The Health Department is convening a meeting of various department heads and administrators in Government Medical College Hospital (MCH), Thiruvananthapuram, and select emergency medicine experts from the private sector here on Friday, in an effort to re-organise the working of the Emergency Medicine department at GMCT and to develop a well-coordinated trauma care and management system.
With the work on the new Emergency Medicine Department (Casualty) at MCH nearing completion, there is an urgent need to revamp the current manner of functioning of the department to ensure that emergency patients are being prioritised, resuscitated, and managed with minimal loss of lives.
“ It is a fact that though we have doctors and nurses trained in ATLS-ACLS (Advanced Trauma Life Support-Advanced Cardiac Life Support) protocols, we do not have an organised system for triaging patients and giving them care. Now that the new Emergency wing is coming up with modern facilities, we need to reorganise ourselves better and put certain protocols in place,” MCH Superintendent M.S. Sharmad said.
Work as a team
“The Casualty wing functions in a very compartmentalised manner, rather than as a trauma team. Only faculty from General Medicine, Orthopaedics, General Surgery, ENT, and Oral-Maxillofacial Surgery currently make themselves available at the Casualty. Triaging is often not proper and there are no standard operating procedures (SOPs) or written protocols as to who is in charge of the initial resuscitation of patients before transferring him to the specialist concerned,” a senior Health official said.
There is no centralised system or protocols for managing the resources. The patient with severe head injury might get admitted to the ward but neuro-surgery consultation and other life-determining decisions that should happen in the golden hour gets delayed indeterminately. There is clinical evidence that putting SOPs in place improves the rapid and accurate assessment and management of trauma patients as it determines the roles and responsibilities of every member in the trauma care team.
“We lack a centralised trauma management system wherein there is speedy evacuation of victims from the accident site to empanelled, designated trauma management hospitals. We also realise that there is a clear lack of SOPs at our tertiary care public sector hospitals, which is definitely affecting patient care. These weaknesses have to be rectified and we need to determine whether it can happen by just strengthening government hospitals or if we have to buy the service from designated private trauma management hospitals,” Rajeev Sadanandan, Additional Chief Secretary (Health), told The Hindu.