Report on Hospital Training - II
AT NEHRU HOSPITAL, BRD MEDICAL COLLEGE,
GORAKHPUR
For partial fulfillment of Bachelor of Pharmacy 7th Semester
Session 2023-24
SUBMITTED IN
Government Pharmacy College, BRD Medical College Campus
Gorakhpur
Submitted By: Submitted To:
Name: SAPNA Dr. PAWAN KUMAR GAUTAM
Roll No.: 2009370500052 (PRINCIPAL)
[Link]- 4th Yr.(7th Sem.) Government Pharmacy College,
BRD Medical College Campus,
Gorakhpur
Dr. A.P.J Abdul Kalam Technical University
Lucknow
(2023-24)
CERTIFICATE
This is to certify that Ms. Sapna has submitted the report on Hospital training-II (BP707P) for partial
fulfilment of B. Pharm 7th Semester, session 2023-24. The contents of the report do not form the basis
for the award of any other degree to the candidate or to anybody else from this or any other
University/Institution.
Dr. PAWAN KUMAR GAUTAM
(PRINCIPAL)
Government Pharmacy College,
BRD Medical College Campus,
Gorakhpur.
…………………………………………………………………….
External Examiner
ACKNOWLEDGEMENT
The training opportunity I had with BRD medical college, Gorakhpur was a great chance for learning and
professional development. Therefore, I consider myself as a very lucky individual as I was provided with
an opportunity to be a part of it. I am also grateful for having a chance to meet so many wonderful people
and professionals who led me though this training period.
I am using this opportunity to express my deepest gratitude and special thanks to Government Pharmacy
College, BRD Medical College Campus, Gorakhpur who in spite of being extraordinarily busy with their
duties gave us an opportunity so that we could learn something so important.
I express my deepest thanks to DR. Rakesh Kr. Rai (CMS) of BRD Medical College, Gorakhpur and
Suman Chaurasiya (Emergency Trauma Department In-Charge) for taking part in useful decision &
giving necessary advices and guidance and arranged all facilities to make life easier. I choose this moment
to acknowledge his contribution gratefully.
It is my radiant sentiment to place on record my best regards, deepest sense of gratitude to Mr. Bhagwant
Prasad Gupta (Chief Pharmacist) for their careful and precious guidance which were extremely valuable
for my study both theoretically and practically.
I perceive as this opportunity as a big milestone in my career development. I will strive to use gained skills
and knowledge in the best possible way, and I will continue to work on their improvement.
Thanking You Sapna
Roll No: 2009370500052
[Link]- 4th Yr.(7th Sem.)
INDEX
[Link] Topic Page No.
1 Objective 0
2 About Hospital 1
3 First Aid 2
3.1 Aims 2
3.2 ABCDE Methods 3
4 Wound-Dressing Technique 4
4.1 Wet to Dry Dressing 5
4.2 Wet to Wet Dressing 6
5 Different Route of Injection 7
6 Dispensary 10
7 Prescription & Diagnostic Reports 12
7.1 Prescription 12
7.2 Pathology Report 13
7.3 Hb1Ac Report 14
8 Summary 15
8.1 Future Plan 15
9 Observation 16
10 Conclusion 17
11 Reference 18
1. Objectives
Objectives of Training :
Hospital training is an observational oriented procedure in which a person is able to learn
practically fromtheir theoretically knowledge.
Hospital training provides practical knowledge to the student.
Hospital training helps to study closely the ground level problem regarding their job profile.
Hospital training promotes an environment in which student are induced to adapt themselves
quickly to changed circumstances.
Training provides practical knowledge to the students.
Training puts the students in real life situation.
Training removes the hesitation of the student regarding their working skill and personality
development.
Training is mandatory as per A.I.C.T.E. and Affiliating Universities and Pharmacy Council of India.
2. About Hospital
Hospitals are centers of treatment. People from all corners of the society and all walks of life
converge hereto cure themselves of their diseases.
I did my training in BRD Medical College, Gorakhpur [273013]
This is also known as “Baba Raghav Das Medical College’’ Gorakhpur It is centre for all
types ofmedical facilities especially for the poor people.
This training also made me realize the importance of hospitals for people and how it affects even
the day-to-day lives of them.
Not only the patients but also the people working in the hospital are truly dependent on it.
It was like a dream come true for citizens of Eastern part of Uttar Pradesh state, that is
Purvanchal, whenthe first seed of inception of this medical college was sown in November of
1969.
Its foundation stone was laid by the then Chief Minister of Uttar Pradesh Late Shri Chandra Bhanu
Gupta.
It was named after a devoted freedom fighter Baba Raghav Das who was a prominent Sarvoday
Leader ofthis area and close associate of Mahatma Gandhi and Acharya Vinoba Bhave.
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3. FIRST AID
First aid is the first and immediate assistance given to any person with either a minor or serious
illness or injury, with care provided to preserve life, prevent the condition from worsening, or to
promote recovery. It includes initial intervention in a serious condition prior to professional
medical help being available, such as performing cardiopulmonary resuscitation (CPR) while
waiting for an ambulance, as well as the complete treatment of minor conditions, such as
applying a plaster to a cut. First aid is generally performed by someone with basic medical
training. Mental health first aid is an extension of the conceptof first aid to cover mental health,
while psychological first aid is used as early treatment of people who are at risk for developing
PTSD. Conflict First Aid, focused on preservation and recovery of an individual's social or
relationship well-being, is being piloted in Canada.
There are many situations that may require first aid, and many countries have legislation,
regulation, or guidance, which specifies a minimum level of first aid provision in certain
circumstances. This can include specific training or equipment to be available in the workplace
(such as an automated external defibrillator), the provision of specialist first aid cover at public
gatherings, or mandatory first aid training within schools. First aid, however, does not
necessarily require any particular equipment or prior knowledge, and can involve improvisation
with materials available at the time, often by untrained people.
3.1 Aims
The primary goal of first aid is to prevent death or serious injury from worsening. The key
aims of firstaid can be summarized with the acronym of 'the three Ps':
Preserve life: The overriding aim of all medical care which includes first aid, is to save lives and
minimizethe threat of death. First aid done correctly should help reduce the patient's level of pain
and calm them down during the evaluation and treatment process.
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Prevent further harm: Prevention of further harm includes addressing both external factors, such
as moving a patient away from any cause of harm, and applying first aid techniques to prevent
worseningof the condition, such as applying pressure to stop a bleed from becoming dangerous.
Promote recovery: First aid also involves trying to start the recovery process from the illness
or injury,and in some cases might involve completing a treatment, such as in the case of applying
a plaster to a small wound.
It is important to note that first aid is not medical treatment and cannot be compared with what a
trained medical professional provides. First aid involves making common sense decisions in the
best interest ofan injured person.
3.2 ABCDE method
Airway (clearing airways): If the patient responds in a normal voice, then the airway is patent.
Airway obstruction can be partial or complete. Signs of a partially obstructed airway include a
changed voice, noisy breathing (e.g., stridor), and an increased breathing effort. With a
completely obstructed airway, there is no respiration despite great effort (i.e., paradox
respiration, or "see-saw" sign). A reduced level of consciousness is a common cause of airway
obstruction, partial or complete. A common sign of partial airway obstruction in the
unconscious state is snoring. Untreated airway obstruction can rapidly lead to cardiac arrest.
All health care professionals, regardless of the setting, can assess the airway as described and
use a head-tilt and chin-lift maneuver to open the airway. With the proper equipment, suction
of the airways to remove obstructions, for example, blood or vomit, is recommended. If
possible, foreign bodies causing airway obstruction should be removed. In the event of a
complete airway obstruction, treatment should be given according to current guidelines.9 In
brief, to conscious patients give five back blows alternating with five abdominal thrusts until
the obstruction is relieved. If the victim becomes unconscious, call for help and start
cardiopulmonary resuscitation according to guidelines.
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Importantly, high-flow oxygen should be provided to all critically ill persons as soon as possible.
Breathing (ensuring respiration): In all settings, it is possible to determine the respiratory rate,
inspect movements of the thoracic wall for symmetry and use of auxiliary respiratory muscles,
and percuss the chest for unilateral dullness or resonance. Cyanosis, distended neck veins, and
lateralization of the trachea can be identified. If a stethoscope is available, lung auscultation
should be performed and, if possible, a pulse oximeter should be applied. Tension
pneumothorax must be relieved immediately by inserting a cannula where the second
intercostal space crosses the midclavicular line (needle thoracocentesis). Bronchospasm should
be treated with inhalations. If breathing is insufficient, assisted ventilation must be performed
by giving rescue breaths with or without a barrier device. Trained personnel should use a bag
mask if available
Circulation (internal bleeding): The capillary refill time and pulse rate can be assessed in any
setting. Inspection of the skin gives clues to circulatory problems. Color changes, sweating, and
a decreased level of consciousness are signs of decreased perfusion. If a stethoscope is
available, heart auscultation should be performed. Electrocardiography monitoring and blood
pressure measurements should also be performed as soon as possible. Hypotension is an
important adverse clinical sign. The effects of hypovolemia can be alleviated by placing the
patient in the supine position and elevating the patient's legs. An intravenous access should be
obtained as soon as possible and saline should be infused.
Disability (neurological condition): The level of consciousness can be rapidly assessed using
the AVPU method, where the patient is graded as alert (A), voice responsive (V), pain
responsive (P), or unresponsive (U). Alternatively, the Glasgow Coma Score can be used.16
Limb movements should be inspected to evaluate potential signs of lateralization. The best
immediate treatment for patients with a primary cerebral condition is stabilization of the
airway, breathing, and circulation. In particular, when the patient is only pain responsive or
unresponsive, airway patency must be ensured, by placing the patient in the recovery position,
and summoning personnel qualified to secure the airway. Ultimately, intubation may be
required. Pupillary light reflexes should be evaluated and blood glucose measured. A
decreased level of consciousness due to low blood glucose can be corrected quickly with oral
or infused glucose.
Environment (overall examination, environment): Signs of trauma, bleeding, skin reactions
(rashes), needle marks, etc., must be observed. Bearing the dignity of the patient in mind,
clothing should be removed to allow a thorough physical examination to be performed. Body
temperature can be estimatedby feeling the skin or using a thermometer when available.
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4. Wound-Dressing Technique
The role of a wound dressing is to provide the optimum conditions for wound healing, whilst protecting
the wound from further trauma and invasion by pathogenic microorganisms. It is also important that the
dressings can be removed a traumatically, so as to prevent further damage to the wound surface during
dressing changes.
Dressing techniques :
The following dressing techniques are easy to do and require no sophisticated equipment. Clean
technique is usually sufficient. Pain medication may be required as dressing changes can be
painful. Gently cleanse the wound at the time of dressing change.
4.1 Wet-to-Dry Dressing
Indication: to clean a dirty or infected wound. Technique: Moisten a piece of gauze with solution
and squeeze out the excess fluid. The gauze should be damp, not
soaking wet. Open the gauze Photo and place it over top of
the wound to cover it Photo B. You do not need many
layers of wet gauze, Place a dry dressing over top. The
dressing is allowed to dry out and when it is removed it
pulls off the debris. It's ok to moisten the dressing if it is too
[Link] often: Ideally, 3-4 times per day. More often on
a wound in need of debridement, less often on a cleaner
wound. When the wound is clean, change to a wet-to-wet
dressing or an antibiotic ointment.
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4.2 Wet-to-Wet Dressing
Indication: to keep a clean wound clean and prevent build-up of exudates. Technique: Moisten a
piece of gauze with solution and just barely squeeze out the excess fluid so it's not soaking wet.
Open the gauze and place it over top of the wound to cover it. Place a dry dressing over top. The
gauze should not be allowed to dry or stick to the wound. How often: Ideally, 2-3 times a day. If
the dressing gets too dry, poor saline over the gauze to keep it moist.
Technique:-
Sedation or general anesthesia may be required. However, usually the dead tissue has no
sensation,so debridement may be done at the bedside or in the outpatient setting.
Photos A & B: Using a forceps, grasp the edge of the dead tissue and use a knife or sharp
scissorsto cut it off of the underlying wound.
Bleeding tissue is healthy, so cut away the dead stuff until you get to a bleeding base.
The patient may only tolerate this for a short period of time. Additionally, you don't want to
cut off tissue that may be viable. So, you may have to do this a little at a time, and repeat
this procedure as needed until all of the necrotic tissue has been removed.
Photo C shows the wound after three weeks of wet-to-dry dressings.
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5. DIFFERENT ROUTE OF INJECTION
A medication administration route is often classified by the location at which the drug is
administered, such as oral or intravenous. The choice of routes in which the medication is given
depends not only on the convenience and compliance but also on the drug’s pharmacokinetics
and pharmacodynamic profile. Therefore it is crucial to understand the characteristics of the
various routes and techniques associated with them. Many interprofessional healthcare team
members are involved in the administration ofmedications to patients.
INTRAVASCULAR
Placing a drug directly into blood stream;-May be intravenous (into a vein) or intra- arterial (into an
artery).Drug solution in injected directly into the lumen of a vein so that it is diluted in the
venous [Link] drug is carried to the Heart and circulated to the tissues. Drugs in oily vehicle or
those that cause haemolysis should not be given by this route. Since the drug is introduced directly
into blood, the desired concentration of the drug is achieved immediately which is not possible by
any other procedure. This route is of prime importance in emergency. Also certain irritant drugs
could be given by this route. Also this is the only route for giving large volume of drugs e.g.
blood transfusion
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INTRAMUSCULAR
In humans, the best site is deltoid muscle in the shoulder or the gluteus muscle in the buttocks.
This method is suitable for the irritating substances that cannot be given route by subcutaneous.
The speed of absorption from site of injection is dependent on the vehicle used, absorption is
quick from aqueous solutions and slow from oily preparations. Absorption is complete,
predictable and faster than subcutaneous route
SUBCUTANEOUS ROUTES
The drug is dissolved in a small volume of vehicle and injected beneath the skin from where the
absorptionis slow and uniform. Substances causing irritation to the tissues should not be injected
otherwise they will cause pain and necrosis (deadening of tissues) at the site of injection.
This method is particularly useful when continuous presence of the drug in the tissues is needed
over a long period. The usefulness of this method is enhanced by the use of depot preparations
from which the drug is released more slowly than it is from simple solution rosis (deadening of
tissues) at the site of injection. e.g. insulin
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INTRADERMAL ROUTE
Drug are injected into papillary layer of skin. For example tuberculin injection for Montoux test and
BCGvaccination for active immunization against tuberculosis BCG: Bacillus- Calmette –Guerin.
INTRATHECAL ROUTE
Blood brain barrier often prevents the entry of certain drugs into the central nervous system. Also
the blood SF barrier prevents the approach of drugs to the meanings. Thus when local and rapid
effects of drugs on meanings are desired the drugs are injected into Subarachnoid (between
arachnoids mater and pia matter) space and effects of the drugs are then localized to the spinal
nerves and meanings e.g. intrathecal injection of streptomycin in tuberculosis and meningitis used
to be used by this route but with the invention of third generation cephalosporin's it is not used
any more to treat these conditions. The injection of local aesthetics for the induction of spinal
anesthesia is given by this route. (the three membranes covering the brain and spinal cord from
outside to inward are Dura matter, arachnoids mater and pia matter .g., spinal anesthetics
INTRAPERITONEAL ROUTE
The peritoneum offers a large absorbing surface area from which drugs enter circulation rapidly
but primarily by way of portal vein. Hence First-Pass effect not avoided. This is probably the
most widely used route of drug administration in laboratory animals. In human, it is very rarely
employed due to the dangers of infection and injury to viscera and blood vessels. e.g peritoneal
dialysis in case of renal insufficiency.
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6. Dispensary
A dispensary can be defined as the main area where the dispensing of the drugs takes place. It is
mainly present for the OPD patients. The various drugs are being distributed to the patients here
on the basis of their prescription written by the doctors. The dispensary in the district hospital
consists of various pharmacists who are present to hand out the medicines to the patients. The
distribution of the drugs inthe district hospital is for free.
The drug distribution in the dispensary takes place through several windows. These windows are of:-
• Women
• Men
• Elderly i.e. above age 60
• Staff members
The people are required to stand according to these lines only in order to get the prescribed
medicines. The pharmacist also has the job to ex plain the time of administration and the amount
of dose to be given to the patient.
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1. Alusil-C – Antacid chewable tablets.
2. Paracetamol tablets and suspension.
3. Calcium tablets.
4. Chlorpheniramine Maleate tablets.
5. B-Complex tablets.
6. Walamycin suspension for children.
7. iprofloxacin Capsules.
8. Flamar gel – analgesic.
9. Doxycyclin capsules.
10. Diclofenac sodium.
11. Tramadol.
12. Perinorm.
13. Metronidazole ointment.
14. Atenolol.
15. Ciprofloxacin Capsules.
16. Flamar gel – analgesic.
17. Doxycyclin capsules.
18. Diclofenac sodium.
19. Tramadol.
20. Perinorm.
21. Metronidazole ointment.
22. Atenolol.
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7. Diagnostic Report
A diagnostic report is the set of information that is typically provided by diagnostic service when
investigations are complete. The information includes a mix of atomic result, text report, images and
codes. The diagnostic report resources suitable for the following kinds of diagnostic reports;
Laboratory (clinical chemistry, hematology, microbiology etc.)
Pathology/histopathology
Image investigation (x-ray CT, MRI etc.)
Other diagnostics-cardiology.
7.1 Prescription
12
7.2 Pathology Report
13
7.3 Hb1Ac Report
14
8. Summary
After 1 month of hospital training I came to learn about how to dispense medicines to the patient,
how to inject injections to them, how to handle trauma and emergency cases. I also learn
about dealing withhospital conditions like diseases of the patients, wards, staff members, different
departments, etc. Almost 1000 of prescriptions were received by the dispensary and we have to
treat them with full hospitality services.
8.1 Future Plan
As I had completed my hospital training from District Hospital, So, I can use my knowledge in
medical field. For ex- if I will be posted in rural area, and if there is no doctor at the time of
emergency, So, I’ll be able to handle the situation by giving proper treatment to the patient at the
time. Another thing that I had learn in my training period about the whole procedure of the
hospital, starting from admitting the patient upto there treatment.
15
9. Observation
Thus, I observed that the hospital is a place where people of all kinds come with their problems
which they believe to be solved by the medical staff. The working in the hospital takes place by
maintaining proper cleanliness in the environment. The staff and the doctors are all hostile and
good-natured towards the patients and listen to their problems. Each and every department has its
own way of working and at the end of the day; all of the work is finished by it. There is no
carelessness towards the patients for their drugs or injections and they are treated on time. The
nursing staffs are present at all times for their care. This type of methodology should really be
applicable in all hospitals so that the public may get treated once and for all to maintain a healthy
country.
16
10. Conclusion
The training in a hospital gives us a conclusion that the training in the hospital was really necessary as
it not only helped us to see how a hospital operates, but it also helped me to learn basic functions of it
like first aid care, how to give injections and dispensing of drugs etc. The conclusion drawn out can be
that I have finally learned as to how important role a hospital plays in peoples’ lives and that the hospital
staff can go to any means to save them since its their duty. Since District Hospital receives only 1 rupees
per patient, so it also shows us their good deed towards mankind and to their service.
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11. Reference
A Text book of Hospital and Clinical Pharmacy; by Dr. Pratibha Nand & Dr. Roop K. Khar.
A Text book of Hospital Pharmacy; by Dr. Ramesh K. Goyal, Dr. R.K. Parikh, Dr. Mayur M.
Patel. 1stedition – B.S. Shah Prakashan.
Diagnostics Reports from Nehru Hospital, B.R.D MEDICAL COLLEGE, GORAKHPUR.
Images :
[Link]
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[Link]
[Link]/pmc/articles/PMC1420733/
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