Goals and Objectives:
GOALS & OBJECTIVES OF PREHOSPITAL CARE
- To learn common organizational structures of Emergency Medical Services.
- To learn the principles of EMS operations, disaster management, prehospital triage’ and EMS research.
- To learn medico legal principles relating to EMS.
- To be familiarize with the local EMS
- Where available, actively participate in EMS.
- To demonstrate familiarity with research methodologies relating to EMS and disaster management.
- To discuss the medico legal issues relating to EMS.
- To discuss the development of EMS prehospital care protocols.
- To discuss basic concepts of mass casualties and disaster management.
- To describe common environmental, toxicological, and biological hazards.
- Encountered in the prehospital care setting.
GOALS & OBJECTIVES OF HOSPITAL CARE
- To assimilate general concepts of emergency medicine, focused history taking, and physical examination skills to develop a systemic evaluation for patients presenting to the emergency department.
- To demonstrate the ability, based on the history acquired, to do an immediate assessment and initial stabilization, followed by a complete directed examination.
- To combine the knowledge with the history and physical examination, to develop an appropriate differential diagnosis for all presentations.
- To demonstrate knowledge of the causes, presentation, and management of commonly presenting emergencies.
- To perform primary and secondary survey with management of polytrauma patients effectively.
- To demonstrate the ability to perform essential emergency procedures.
- To be able to differentiate and place patients on care pathways which lead to appropriate discharge with follow up when needed, admission to an ED based observation unit or admission into hospital.
- To work in the difficult and challenging environment of the Emergency Department and to be able to re – prioritize and respond to new and urgent situations.
- To be a part of a multi – disciplinary team where good communication and interpersonal skills are essential.
- To be able to work both within and lead a team to ensure the patient‘s needs.
- To be able to work closely with a wide variety of in-patient teams and with primary care and pre-hospital clinicians.
- To be committed to the highest standards of care and of ethical and professional behavior within the specialty of Emergency Medicine and within the medical profession as a whole.
- The Emergency Physician should be caring, empathetic, conscientious and practices medicine without prejudice.
- To continually seek to improve care by utilizing up to date evidence, being committed to lifelong learning and being innovative.
FACULTY MEMBERS
Sr.No| Name of the Faculty|Degree|Registration Number|Designation|Photo|
Facilities in the Department:
Infrastructure
- Civil facilities and building
- Building – Modified multipurpose building Available
- Reception area
- Case registration desk
- Helper desk
- Triage area ( EMO room ) and Resuscitation area – Ground Floor
- Surgical Resuscitation area – Trauma Bay 1 and 2
- Casualty – 22 beds
- Central Oxygen and Suction facility
- Doctor’s Room
- Nursing Station
- Plaster Room
- Waiting area for relatives with patients
- Refreshment Stall
- Diagnostic Facilities
- ECG
- X- Ray
- Ultrasonography ( Portable )
- CT-Scan, MRI ( nearby )
- Various biochemical investigations as per Annexure 17
- Supportive Facilities
- Ambulance Service
- Police Station
- CCTV Supervision
- PRO
- Phone Call facility
- Disaster Preparedness and control room
- Fire Safety
- Volunteer Service
- Generator facility
- Cold Storage and Postmortem room
- Operative Facilities
- Well Equipped Operation theater – 2
- IITV
- Critical Care Facility
- Bed side multipara monitors
- Ventilators
- Continuous vital sign monitoring
- Beds in ICU – 6
- Liaison with organ donation bank
- Blood Bank
- Blood and various blood components available
Human Resource
- Consultants
- Physician
- Anesthetist
- Surgeon
- On call orthopedics, neurosurgeon, plastic surgeon, ENT surgeon
- Resident Doctors
- Senior residents
- Postgraduate junior residents
- Interns
- Emergency Medical Officer
- EMO as first responder at triage area
- Paramedical Staff
- Nurses on shift duty / EMT trained
- Technicians ( X –Ray, ECG, OT, Sample Collection ), ( Clerk, Computer Operator,Servent, Sweeper )
- Physiotherapist
Work Style
A.Patient Management
- First Responder and their duties
- Emergency cases are attended first EMO and triage is done.
- Primary survey and resuscitation are performed as per standard guidelines and protocols by Emergency Physician.
- Airway management, resuscitation C- Spine immobilization, wound debridement and suturing bone immobilization, vascular access, foreign body removal are performed in medical / surgical emergencies by senior resident and consultant.
- Diagnosis investigations carried out as per requirement.
- After stabilization patients are handed over to concern specialty for definitive care.
- Various emergency procedures are done in the department by faculty members and residents for better management of patients.
- Extended and specialized emergency medical care is provided during special festivities
- Special Equipments are available and used for better emergency management of patients.
- Special emergency medical care provided for VVIP coverage whenever required.
B.Academic activities for
- Emergency Medicine resident during their 3 years of residency in the form of bedside teaching, grand rounds, regular case presentations, didactic lectures, discussions and simulated learning sessions on manikins. Record is maintained in log book
- Second year residents of various clinical and non- clinical branches, Interns, UG students and paramedical staff are also trained regarding various medical and surgical emergencies
- Disaster preparedness training and Mock drills are conducted at regular interval.
- CME and seminars are held regularly.
List of Didactic lectures for PG students
- Cardio – Pulmonary Resuscitation and assessment.
- D/d of cardiac symptoms.
- Treatment of Acute LVF / CCF.
- Treatment of Acute MI.
- Interpretation of ECG.
- Interpretation of X-ray Chest.
- Interpretation of echocardiography.
- Central Venous pressure monitoring.
- Pericardiocentesis.
- Inotropic agents.
- Treatment of Hypertention – Urgency & Emergency.
- Approach to Coma.
- Treatment of status epilepticus.
- Treatment of status asthmatics.
- Diabetic emergencies
- Management of Shock
- Airway Management.
- Pharmacologic agents used in Anesthesia.
- Standard monitoring techniques.
- Pre – Operative Cardio – Pulmonary assessment.
- Principles of pain management.
- Pathophysiology of Trauma.
- Diagnostics and Therapeutic Intervention in critically ill patients.
- Rationality of Lab. Test in critically ill patients.
- Arrhythmias and treatment.
- AHA recommendation in resuscitative procedures.
- Cardiac arrest.
- Pathophysiology of respiration
- Acute abdominal pain ( Medical / Surgical ).
- Principles of care of the pre- operative patient.
- Common Surgical procedures.
- Ageing process.
- Principles of manage geriatric patient.
- Detailed neurological examination.
- CSF Physiology shunt and malfunction.
- Management of emergent complications of pregnancy.
- Management of labour complicated / uncomplicated.
- Diagnosis of vaginal bleeding.
- D/D visual loss.
- Principles of ocular trauma management.
- Evaluation of musculoskeletal trauma.
- Acute and chronic pain management in musculoskeletal trauma.
- Management of facial trauma.
- Evaluation of upper airway disorders.
- Principles of management of violent patient.
- Acute psychosis.
- Acute Poisoning - General management.
- Approach to trauma patient.
- Learning of systematic approach to trauma management including statewide trauma systems & categorization.
- Management of rental calculi.
- Management of renal and genito – urinary trauma.
- Pathophysiology of wound healing.
- Wound evaluation and management.
- Closure techniques.
- Complications of traumatic wounds.
- Resuscitation issue in pregnancy.
- Acid-base disorders.
- Blood gases: Pathophysiology and interpretation.
- Lacerations to the face and scalp.
- Fingertips and Nail Injuries.
- Lacerations of the extremities and joints.
- Soft tissue foreign bodies.
- Puncture wounds and bites.
- Syncope.
- Valvular emergencies.
- Acute myocardities.
- Aortic dissection and aneurysms.
- Tuberculosis.
- Swallowed foreign bodies.
- Appendicitis.
- Peptic ulcer disease and gastritis.
- Intestinal Obstruction.
- Acute Cholecystitis.
- Complications of General surgical procedures.
- Complications of gastro- intestinal devices.
- H.I.V. Infection
- Rabies.
- Reportable communicable diseases.
- Antibiotics in emergency department.
- Blood Transfusions.
- Blood Component therapy.
- Ataxia & gait disturbances
- Jaw emergencies & Nasal emergencies.
- Oral and Dental emergencies.
- Strangulation.
- Approach to Dermatologic patient in EMD.
- Head injury.
- Penetrating and blunt neck trauma.
- Abdominal injuries.
- Genito – Urinary trauma.
- Wound Ballistics.
- Early evolution and management of orthopedics injuries.
- Injuries to Hand and digits.
- Injuries to Elbow and forearm.
- Wrist injuries.
- Injuries to Shoulder complex and Humerus.
- Trauma to Pelvis, Hip and femur.
- Knee injuries.
- Ankle injuries.
- Compartments syndromes.
- Emergencies in systematic Rheumatic diseases.
- Death notification.
- Principles of emergency department sonography.
- MRI principles and Applications.
- Pre- hospital equipments and Adjuncts
- A Poisoning & BITES.
- O.P. poisoning.
- Diazepam poisoning.
- Acid poisoning.
- Snake bite.
- Scorpion bite.
- B.C.V.S. & Respiratory emergency.
- Acute MI & Unstable Angina.
- LVF with Pulmonary edema.
- AF with fast VR.
- Ventricular tachycardia.
- Acute exacerbation of Asthma / COPD.
- Pneumothorax.
- Hypertensive encephalopathy.
- Acute respiratory failure.
- G.I.T. / G.U.T.
- Acute Gastroenteritis with severe dehydration.
- Hemetemesis.
- Hepatic encephalopathy, Acute fulminant Hepatitis.
- Acute Renal failure.
- Ureteric encephalopathy.
- Acute Mesenteric ischemia.
- Acute pancreatitis.
- Hematological emergencies
- Severe Anemia wit C.C.F.
- Thrombocytopenia.
- P-falciparum Malaria with complication.
- Thalassemia.
- Haemophillia.
- Disseminated intra vascular coagulation.
- Acute hemolytic crisis.
- Acute haemorrhagic fever.
- Electrolytes and Metabolic emergencies
- Hyperkalemia.
- Hypokalemia.
- Hyper natremia
- Metabolic acidosis.
- Metabolic alkalosis.
- Neurology
- AIDP with unstable vitals.
- C.V. Stroke with unstable vitals.
- GTCS & Status epilepticus.
- Meningitis / Encephalitis.
- Myasthenia crisis.
- GBS.
- Intracranial Hypertension.
- Endocrine
- Hypoglycemia.
- Diabetic ketoacidosis.
- Nonketotic hyperosmolar coma.
- Myxedema coma.
- Acute adrenal insufficiency.
- Thyrotoxicosis – Storm
- Miscellaneous
- Neuroleptic Malignant.
- Tetanus.
- Lactic acidosis.
- Shock.
- Burns.
- Electrical Injuries.
- Anaphylactic reaction.
- Rhabdomyolysis.
- Central venous cannulation.
- Cardioversion.
- Thoracostomy.
- Spinal cord injury
- Multiple fractures.