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Mr. Patrick Plunkett

Clinical Professor (Surgery)

 

Clinical Professor (Clinical Medicine)


  Deprivation and healthcare inequity   EMERGENCIES   EMERGENCY   HEALTH PROFESSIONALS   HEALTH SERVICES RESEARCH   health systems and policy
Details Date
Council Member, Pre-Hospital Emergency Care Council 2012 - current
Member, Section of Emergency Medicine, UEMS 2012 - 2016
Member, Professional Standards Committee, College of Emergency Medicine 2012 - 2014
Chair of National Board for Ireland and Council member, College of Emergency Medicine 2008-2010
Board Member, Faculty of Accident & Emergency Medicine (Granted Royal Charter as "College of Emergency Medicine", 2008) 1999 - 2005
Member, Education and Examination committee, Faculty of Accident and Emergency Medicine 1992 - 2004
Chairman, Advisory Committee on Emergency Medicine Training (ACEMT); Member, Irish Surgical Post-Graduate Training Committee (ISPTC) and Member, Basic Surgical Training committee (BST), Royal College of Surgeons of Ireland 2001 - 2004
Council Member and member of Executive Committee, European Society for Emergency Medicine 2005 -2009
Member, Advanced Trauma Life Support (ATLS) Committee - RCSI 1990 - 2003
Member, Medical Advisors Group (MAG) of Pre-Hospital Emergency Care Council (PHECC) 2001-2004
Details Date From Date To
Emeritus Editor, European Journal of Emergency Medicine 2009 current
Medical Adviser/ Lead - St John Ambulance, Ireland Dec 2013 Dec 2014
Commissioner, St John Ambulance Brigade of Ireland 2008 2013
Member of Editorial Boards of the European Journal of Emergency Medicine, the Polish Journal of Emergency Medicine and of "Emergencias", the Spanish emergency medicine journal 2008 current
Member, Consultant Committee, Irish Medical Organisation 2008 2009
Editor-in-Chief, European Journal of Emergency Medicine 2005 2008
College Tutor and member of Specialist Advisory Board (SAB) in Accident & Emergency Medicine, Royal College of Surgeons of Edinburgh 2003 2006
Patrick K Plunkett, Capacity - A quart into a pint pot?, Doolin Memorial Lecture, Royal College of Surgeons of Ireland, December 3rd, 2016, Irish Medical Organisation, Invited Talk, PUBLISHED  TARA - Full Text  URL
O'Connell S, Lillis D, Cotter A, O'Dea S, Tuite H, Fleming C, Crowley B, Fitzgerald I, Dalby L, Barry H, Shields D, Norris S, Plunkett PK, Bergin C., Opt-Out Panel Testing for HIV, Hepatitis B and Hepatitis C in an Urban Emergency Department: A Pilot Study, PLoS One, 11, (3), 2016, Notes: [OBJECTIVES: Studies suggest 2 per 1000 people in Dublin are living with HIV, the level above which universal screening is advised. We aimed to assess the feasibility and acceptability of a universal opt-out HIV, Hepatitis B and Hepatitis C testing programme for Emergency Department patients and to describe the incidence and prevalence of blood-borne viruses in this population. METHODS: An opt-out ED blood borne virus screening programme was piloted from March 2014 to January 2015. Patients undergoing blood sampling during routine clinical care were offered HIV 1&2 antibody/antigen assay, HBV surface antigen and HCV antibody tests. Linkage to care where necessary was co-ordinated by the study team. New diagnosis and prevalence rates were defined as the new cases per 1000 tested and number of positive tests per 1000 tested respectively. RESULTS: Over 45 weeks of testing, of 10,000 patient visits, 8,839 individual patient samples were available for analysis following removal of duplicates. A sustained target uptake of >50% was obtained after week 3. 97(1.09%), 44(0.49%) and 447(5.05%) HIV, Hepatitis B and Hepatitis C tests were positive respectively. Of these, 7(0.08%), 20(0.22%) and 58(0.66%) were new diagnoses of HIV, Hepatitis B and Hepatitis C respectively. The new diagnosis rate for HIV, Hepatitis B and Hepatitis C was 0.8, 2.26 and 6.5 per 1000 and study prevalence for HIV, Hepatitis B and Hepatitis C was 11.0, 5.0 and 50.5 per 1000 respectively. CONCLUSIONS: Opt-out blood borne viral screening was feasible and acceptable in an inner-city ED. Blood borne viral infections were prevalent in this population and newly diagnosed cases were diagnosed and linked to care. These results suggest widespread blood borne viral testing in differing clinical locations with differing population demographic risks may be warranted.], Journal Article, PUBLISHED  DOI
Kelleher E, Plunkett PK, O'Dwyer AM, Cooney J, Emergency Medicine Trainees' Confidence in Psychiatric Assessments, Psychosomatics, 55, (4), 2014, p415 - 417, Notes: [The Royal College of Psychiatrists recommends that emergency medicine (EM) personnel should feel confident in making an initial assessment of people with mental health problems. Trainees in EM are often the first doctors to assess and manage patients with psychiatric problems. Such patients constitute up to 35% of Emergency Department (ED) presentations, with the most frequent problems being self-harm (31%), substance misuse (20%), psychosis (17%), and mood disturbance (15%). The College of Emergency Medicine recently issued a toolkit for Mental Health in EDs in February 2013. It recommends that "mental health should feature specifically within junior induction" and that liaison psychiatry have a key role in the education of staff ePub ahead of print doi: 10.1016/j.psym.2013.07.006], Journal Article, PUBLISHED
S O'Connell, Lillis D, O'Dea S, H Tuite, C Fleming, D Shields, S Norris, B Crowley. P Plunkett, C Bergin , Results of a Universal Testing Programme for Blood Borne Viruses in an Urban Emergency Department, including Rates of Diagnosis and Linkage to Care, AASLD The Liver Meeting, Boston, MA, November 7-11 2014, 2014, Meeting Abstract, PRESENTED  TARA - Full Text
Iyer PM, McNamara PH, Fitzgerald M, Smyth L, Dardis C, Jawad T, Plunkett PK, Doherty CP,, A seizure care pathway in the emergency department: preliminary quality and, Epilepsy Research and Treatment, (Epub May 29 2012 ), 2012, p273175 , Notes: [Aim. To evaluate the utility of a seizure care pathway for seizure presentations to the emergency department (ED) in order to safely avoid unnecessary admission and to provide early diagnostic and therapeutic guidance and minimize length of stay in those admitted. Methods. 3 studies were conducted, 2 baseline audits and a 12-month intervention study and prospective data was collected over a 12-month period (Nov 2008-09). Results. Use of the Pathway resulted in a reduction in the number of epilepsy related admissions from 341 in 2004 to 276 in 2009 (P = 0.0006); a reduction in the median length of stay of those admittedfrom 4-5 days in the baseline audits to 2 days in the intervention study (P '⧠0.001); an improvement in time to diagnostic investigations such as CT brain, MRI brain and Electroencephalography (P '⧠0.001, P '⧠0.048, P '⧠0.001); a reduction in readmission rates from 45.1% to 8.9% (P '⧠0.001); and an improvement in follow-up times from a median of 16 weeks to 5 weeks (P < 0.001). From a safety perspective there were no deaths in the early discharged group after 12 months follow-up. Conclusion. The burden of seizure related admissions through the ED can be improved in a safe and effective manner by the provision of a seizure care pathway. ], Journal Article, PUBLISHED  DOI  DOI  URL
Wakai A, O'Sullivan R, Staunton P, Walsh C, Hickey F, Plunkett PK, Development of key performance indicators for emergency departments in Ireland, European Journal of Emergency Medicine, 19, (ePub Feb 29 2012), 2012, Notes: [Abstract OBJECTIVE: The objective of this study was to develop a consensus among emergency medicine (EM) specialists working in Ireland for emergency department (ED) key performance indicators (KPIs). METHODS: The method employed was a three-round electronic modified-Delphi process. An online questionnaire with 54 potential KPIs was set up for round 1 of the Delphi process. The Delphi panel consisted of all registered EM specialists in Ireland. Each indicator on the questionnaire was rated using a five-point Likert-type rating scale. Agreement was defined as at least 70% of the responders rating an indicator as 'agree' or 'strongly agree' on the rating scale. Data were analysed using standard descriptive statistics. Data were also analysed as the mean of the Likert rating with 95% confidence intervals (95% CIs). Sensitivity of the ratings was examined for robustness by bootstrapping the original sample. Statistical analyses were carried out using SPSS version 16.0. RESULTS: The response rates in rounds 1, 2 and 3 were 86, 88 and 88%, respectively. Ninety-seven potential indicators reached agreement after the three rounds. In the context of the Donabedian structure-process-outcome framework of performance indicators, 41 (42%) of the agreed indicators were structure indicators, 52 (54%) were process indicators and four (4%) were outcome indicators. Overall, the top-three highest rated indicators were: presence of a dedicated ED clinical information system (4.7; 95% CI 4.6-4.9), ED compliance with minimum design standards (4.7; 95% CI 4.5-4.8) and time from ED arrival to first ECG in suspected cardiac chest pain (4.7; 95% CI 4.5-4.9). The top-three highest rated indicators specific to clinical care of children in EDs were: time to administration of antibiotics in children with suspected bacterial meningitis (4.6; 95% CI 4.5-4.8), separate area available within EDs (seeing both adults and children) to assess children (4.4; 95% CI 4.2-4.6) and time to administration of analgesia in children with forearm fractures (4.4; 95% CI 4.2-4.7). CONCLUSION: Employing a Delphi consensus process, it was possible to reach a consensus among EM specialists in Ireland on a suite of 97 KPIs for EDs.], Journal Article, PUBLISHED  DOI
Plunkett PK, Byrne DG, Breslin T, Bennett K, silke B, Increasing wait times predict increasing mortality in emergency medical admissions, European Journal of Emergency Medicine, 18, 2011, Notes: [Abstract: Background: The actual impact of emergency department 'wait' time on hospital mortality in patients admitted as a medical emergency has often been debated. We have evaluated the impact of such waits on 30-day mortality, for all medical patients over a seven year period. Methods: All patients admitted as medical emergencies via the emergency department between 2002 and 2008 were studied; we looked at the impact of time to medical referral and subsequent time to a ward bed on any in-hospital death within 30 days. Significant univariate predictors of outcome, including Charlson co-morbidity and Acute Illness Severity Score, were entered into a multivariate regression model, adjusting the univariate estimates of the readmission status on mortality. Results: We studied 23,114 consecutive acute medical admissions between 2002-2008. The triage category in the Emergency Department was highly predictive of subsequent 30-day mortality ranging from 4.8% (Category 5) to 46.1% (Category 1). After adjustment for all outcome predictors, including comorbidity and illness severity, both Door to Team and Team to Ward times were independent predictors of death within 30 days with respective Odds Ratios of 1.13 (95% CI 1.07, 1.18), and 1.07 (95% CI 1.02, 1.13). Conclusion: Delay to admission can be shown to independently adversely influence mortality outcome. We recommend maximal target limits of 4 and 6 hrs for referrals and admissions respectively, based on these mortality observations.], Journal Article, PUBLISHED  DOI  URL
F McCarthy, S De Bhaldraithe, C Rice, CG McMahon, U Geary, PK Plunkett, P Crean, R Murphy, B Foley, N Mulvihill, RA Kenny, CJ Cunningham., Resource utilization for syncope presenting to an acute hospital Emergency Department., Irish Joural of Medical Science., 179, (4), 2010, p551 - 555, Journal Article, PUBLISHED  DOI
O'Kelly FD, Teljeur C, Carter I, Plunkett PK, The impact of a GP cooperative on lower-acuity Emergency Department attendances, Emergency Medicine Journal, 27, (10), 2010, p770 - 773, Notes: [Background: In 1998 'Dubdoc', Ireland's first out-of-hours general practice emergency service, opened in an outpatient suite in St James's Hospital with a separate entrance 300 m from the emergency department (ED). Dubdoc was established with the aim of providing an easy access out-of-hours service for ambulatory patients of those doctors supplying the service. Aim To determine whether ED attendances for patients in the lower acuity triage categories 4 and 5 have changed since the establishment of 'Dubdoc'. Methods A retrospective review of all attendances at the 'Dubdoc' service was compared with attendances at the ED for triage categories 4 and 5 of the same hospital over a 9-year period (1999-2007 inclusive) for equivalent times of day. Results ED attendances during 'Dubdoc' hours have decreased as a proportion of all attendances for triage categories 4 and 5. ED attendances for triage categories 4 and 5 fell substantially during the study period. Conclusions Although the presence of the 'Dubdoc' service has resulted in a decrease in ED attendances for triage categories 4 and 5, this is a minor proportion of the overall decrease in attendances in this group of patients.], Journal Article, PUBLISHED  DOI
Miró OS, Burillo-Putze G, Plunkett PK, Brown AF, Female representation on emergency medicine editorial teams., EUROPEAN JOURNAL OF EMERGENCY MEDICINE, 17, (2), 2010, p84 - 88, Notes: [Abstract OBJECTIVE: To analyse the presence of women on the editorial teams of emergency medicine journals and the potential relationship between the pre-eminence of the journal and their presence. MATERIALS AND METHODS: In this cross-sectional study, we examined 10 journals cited under the heading of 'Emergency Medicine' by Thomson Scientific in the Journal Citation Reports and 14 additional emergency journals not cited but which publish investigations in emergency medicine. We evaluated the editorial board posted on their websites, determining the number of men and women occupying executive tasks, as well as the sex of the editor-in-chief of each journal. RESULTS: We identified 372 people working on the editorial teams (mean: 15.5, SD: 13.5), 49 being women (13.2%). Of these 372 people, 28 were editors-in-chief but only one was female (3.6%). We found no statistical differences between indexed and nonindexed emergency journals regarding female representation on the editorial team or in the position of editor-in-chief. Neither did we find any relationship between female presence and the pre-eminence of the indexed journals using impact factor as a surrogate marker. CONCLUSION: Very few women are found either on editorial teams or in editor-in-chief positions in the emergency medicine journals, irrespective of the pre-eminence of the journal. It should be investigated whether a negative journal bias underlies these findings.], Journal Article, PUBLISHED  DOI
  

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Plunkett PK, How to make your paper more acceptable to the Journal Editor, IV National Congress on Emergency Medicine, Antalya, Turkey, May, 2008, Emergency Physicians Association of Turkey, Invited Talk, PUBLISHED
Plunkett PK, Emergency Medicine, a crucial specialty, IV National Congress on Emergency Medicine, Antalya, Turkey, May, 2008, Emergency Physicians Association of Turkey, Invited Talk, PUBLISHED
Plunkett PK, Management of Status Epilepticus in the Emergency Department, 2008 Winter Symposium on Emergency Medicine and Intensive Care, Karpacz, Poland, Feb 28th - Mar 4th, 2008, Polish Society for Emergency Medicine, Invited Talk, PUBLISHED
Plunkett PK, Friends, Family and "Frequent flyers", 2008 Winter Symposium on Emergency Medicine and Intensive Care, Karpacz, Poland, Feb 28th - Mar 4th, 2008, Polish Society for Emergency Medicine, Invited Talk, PUBLISHED
Plunkett PK, Measuring competency in training and research , 4th European Congress on Emergency Medicine, Heraklion, Crete, October 4th to 8th, 2006, Invited Talk, PUBLISHED
Plunkett PK, European Working Time Directive - Implications for training , 4th European Congress on Emergency Medicine, Heraklion, Crete, October 4th to 8th, 2006, Invited Talk, PUBLISHED
Plunkett PK, How Professional Examinations Can Be Used to Modify Attitudes to Research Methodology, 2nd Mediterranean Emergency Medicine Congress, Sitges, Spain, Sept 13- 17, 2003, European Society for Emergency Medicine - -American Academy for Emergency Medicine, Invited Talk, PUBLISHED
Plunkett PK, Intravenous Drug Abuse: Severe Unexplained Infections, 2nd Mediterranean Emergency Medicine congress, Sitges, Spain, September 13-17, 2003, European society for Emergency Medicine - American Academy of Emergency Medicine, Invited Talk, PUBLISHED

  

Award Date
Knight of Grace, Most Venerable Order of the Hospital of St John of Jerusalem 2010
Serving Brother, Most Venerable Order of the Hospital of St John of Jerusalem 2005
Lord Mayor's Award, Dublin 2007