FOR DR MICHELLE MYBURGH, MEDICLINIC BLOEMFONTEIN’S NEW HEAD OF THE EMERGENCY CENTRE, A TYPICAL DAY AT THE “OFFICE” LOOKS LIKE NO OTHER. LEADING UP TO WORLD TRAUMA DAY ON OCTOBER 17, WE CHAT TRIAGE, TRAUMA AND COLOUR CODES.
A seemingly quiet day at any hospital’s emergency room can change within minutes. And that is the beauty of her job, explains Michelle over a cup of coffee. “I get to use my skills
and creativity to help people in very different situations, which means I can save lives. I’m never left untouched after a busy day in the ER.” Which brings us to an important system implemented by all ERs throughout the world – Triage. Chances are, if you’ve ever visited an emergency department for any reason, you most likely would have been exposed to some form of triage before being seen by a doctor. You would have possibly heard
that you have been given a ‘colour’ and that you would be helped according to this colour. “The reason why we want to emphasise the use of this system to people, is for them to be
educated if they might land up in the ER. People can easily become frustrated if they are waiting for treatment in the emergency room and other patients receive treatment before
them. The Triage system is not an exact science, it merely helps us to direct our resources at doing the greatest good for the greatest number of patients,” explains Michelle. And with
Mediclinic Bloemfontein having by far the busiest Emergency Centre among all the Mediclinics nationwide, this system is highly necessary and helpful. Triage comes from the French world ‘trier’, which literally means ‘to sort’. This is necessary when the resources available are outnumbered by the people needing a specific resource and a way needs to be found to make sure these resources are directed fairly. “It’s simple: When there are more patients than there are doctors, nurses or beds available, decisions need to be made on whom to help first,” says Michelle. Michelle is passionate about the Triage system, and as final year Master’s student in Paediatric Emergency Medicine at the Edinburgh University, Michelle’s knowledge of emergency care is rich and she is personally and emotionally invested in her patients’ wellbeing. Also being a mom to two girls – a four-year old and a seven-year old – Michelle shares that her heart is not left untouched when parents rush to the ER with an injured child when in fact, the injury could have been prevented. “Yes, you cannot completely prevent all bad things that could happen to your children in life. But there are certain measures you can put in place to steer clear from preventable injuries.
Like using car safety seats for your little ones. I could talk about this forever. The trauma and injures (even death) I see in the ER due to the use of ineffective, or no car seats, is startling.” Mediclinic Bloemfontein’s Emergency Centre has four permanent doctors, and 17 staff in total. Michelle says it’s a dream come true to serve at the head of the centre. “My career is a calling. When I was young, I actually started studying astrophysics. But God directed my path towards medicine, and I believe it’s what I was placed on earth to do. I couldn’t imagine it being any other way.” Michelle also has a reputation among patients and hospital staff of being extremely empathetic, understanding and kind towards all her patients. She goes the extra mile and will always pop in post-treatment to check up on the wellbeing of her patients. So, to get back to the triage system at the ER: The South
African Triage Scale (SATS) is a widely accepted scientific tool to determine how stable the patient is. This is based on a combination of vital signs and specific signs or symptoms
(for kids and adults). These conditions or signs are either life-threatening, have to potential to become life-threatening or are time sensitive, needing early intervention to prevent
long-term damage. “Remember, a Triage colour does not take into account how sick you are feeling or your need to see a doctor. It is simply a way to see who can wait and who cannot, based on your objective current condition in relation to others waiting. Sometimes this can be frustrating or distressing, especially for parents with a sick child. But this system is implemented for the exact reason to treat each patient fairly,” says Michelle.
TRIAGE COLOURS EXPLAINED
RED: Emergency. These patients have a life-threatening condition and are taken through immediately. They will die if not tended to immediately.
ORANGE: Very urgent. These patients need intervention or review within 10 minutes. This is automatic in babies under two months, because their clinical signs can be difficult to
YELLOW: Urgent. These patients need intervention or review within one hour. A possible fracture also falls in this category.
GREEN: Routine. These patients have no danger signs and their vital signs are normal. Technically, they need to be seen within four hours.
ER24 Emergency number: 084 124
Mediclinic Bloemfontein’s emergency centre number: 086-051-051.