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Emergency can be defined as a life threatening situation involving an injury / acute illness which requires immediate treatment. The emergency department renders a comprehensive range of services from first aid to sophisticated management of surgical and medical emergencies and full-scale trauma care. Laboratories, Radiology Department, Pharmacy and MRD ( separate case-sheet registration section in Emergency department itself) function round the clock.

Emergency Department has efficient personnel such as Emergency physicians ,CMOs, Nurses on duty round the clock and consultants of various departments are available round the clock. Supervision of treatment of life threatening injuries / illness is done by qualified and competent surgeons in their respective fields. Cardiologist, Cardio-thoracic Surgeon, Neurosurgeon, Paediatric Surgeon, Neurologist & Radiologist are available on call whenever needed. Medical Records are maintained for all the patients and retained, which includes injuries, findings and treatment.

Acute myocardial infarction( Heart-attack ) , stroke, poisoning, complications of Diabetes and Hypertension, multi-organ failure, trauma,major surgical emergencies are the common cases that are treated efficiently in the emegency department.The department has state-of –the art equipment. The major equipment available are Transport ventilators, Defibrillators, Automated External Defibrillators( AEDs), syringe pumps, infusion pumps,blood warmers,muti-parameter monitors. Each bed has central oxygen and suction facility.The department has three fully-equipped ambulances also.

The EMS Department is headed by the Professor of Emergency Medicine who has a direct reporting relationship with Medical Superintendent and DMS of the hospital. The nursing Staff of Emergency Department are highly skilled and competent in handling emergency medical services. They are given ACLS & BLS training periodically. They are also given orientation, in dealing with public and to communicate with people who are under shock, stress, fear and anxiety.

An exclusive trauma operation theatre complex is available at MGMCRI. The 20-bedded unit situated adjacent to the casualty will now provide better coordinated care round-the-clock for victims of traffic accidents or patients with fractures or injuries in the head, spine or abdomen. The state-of-art equipment includes new versions of CT/MRI machines, ventilatory support and an ambulance service.

The hospital can now expect to improve upon survival chances of road traffic accident victims on Cuddalore-Pondy highway. Getting these victims into a hospital within the golden hour (one hour) of sustaining a traumatic injury can vastly improve survival rates and treatment outcomes.


Responsibilities
The Chief Casualty Medical Officer is responsible for overall maintenance of the EMS Department. The CMOs facilitate the patient directed to all concerned consultants. The Nurses are responsible for carrying out the Doctors orders. Location

The emergency department is located with an easy access for patients and ambulances. There is a separate entrance to the department,making it easier for the public to get access of the department in emergency situations. It is well marked with proper sign-board lighting and is easily visible and accessible from the main road. It provides a full range of service to the numerous urban and rural public.

 


The EMS Department caters to patient care 24 x 7 x 365 days. It is equipped with state-of-the-art equipment and highly dedicated and trained medical team of clinicians, nurses, paramedics and attenders.

It is a well equipped, 40 bedded (Emergency unit) Casualty with triage area, resuscitation and observation ward and it has centralized oxygen supply and suction.
Adequate number of Monitors, Defibrillators, Ventilators are available.
1. Triage area - 600 sq feet with 6 beds with monitor facilities
2. Observation - 800 sq feet with 14 beds
3. Minor OT - 400 sq feet equipped the perform minor problems
4. Trauma Care/splintage and Casting area for Orthopaedics - 400sq feet
5. 500 MAX – ray - 400 sq feet
6. 300 MA X-ray - 375 sq feet

EQUIPMENT

The following equipment are available in the Casualty :
1. Multi parameter monitor - 40
2. Defibrillator - 5
3. ABG machine - 1
4. AED - 2
5. Crash Carts - 5
6. Portable X-Ray machine - 1
7. Portable ventilator - 3
8. Breath analyzer - 1
9. Blood warmer - 2

TRIAGE:
Triage is a process of sorting out patients based on their need for immediate medical, surgical condition. In order that each patient receives treatment according to his or her needs. Triage shall be carried out as per documented procedure. All Para-medical staff and Emergency medical staff are involved in triaging patients.

Color tags used:

A 4-colour code is used within the EMS Department to classify the patients based on the emergency care to be provided to them:
Red - alive – requires emergency care (instantaneous attention)
Yellow - alive (needs attention within 5 minutes)
Green - Injured can wait with initial first aid
Black - death

1. Patients with Red are shifted to the Resuscitation room for immediate medical care and further management
2. Patients with Yellow and green can wait after first aid
3. Patients with Black are shifted to Mortuary.
Relevant cases are registered under Medico-Legal Case (MLC) and Police is intimated.

Disaster (Code Red)
Hospital has an established and well rehearsed plan to cover any internal or external disaster (by the Disaster Management Committee). The Emergency Department plays an active role in such disastrous situation in co-ordinating with the hospital disaster management committee. The patients are rapidly sorted and sent to appropriate treatment areas. Priorities are based on the degree to which the patient’s life is threatened.

Code Blue
All the Medical Officers (CMO) and the nurses working in casualty are well versed with cardio – pulmonary resuscitation. During acute emergency, code Blue is announced. The CPR team rushes to casualty.
The CMO on duty shall attend and initiate treatment and guide the patient’s attendant(s) to complete the formalities.. The patients will be moved out to Intensive Care Unit after resuscitation by CPR team.. All the findings are recorded in the patient case sheet.Dangerously ill consent is obtained and the relatives are informed about the patient’s condition periodically.

LEGAL CONCERNS:
Emergency Department staff, particularly Medical and nursing are responsible for all the legal documents. MLC Record and AR entry are done by the CMO and intimated to the nearest Police Station by a messenger (attender). A case-register is maintained in the casualty department.

Patient classification:

1. Emergency patients are given immediate attention within the casualty and later shifted to respective department such as OT, ICU, ICCU, MICU etc.
2. Patients who require medical attention within a reasonable time are kept in observation ward and attended.
3. Patients with no acute and minor disorder are shifted to treatment room.

AMBULANCE SERVICE:

1. Our casualty has three well equipped Ambulances which function round the clock.
2. On emergency calls, the Ambulance is sent to the place from where the call originates.
3. Ambulance are also arranged to transport patient to other centre at the request of the relatives as well as for referral cases.