Emergency medicine, one of the youngest specialties, has grown to become a challenging and increasingly popular specialization. It is the specialty defined by its patients rather than by any physician classification system.
Emergency care is an essential part of any healthcare system and as such must be available 24 hours per day The emergency department is a core clinical unit of a hospital and the experience of patients attending the emergency department significantly influences patient satisfaction and the public image of the hospital.
Its function is to receive, triage, stabilize and provide emergency management to patients who present with a wide variety of critical, urgent and semi urgent conditions whether self or otherwise referred.
The Emergency department handles and manages patients of various specialties, such as:
- The management of pediatric patients
- The management of major poly trauma & head injury patients
- The management of acute coronary syndrome patients
- The management of acute respiratory distress patients
- The management of infectious patients
- The management of acute cerebero vascular accidental patients
- The management of acute surgical patients
- The management of acute & chronic renal failure patients
- The management of psychiatric illness patients.
- The emergency department also provides for the reception and management of all types of disaster patients.
The various procedures done in the emergency department are as follows :
- Advanced airway management techniques, endotracheal intubation (Including usual tubes, laryngeal mask airway LMA)
- Needle cricothyroidotomy and surgical cricothyroidotomy.
- Needle and tube thoracostomy (Chest tube insertion)
- Procedural sedation and analgesia (Includes use of ketamine, propofol, thiopentone, iv benzodiazepines and potent opiates like morphine and fentanyl)
- Cardiopulmonary resuscitation
- Pericardiocentesis
- Focused abdominal scan for trauma (FAST)
- Central venous cannulation (Internal jugular, subclavian, femoral and brachial)
- Regional anesthetic blocks (Includes digital, ankle and wrist blocks)
- Regular & plastic suturing and tendon repairs
- Anterior and posterior nasal packing
- Joint reductions and plaster application
- Intraosseous line insertion
- Diagnostic peritoneal lavage and abdominal paracentesis
- Pleural fluid aspiration
- Lumbar punctures
- Suprapubic catheterization
- And the rest of the other minor procedures like ABG, intra-arterial line placement, venous cut down, etc.
The Emergency department at KMCH is equipped with all latest lifesaving equipments that are required in an emergency department. The department is also well spaced and sectioned with all inter relating departments that are required while handling any kind of emergencies.
Triage
The ER has a spacious triage area to sort out patients on arrival to the emergency department according to the seriousness of the patient.
Reception
There is a close operational relationship between Triage and reception. After triage, patient details are recorded by the clerical staff and a medical record either raised or a previous medical record retrieved.
Resuscitation room
The facilities and equipments available are:
- Oxygen Outlet
- Suction outlets
- Cardiac monitort
- Pulse oximetert
- Resuscitation trolley with all emergency medicationst
- Defibrillatort
- ECG recordert
- Ventilatort
- Infusion pumpst
Treatment bed - adult and pediatric
The facilities and equipments available along the bedside are:
- Oxygen outlets
- Suction outlets
- Cardiac monitor
- Infusion pump
- NIV & CPAP
Imaging Services
The department has dedicated imaging services exclusively for the emergency department patients. Immediate access to X-ray Immediate access to CT scanning, Magnetic Resource Imaging (MRI) & Ultrasound A system of electronic display of images and reports (i.e. Picture Archiving Communications System or PACS)
Medical Records
TAccess to patients' previous medical records is obtainable without delay and available 24 hours/day.
Intensive Care Unit and Coronary Care Unit
Immediate access to ICU & CCU services for critically ill patients.
Operating Rooms
KMCH ER department has 2 well equipped minor OT for performing all minor & semi major surgical procedures.
Ambulance Services
KMCH ER has 9 ambulances for immediate disposal for pickup of any patients within the city limits and outstations. 4 Ambulances are fully equipped with cardiac monitor, defibrillator, O2, ventilator etc. The Ambulances are manned by paramedical staffs who are well trained in handling trauma patients and BLS certified.
Air Conditioning
The emergency department should have a separate air system capable of rapid change from Recirculation to fresh air flow. Special purpose rooms (eg. Infectious Disease Isolation Room) Or areas (i.e. pediatric waiting area) may have special flow and filtering requirements.
Information/Communications Support
Emergency departments are high volume users of telecommunications and information Technology. Telephones are available in all offices, at all staff stations, in the clerical area and in all consultation and other clinical rooms.
A central communications system or paging system is in place. A dedicated telephone line to receive requests from outside medical practitioners & to receive information about trauma victim is present. An intercom or public address system that can reach all areas of the emergency department and the entire hospital is available.
Emergency Power
Emergency power is available to all lights in the Resuscitation and Acute Treatment/Observation areas of the department. All computer terminals have access to emergency power In the event of a total power failure.