This is the admissions matrix – it will guide you with admissions here at Sutherland and be very useful for you!

To use it: type e.g. “pneumonia” into the search bar and you can find information on patients with pneumonia and their admitting specialty. 

It also contains numerous “contacts” and other information needed when working at TSH ED – e.g. common pager numbers, pathology phone numbers and access to “policies” to guide admissions and management here at Sutherland. 

The Matrix can be found here: http://vmseapp-mas001.nswhealth.net:116/?FAC=TSH and on the ED intranet page.

You can add the link to your firstnet: – see yellow highlighted area – select “Add or Remove Buttons” then copy and paste the matrix link. 

 

If admissions are not listed or links not working please let Lucy McKenzie or Ollie Barrett know. 

A quick heads up of some useful information about Sutherland nuances

Paeds: 

  • Under NSW Health Policy a Paediatric patient refers to age less than 16yrs. Anyone 16years and over is an Adult within NSW Health. Some cases who have not yet transitioned to the Adult service will be admitted by Paeds – this is under their discretion & if they are critically unwell they should be referred to NETS in the first instance versus state Adult medical retrieval. NETs 1300 362 500
  • Patients aged 16 years or greater & still going to school are seen in the Paediatric ED at Sutherland and generally admitted to the Paediatric ward under the relevant admitting team
  • First presentation DKA gets stabilised here at TSHED but admitted to SGH Paeds due to extra resources needed for these patients available only at SGH 
  • Paed Trauma: gets stabilised here & referred by the PATCH pathway – Paediatric Trauma hotline 1300 487 286 option 2 

Adults: 

  • Admissions to SGH occur for the following specialilties: Vascular, Renal and Haematology (we have a Haem/Renal Reg at TSH but they are a consult only service). All referrals for admission go via the SGH subspeciality reg. 
  • Critical bleeding: we do not have interventional radiology at TSH – patients requiring this service need to be d/w with the IR medical officer at SGH 
  • Massive PE – we do not have a Code PE team for haemodynamically unstable PE patients at TSH. All patients with a submassive/massive PE need referral to Respiratory +/- ICU. 
  • Lower GI bleeding: is managed by Gastro at TSH. Involve Surgery if the patient has had a recent surgical procedure or is known to a TSH Lower GI surgeon for this condition. 
  • Dr Kulkarni is generally on-call for Ortho Mondays at TSH and in the setting of a Spinal fracture Ortho TSH are to be consulted if Dr Kulkarni is on-call. If not direct to Neurosurgery SGH . 
  • Intracranial haemorrhage – a common presentation to ED. Speak first to SGH Neurosurgery and if not an operative candidate admit TSH: Admit Neurology if age less than 85 years and after confirming no neurosurgical intervention required. Admit Geriatrics if age greater than or equal to 85 years; or with significant chronic disability; active geriatric syndromes or social issues 

Radiology: 

  • Paediatric CT scans at TSH ED:  Paediatric Radiology is  a separate specialty area with specific RANZCR credentialling that not all of the Radiologists at TSH have. The Radiologists may opt to provide a verbal report only or a written report with a disclaimer:  ie. The report is written by a generalist radiologist not a paediatric specialist
  • The radiologist is on call after midnight for urgent scans needing a verbal reports; however you need to call the on-call Emergency Consultant to obtain approval to do this 
  • Time critical scans in most instances require a VBG creatinine
  • Ultrasound call-back criteria attached: clinically urgent scans that warrant a call back are suspected ectopic, testicular torsion, ovarian torsion, Paeds acute abdo. DVT scans are not part of the call back criteria. 

ASSET/Southcare referrals: 

  • ASSET do not need to see every older aged person; only those with specific intervention required. 
  • See the quick referral guide attached for hospital teams who will follow up patients in the community; we also have Hospital in the Home CNC: and The Geriatric Flying Squad available for referrals.