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The Accident & Emergency Department (A & E) has a total strength of 9 senior staff complemented by approximately 20 Medical Officers. The Medical Officer pool comprises trainees and non-trainees, locum, resident doctors and those seconded from other departments. Junior staff is assigned to a member of the senior staff who oversee their training and performance during their posting.
This team is responsible for the acute care of all medical and surgical emergencies presenting to A&E either in the ambulatory setting or through the emergency ambulance service (both via the Singapore Civil Defence Force and private ambulances). The department also contributes to the National Disaster Management plan by providing medical teams.
The department actively provides training for basic and advanced trainees in emergency medicine, internal medicine, surgery, general practice as well as non-trainees. It is also active in conducting continuing education for general practitioners, nurses, ancillary medical staff and paramedics.
Principles of Emergency Care as it relate to triage, resuscitation, stabilization and initial 24hour management of patients:
- Abdominal and gastrointestinal system including GI bleeding, dehydration, rupture AAA, acute abdominal conditions.
- Cardiovascular Disease including ACLS, thrombolysis, hypertensive crisis, pacing
- Cutaneous Disease
- Haematological problems
- Head & Neck Disorders
- Musculo-skeletal Disease
- Neurological Disease
- Paediatric Problems-including NAI, trauma management, meningitis, febrile fits, sepsis, GI disorders of infancy e.g. intusseption, pyloric stenosis, volvulus, feeding problems
- Psychiatric Disorders
- Respiratory Disorders
- Disorders caused by immunological, biological, chemical and environmental agents
- Advanced Trauma Management
- Oro-tracheal intubation
- Chest drainage
- Central venous access
- Carotid sinus massage
- Paediatric advanced airway management
- M&R of fracture/dislocations and immobilisation techniques
- Suturing
- Slit lamp examination and removal of Eye FB
- Control of epistaxis
- Laryngeal examination
- Use of portable ventilators
- Orogastric lavage
- Case Conference - twice a month, 2 hours
- Topic Focussed Journal Reading - once a month, 1.5 hours
- Didactic Lecture - once a month, 1.5 hours
Held at the beginning and at the end of the posting
The department is active in conducting research and actively encourages the participation of medical officers in these activities. Each registrar has at least one on-going project aided by consultant/associate consultants. Research projects are presented at the yearly annual scientific meetings either within the emergency medicine fraternity or in multi-disciplinary national and International conferences.
The basic trainee having attained the MRCP or MRCS Part 1 will undergo practical apprenticeship in the department. The trainee will have to log cases seen, resuscitations and procedures performed. The basic trainee will be task to manage a comprehensive array of medical and surgical emergencies during their posting, supervised by senior A&E staff. The basic trainee will be expected to participate actively in journal clubs, lectures, morbidity rounds and research conducted by the department.
CGH A&E Dept is recognized by the Academy of Medicine for advanced specialty training in emergency medicine. The AST Program is designed to give the trainee an in-depth clinical experience in the management of medical and surgical emergencies, and a good grounding of ED administration, research and training.
Upon completion of the Program, the trainees are expected to be independently proficient in the care of the acutely ill patient as well as knowledge in the use of equipment that are generally required in the ED. Pre-hospital aspects of emergency care are also emphasized during the AST.
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