Sepsis deaths in hospitals.

It’s true that blood poisoning is another name for septicaemia/sepsis, but what I remember my mother calling blood poisoning (exactly what you describe) wasn’t full blown sepsis because I never had a fever or felt unwell with it.

I suspect that the explanation is that back then, there was almost no bacterial resistance to antibiotics, so that careful cleaning and disinfection was usually sufficient, and when it wasn’t, then the penicillin you’d get from the doctor as a second line of treatment was enough to fix your incipient blood poisoning.

IOW I think the present problem is greatly exacerbated by bacterial resistance to antibiotics. We had an absolute wonder drug and we carelessly wasted it.

Probably she was worried about tetanus aka lockjaw, which is a different disease.

Most people are now vaccinated as children, and people in at risk jobs get boosters as adults, so there's a lot less of it. But it was a big problem in my parents generation.

And of course other countries don't have old people or people with cancer.

are they gone abroad?

yeah but you don't need a consultant necessarily to treat everyone in the ED

drink and drugs a major factor in the ED problem. Anywhere you can wander on foot to the hospital its an issue

james for example is like a zombie film at the weekends

in many ways its worse than the ludicrous wait times

injury units are a great idea and concentrating the EDs in the big hospitals make sense, but they are closed when you need them

so everyone ends up in ED

if you are lucky to break your arm or get stabbed at 10am its grand, but it never seems to work out that way

have you first hand experience that EDs are full up with old people in need of palliative care?

Given the numbers in the ED, he should have helped out.

I survived sepsis a few years , I went to my GP with what I thought was a bad flu , after a preliminary test I was given a letter and told to go to AE .

Within two minutes if arriving in hospital I was admitted and placed in resus. Couldn’t tell about the first 24 hrs , other than I woke up with drips in both arms.

I was lucky , spending only a shot time in hospital however have damage to my liver and there was concerns over my kidneys and heart.

My GP said she reckoned I was within 12 hours of dying if I hadn’t seen her.

UHL will never change, they seem to love having 1 doctor on over the weekend in the ED.

I attended a night there was a terrible car accident(Involving 2 people) out in west limerick as I was directed to by my doctor. Nobody, out of 4 of us in ED were seen that night(7pm - 4am(I left at 4am)). There was one elderly lady awaiting seeing the doctor at that time also.

I said at the time, what in the name of god would happen if an actual serious incident occurred, eg a mass casualty event or even a car crash involving 4 people who needed urgent care. Its a farce.

Its bizarre to me that such a large building, with such a large catchment area can be dependent on so few staff all of the time. Of course the HSE will paint this as not the norm, but I am sure we will have enough anecdotes here to prove otherwise.

My wife nearly died from sepsis 3 yrs ago, she went in for a hysterectomy and came home after a day recovering. She started feeling sick so we went back in to hospital. It was during covid so I was sent home again. I thought she was dehydrated and a night with a drip would sort it out.

I got a phone call in the morning to come in quickly to see her as she was being rushed in for a emergency operation. They had to put a colostomy on to save her life. She was mere hrs from death, if we left it any longer when we went back in she would have died. When we looked for answers they circled the wagons and tried to say she had the infection before the hysterectomy.

The 191 patients waiting = €19,100 in additional income for the hospital for a single night. Surely they could afford the additional staff? Especially given that the rostered staff are paid by the HSE?

Crowded A&E = more income, which should translate into more doctors on duty.

A huge % of those attending A&E are either not required to pay (GP referral, medical card) or just don't pay.

I don't buy that. You don't need to see a patient for 5 mins and spend hours doing paperwork. Something wrong if that's the case.

Writing clinical notes, booking/reviewing scans and bloods, reviewing previous patient letters, contacting relevant teams, prescriptions etc. A doctor will have multiple active patients on their caseload and doing all the above in between seeing patients while awaiting investigations.

As a doctor who covers ED any of my non-patient facing tasks are generally all related to the care of the patients on my caseload. Just because we're not standing in front of a patient does not mean we aren't carrying out tasks relevant to their care.

A clear case of taking one dataset telling one thing and another telling a different thing and saying they are comparable.

When you google deaths in Australia due to sepsis the first report is on 5,000 deaths from 18,000 admissions to ICU, a mortality rate of 28%

For Ireland when you have a cursory look at the sepsis reports you see 3,000 deaths and you conclude "Ireland bad".

But when you actually look at the Sepsis reports you see in 2022 Ireland had 3,718 people admitted to critical care with sepsis and a mortality rate of 34.9% equating to 1,298 deaths. The total figure of 3,000 includes those not admitted to ICU.

The total deaths in Australia due to sepsis seems hard to find, probably due to sepsis often being the ultimate cause of death in cancers and other diseases. Its likely far higher than 5,000 though. A data set I did find had it at 12,000 in 2018

So, stop cheery picking "Ireland Bad" data without making any effort to see is what you are asserting actually matches reality.

Ireland's record is not great in this respect and improvements could definitely be made, but our hospital mortality rates are comparable with similar countries contrary to the "Ireland is a third world country brigade"

I agree with you on the latter point, however patients often take issue with seeing me or my colleagues sitting at a computer inferring that we're doing nothing when in fact we're doing tasks relevant to the care of our patients. That includes time-critical tasks (for eg getting an urgent chest x ray for a patient in respiratory distress, ordering cultures for a suspected sepsis, reading previous letters to identify necessary information for this critically unwell patient with a complex medical background that I've never met before).

Two weeks ago I had a call put through to my personal phone number by the hospital at 2AM while covering both ED and the wards. "Hi I'm looking for the doctor". I replied "Yes that's me" to which the person said "Just checking to see if there's actually a doctor there" and then hung-up. It was the relative of a patient in the ED waiting room.

I was 17 hours into a 24h shift with no sleep, I hadn't eaten since 11am the day before and had a full emergency department under my care as well as 2 wards juggling everything. The narrative that the doctor on-call is sitting around doing nothing when in actual fact they are drowning in work and clinical risk is soul-destroying when you are that doctor.

This is poor management. 3 x doctors for 180+ patients? Even with half the number of patients is still too few. Do the maths on each doctor spending at least 15min per patient.

At some stage there needs to be some accountability for hospital managers for poor planning/staff allocation. Especially considering the amount of money hospitals are given by the exchequer to deliver these services - there's no shortage of funds. €1m, which is small change for a hospital of this size, would get them 4 x consultants.

Like I said my issue is not the staff.

But the fact remains of not seeing a doc for 12 hrs and being seen 2-3 times in 24 hrs, while people moving paper means the system is not fit for purpose. I've spent days in A&E either myself or with family members sometimes in life and death situations.

I think people have forgotten how it's meant to work. But this isn't it.