'Hot Floor' bristles with emergency-support technology

By MARTIN JOHNSTON health reporter

Doctors call it the Hot Floor - the emergency department level at the new Auckland City Hospital.

The use of space-age names doesn't end there in the department traditionally known as a hospital's front door.

The central staff area is dubbed the Flight Deck. Festooned with computers for patients' medical records, it is raised about 30cm above the emergency department floor, giving nurses and doctors a good view of the 30 or more patients who will inhabit the cubicles and rooms around it.

The new, $200 million hospital, which combines the inpatient services of Auckland, Green Lane and National Women's Hospitals, will receive its first patients on Saturday, but its adults emergency department will not open until October 15.

Sited next to the Starship children's emergency department, opened in June, it has a public dropoff carparking area accessible from Park Rd, Grafton.

At 50 beds, the new emergency department is twice the size of its predecessor next door at Auckland Hospital. Add to that the 45 beds in the admissions and planning unit, compared with 17 at the existing acute assessment unit, an emergency x-ray and CT scanning unit, plus plenty of the latest medical technology and the Hot Floor marks a major advance on its often-overcrowded predecessor.

But Auckland District Health Board chiefs are trying to play down the new department. They hope to escape the new-emergency-department phenomenon which saw Middlemore Hospital's department flooded with hundreds of extra patients a month when it opened in 2000.

Auckland Hospital's emergency and acute assessment areas already handle more than 50,000 patients a year.

The extra beds at the City Hospital's Hot Floor and the greater medical resources of the admissions and planning unit are expected to improve the flow of patients.

They also are aimed at reducing the emergency department crush during surges of winter illnesses, which has often left queues of patients on trolleys in corridors waiting for admission to a ward.

X-ray machines in the four-bed resuscitation area move on ceiling-mounted arms.

"It gives you immediate access for the urgent x-rays you require in resus situations," the board's building programme general manager, Nigel Murray, said yesterday.

Mounted on another arm beside the bed, along with the latest diagnostic gear, is a patient monitor computer to record heart rate and other vital signs.

"It's hard-wired into our network. The information off it is available on any PC in the building if you're authorised to see it."

Dr Murray demonstrates this by using it to check on the heart rate of several patients at Green Lane Hospital, where the system is already in use.

Dr John Henley, clinical director of the admissions and planning unit, said patients could be kept there for up to 36 hours before being admitted to a ward or discharged.

New features include a high-dependency area and exercise-test facilities for potential heart patients that will remove an area of concern for staff assessing chest-pain patients.