Dr Tushau Prasad, Consultant Emergency Medicine, Wockhardt Hospitals, Mira Road talks about emergency medicine and care
There are likely more myocardial infarctions in India when compared to other countries in the world. Moreover, ischemic heart disease is the leading cause of death in the country too along with road accident injuries. Communicable diseases are there throughout the country, while non-communicable diseases (heart attacks, strokes, asthma, chronic lung disease, pregnancy-related deaths) account for higher mortality in 30 – 69-year-olds. Emergency medicine is a relatively new concept in India. Not many are aware of it.
Everything about emergency medicine and care
While there is the need for primary prevention and vertical programs to manage the burden of both communicable and non-communicable diseases, they do not provide the complete solution. . Every day, India faces the dual challenges posed by emergencies related to infections and communicable diseases and those related to chronic diseases and trauma. About 20 per cent of all emergency-related visits are related to trauma. According to The World Health Organization (WHO), by 2020 road crashes will cause 546,000 deaths in India. Current data indicate that cardiac diseases and stroke will be a major cause of death and disability in 2020.
The use of protocols also known as standing orders, pre-printed order sets, advanced nursing interventions, advanced triage protocols, and computerised order sets has been recognized as a method of enhancing safety while expediting patient care. Protocols are institution-based guidelines, developed for specific disease conditions or chief complaints, that allow the emergency room to initiate diagnostic tests and interventions. Early implementation of protocols has been reported to decrease patient length of stay in the emergency department by making diagnostic test results available early, improving patient time to care, and bed availability. Using protocols has also been shown to facilitate the early treatment of pain and decrease delays in critical interventions, such as antibiotic administration for patients with pneumonia and thrombolytic therapy for patients with acute myocardial infarction and acute stroke.
The last word
The current scenario represents a unique challenge for the hospital emergency room to treat patients in the 1st hour itself in varied emergencies. To make sure the sickest are identified and receive the best evidence-based treatment the formation of evidence-based protocol which runs in a code format, makes sure all stakeholders respond with an equal level of simultaneous effort towards managing such cases.
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