Emergency services in
hospitals
OMC and SS unit II
"Medical Emergency" is defined as a situation
when the patient requires urgent and
high-quality medical care lo prevent loss of life
and limb and initiate action for the Restoration
of healthy life
Definition – "Emergency" may also be defined as a condition
determined clinically or considered (perceived)
medical by the patient or his/her relatives (attendants)
as requiring urgent medical services, failing
emergency which, it could result in loss of life or limb.
An "Accident" is defined as "an unexpected,
unplanned occurrence which may involve
injury" or "an unpremeditated event resulting in
recognizable damage".
20th century – accident room
1960s – walk in medical clinics/ medical care for
patients.
Developmen 1961 – plat committee recommendation- accident
and emergency dept.
t of casualty
1963 - central council of Health- urged state govt. to
have emergency medical services in all majorities and
town.
Scope – Increasing vehicles, non-communicable &
communicable diseases and offer emergencies.
IMMEDIATE LIFE SENSITIVE & LAW, MLC,
SAVING CARE EMOTIONAL LEGAL
24/7 – EFFECTIVE NEEDS PROCEDURES.
& EFFICIENT FULFILLMENT.
SERVICE.
Functions
ICT IN CASE OF RESEARCHER &
EMERGENCY. TRAINING,
EDUCATION.
Major – All special services including
diagnostic and therapeutic services for
different categories of emergencies.
Basic-All basic emergency facilities –
Types of GDMO 24/7 – specialists on call duty.
emergency
Standby – PHC & CHC – 24/7 trained
services nurses –GDMOS on call duty.
Referral – Subcenters- severity of need –
First aid, then sent to tertiary hospitals.
Location(Outer) – ground floor,
entrance – direct access – main
road, parking of ambulance/ car/
other vehicles ramp, sign posting.
Planning
Considerations
Inner side – near to OT, Lab,
Blood bank, mortuary.
As per no. of patients/day. Eg: 100
pts/day or 1000sq ft. another 500 sq ft.
to prevent crowding.
Size/ type of hospital- patients load
10-15% of OP patients
Space
Requirements Diagnostic and therapeutic facilities
availability.
Plan for over usage than under usage.
Larger hospitals – separate interdependent dept.,
future expansion rooms with good accessibility,
entrance, ramps, wheel bound rails, two-way
swinging doors.
Waiting halls – toilets, drinking water, telephones,
MSW, triage.
Physical
facilities & Purpose- at time of disasters, trollies & wheelchairs.
layout Nursing station-full view, resuscitation cubicles,
pediatric cubicle, observation and examination
rooms.
Nurses rest room, minor OT, plaster room, seperate
room for burns & infection diseases/ radio diagnosis
dark room, police room/ brought in dead room
Principle – “design follows function”.
“Minimum Criss- crossing of patient traffic”.
Joining corridors at least 3 meters width; floors
non slippery – bright wall colors.
Architectural
design Communication
Internal network
Outside communication
• Centralized piped O2 • Special medications
and suction supply ,IV equipment and
fluids
Equipment • Airways , outlets and
resuscitation bags • Bandages, drug and
and supply • Wall mounted or plasters
portable manometer • Utility table, emesis
• Portable defibrillators basin, Kidney tray.
and ECG • Slit lamp, loupe, ENT
• Respiratory aids, Ambu exam equipment.
bags, Venti masks , • OT and ICU
nebulizers and cardiac equipment
monitors • Trollies and
wheelchairs
Equipment
and RELIABILITY
AND
EXTENSION OF
USEFUL LIFE
ENSURE
SAFETY
maintenance READINESS OF
EQUIPMENT
OF
EQUIPMENT
OPERATIONS
AND
issues AND
DECREASE THE
MINIMUM
WASTAGE OF
DOWN TIME RESOURCES
Staffing
According to
Size and nature of hospitals
Workload of department
Availability of resources
Categories
Medical (competent, intelligent, qualified, flexible and initiate life)
Paramedical( ECG and OT assistants, Radiographers)
Group-D (Orderlies, drivers, sweepers)
Registration and recording
Serial registration numbers
MLC and court procedures
Demographic parameters
Date, time of arrival, chief complaints, examination findings,
Baseline investigations
Diagnosis and management
Discharge/referrals/death
Laboratory , radiology and ECG investigations
Safe custody
Vital parameters recording
Records on Impressions of emergency consultants
investigation Emergency to indoor transit record
Referred to other hospitals
MLC and history of patients – information to police
Separate reporting and recording with police for MLC cases
Monitoring and evaluation
Total patients Completeness,
Peak and slack hours
treated/week/mont adequacy, accuracy
of emergency
h of records
Correctness and Errors in diagnosis Causes of
substantiation of and management of complications and
final diagnosis patients death
Medical audit – review
committee
Members – senior consultants of broad disciplines –
medical, surgery, ortho, pediatrics, MRD officer
Meeting at regular intervals
Confidential reports maintenance
Grievance redressal system- CPA, complaint boxes( In
charge – senior consultant)
End
