University Hospital Galway defends response to patient collapse

University Hospital Galway (UHG) has defended its response in a case where a patient collapsed and hit his head last week while awaiting treatment at its emergency department.

A couple who witnessed the incident believe the patient would have been better off trying to seek help in a hospital in Dublin.

The couple, who were visitors to Galway and do not wish to be named, said the UHG emergency department was not overly busy when the incident occurred on the afternoon of August 17th.

Response time for triage or initial assessment was about an hour, although there were less than 30 people in the waiting area, the couple said.

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They said a man in his 50s was waiting to be called, and looked as if he was in distress. According to the couple, who were sitting close by, the man stood up and started stumbling toward the triage door when he collapsed, and hit the back of his head on the floor “with an unmerciful smack”.

The man went into cardiac arrest, the witnesses said, and there was no resuscitation trolley in the emergency department. Staff came running out, a doctor began chest compressions, and it took several minutes to locate a resuscitation trolley from elsewhere, they said.

The Saolta healthcare group, which manages five public hospitals in the west and northwest,confirmed a patient had collapsed in the waiting area but said he had already been "triaged" or assessed.

However, the couple who witnessed his collapse said they did not see him wearing a plastic bracelet indicating he had been through triage.

“At the time the emergency department was very busy and congested,”the hospital said.

“ The patient collapsed in the waiting area and was treated immediately as an emergency in the waiting room,” it said.

“The emergency department is equipped with all necessary resuscitation equipment. This patient received immediate treatment and was then admitted to an inpatient bed,”it said.

Last week, the Saolta group confirmed an investigation was ordered into the death of a woman whose body may have lain undiscovered for up to 10 hours in a toilet next to the UHG emergency department.

That incident is believed to have occurred over the August bank holiday weekend.

Former taoiseach Enda Kenny admitted in 2015 that UHG's emergency department was "not fit for purpose" , with severe overcrowding.

The hospital regularly issues appeals to the public to expect delays and issued the latest such notice on August 22nd, advising the emergency department was “extremely busy”, with 32 patients awaiting admission to hospital.

A review of the hospital's emergencydepartment last year by Royal College of Nursing in Northern Ireland criticised conditions and management.

The review, details of which were published in The Irish Times in January 2017, found nursing staff felt disempowered and frustrated, patients were at risk and “nobody is in charge” at a departmental or corporate level .

The biggest problem identified by many staff interviewed was the lack of senior doctors on the “shop floor”, leading to delays in the assessment and treatment of patients, the review said.

The review was commissioned by Saolta group, and followed a series of conciliation conferences at the Labour Relations Commission involving hospital representatives and staff unions.