Australian Doctor Australian Doctor 27th October 2017

News ‘Flying squads’ land in aged care expanded in the past 18 months and we now have the equivalent of one FTE geria- trician and 2.5 FTE specialist nursing staff. Sydney geriatrician Dr Jayita De describes how the St George Hospital Geriatric Flying Squad is called in to manage patients in aged care facilities. Australian Doctor: Originally these ‘flying squads’ were established to cover dementia care when the Federal Gov- ernment reduced financial support to nursing homes. But there’s no actual flying in ‘flying squads’, so how do you work? AD: What treatments do your teams provide? resident’s GP when making a referral. GPs like the advantages of having a geriatrician readily available for patients, says Dr Jayita De. AD: What are you doing that GPs can’t do? Dr De: GP colleagues say the challenge lies in managing the time constraints involved in juggling surgery hours and the complex needs of aged care residents. We are able to discuss complex advanced care decisions with residents and family members. Dr De: We cover 34 facilities containing 2700 beds. GPs who look after residents in the area may refer to the service directly via the Geriatric Flying Service (GFS) mobile AD: But the intention was phone number. that flying squads would Alternatively, they may manage patients with severe request the residential aged behavioural problems. What care facility (RACF) staff kinds of patients are you to contact the GFS team. In C H A instance, U S D o c RACF H a l f staff p a g called e l a in n to - see? 1 2 0 1 7 - every are asked to liaise with the tion and breathlessness and Dr De: Every request is differ- symptoms related to life-lim- ent. Over the past few weeks, iting illnesses such as conges- referrals have included delir- tive heart failure and chronic ium care, an acute clinical lung disease. deterioration due to infection Additionally, we deal with and heart failure. We see resi- frailty issues such as fracture dents at the end of life needing management, wound care and terminal care management. vascular insufficiency. Some The symptoms we man- referrals are for non-specific age include intractable pain, symptoms such as “Mrs X is nausea, vomiting and pru- lethargic and drowsy”. ritic rashes. We also manage 1 0 symptoms - 1 9 T 1 related 6 : 4 to 4 : terminal 4 0 + 1 1 : 0 0 AD: How did the St George illness such as distress, agita- ‘flying squad’ get started? Dr De: We started with a sin- gle nurse practitioner armed with a mobile phone and a basic medical kit to cater to the nearly 3000 residential aged care residents. The ‘after hours’ service started in November 2014 with the addition of a tran- sitional nurse practitioner working weekends. Our staff numbers have Dr De: The medical kit has grown to include IV therapies (antibiotics, diuretics, flu- ids) and basic dressings. We are also gearing up to pro- vide point-of-care investiga- tions with access to an I-stat machine and portable ultra- sound scanner. AD: What response have you had from GPs? Dr De: The feedback has been positive. We have managed to form a therapeutic network with a number of the local GPs who work in the RACFs. They have praised the ease of referral, the rapid response time and the advantages of having a geriatrician readily available for their patients. Dr De spoke with Jocelyn Wright. A L it tle R ed F AVOURITE o f T HE I RON D EFICIENT W OMAN FERRO-GRAD C ORAL FIRST-LINE TREATMENT FOR IRON DEFICIENCY 1 # Ferro-Grad C is Australia’s No.1 GP-recommended iron supplement 2 – the only one with added Vitamin C to aid absorption. *1,3 Recommend daily for 3-6 months. 1,4 # Based on IMS Sales Data, February 2017. Market research, October 2014, GP diagnosed iron deficient consumers. *Of the commercially available forms of iron therapy suitable for the treatment of iron deficiency anaemia. Ferro-Grad C contains dried ferrous sulphate 325 mg (equivalent to 105 mg elemental iron) and sodium ascorbate 562.4 mg (equivalent to 500 mg Vitamin C). For the prevention and treatment of iron deficiency. References: 1. Iron Deficiency [revised March 2016]. In: eTG complete [Internet]. Melbourne: Therapeutic Guidelines Limited; March 2017. Accessed April 2017. 2. National Prescribing Service (NPS). Case study 66 report: Iron-deficiency anaemia. January 2011. 3. Brise H & Hallberg L. Acta Med Scand 1962;171 (Suppl 376):51–8. 4. Pasricha SS et al. Med J Aust 2010;193:525–32. Mylan Health Pty Ltd trading as Mylan Health (ABN 29 601 608 771) of Level 1, 30 The Bond, 30-34 Hickson Road, Millers Point, NSW 2000, Australia. Ph: 1800 314 527. Ferro-Grad C is a registered trademark. FGC-2017-0010. April 2017 ABB3325_A4. ABB3325_FERRO_GRAD_C_210x273_AD_R3.indd 1 8 | Australian Doctor | 27 October 2017 www.australiandoctor.com.au 6/27/17 3:35 PM

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