ED Bypass

1. Bypass is initiated by ether the ANUM or FACEM (CMO if it is overnight) but must be concurred by both in-charge ED persons before the call of bypass is made.

2. If the bypass is initiated by in-charge FACEM, the FACEM should call 1300 133 127 (or 1300 889 161 to the VA clinician) directly and request a pause of 2 hours. The FACEM does not need a pre-approval from the hospital admin.

3. Text John or Warwick a screenshot plus any essential information, such as ramping x1, waiting 4, active resuscitation etc. The FACEM should concentrate on managing the floor and re-direct any pushbacks from the admin to John/Warwick.

4. Please ask the ANUM to pre-warn the coordinator about an impending bypass situation, to try to avoid bypass e.g. by improved bed access.

5. When the bypass is called, the number of available ward beds is irrelevant. Moving patients from ED to wards and cleaning the cubicles take time and consumes ED resources.

6. Bypass should be called off as soon as both the ANUM and FACEM feel the situation is under control and a safe work environment is restored in the department.

7. You are only responsible for the patients under the care of you and your registrars/CMO (including nurse practitioner or physician assistant when they are available).

You can count on us for the support whenever you make the clinical decision of bypass. Safety, for our patients, our colleagues and your career is our priority.