manager Urgent and Emergency Care
Toni Platts – Deputy Head of Nursing Urgent and Emergency Care
Sally Smith – ED Matron
Mandy Roberts – ED Consultant Nurse
Dr Thomas Larsen – Consultant Emergency Medicine and Clinical Director for Urgent & Emergency Care
Dr Sita Anala – Consultant Emergency Medicine
Dr Richard Austin – Consultant Emergency Medicine
Dr Sebastian Clark – Consultant Emergency Medicine
Dr Milena Kostic – Consultant Emergency Medicine
Dr Devasena Subramanyam – Consultant Emergency Medicine and Deputy Director Medical Education, Bedfordshire Hospitals NHS Trust
Dr Siva Parameswaran – Locum Consultant Emergency Medicine
Dr Firoze Sogiawalla – Locum Consultant Emergency Medicine
Dr Nicholas Whitlock -Locum Consultant Emergency Medicine
Folwell Ward 01234 355 122 x5208
Clinical Decision Unit 01234 355 122 x4224
Emergency Department 01234 355 122
ED Secretary Joanna Dixon 01234 792 205
Luton and Dunstable University Hospital Emergency Department (also known as Accident and Emergency or ‘A&E’)
The Luton and Dunstable University Hospital’s Emergency Department operates 24 hours a day, 365 days a year and provides a comprehensive emergency service for Luton, South Bedfordshire and parts of Hertfordshire – a total population of almost 400,000.
Our ED is one of the busiest in the region, in 2017 we saw more than 80,000 patients, a further 35,000 patients were seen by an ‘Urgent GP’ service, which is located on site.
The ED is divided into four areas:
For the most sick and severely injured patients (usually arriving by ambulance), highly equipped and allows advanced management of patients.
For the majority of sick patients and provides a trolley based area for examinations and treatment.
See & Treat
For minor injuries and illnesses, and is staffed primarily by our Nurse Practitioners.
In 2012 we saw and treated almost 18,000 children. We now have a facility, the Paediatric Emergency Department is staffed by children’s nurses.
Emergency Assessment Unit (EAU)
Our EAU is located adjacent to the ED and offers modern and comfortable facilities for the arrival of sick patients, referred as emergencies by their GPs.
Located within the EAU are facilities for the rapid assessment and management of patients with ambulatory conditions. This means that patients can be started on a treatment pathway and allowed to go home quickly for continued care.
The EAU is also a reception area for further assessment of patients who have been seen initially within the ED. It is staffed 24 hours a day by experienced medical and nursing staff, including three dedicated Acute Care Physicians, who also provide Consultant cover to the Medical Short stay unit and Ambulatory Care Centre.