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Lack of specialist docs and nursing staff in Emergency Department of hospitals of Madhya Pradesh

Bhopal 14.12.2021. According to Dr Naresh Purohit , Executive Member of the Federation of Hospital Administrator
most of the hospitals of the state lacked presence of general doctors, specialists and nursing staff dedicated for emergency departments .
Citing his recent scientific report in the Journal of Hospital Hygeine Principal Investigator for the study Dr Purohit told Blue Eyes that of the 50 emergency care centres in 20 district hospitals, 10 government teaching and 10 private hospital settings of Madhya Pradesh in one year (2020-2021 ),
emergency and injury cases annually accounted for 9-11% of all patients presenting to a health facility, and 19-23% of admissions in government hospitals and 30-34% admissions in private hospitals.

He said amongst the critical infra-related quality parameters assessed in the emergency departments (EDs), the following were important deficiencies: absence of point of care lab 70%, demarcated triage area 65%, police control room 52%, separate access for ambulance 55% and adequate spacing for emergency department 50%

Dr Purohit explained that emergency care can be defined as the delivery of time-sensitive interventions needed to avert death and disability and for which delays of hours can worsen prognosis or render care less effective.

He pointed in his report that while compliance with availability of overall recommended biomedical equipment and critical equipment were largely found satisfactory at all private hospitals 80-85% and government medical college hospitals 62%, deficiencies were found largely in smaller government hospitals 45-60%

He said that since it is essential to have the complete list of all recommended emergency medicines round the clock in the emergency departments, the report revealed that only 9% of all hospitals fulfilled this criterion.

According to the report, many government medical colleges lacked common HDU or high dependency units 55% Cardiac ICU 55% and Neuro ICU 55 %. In addition, they also lacked facilities for Coronary Artery By-pass Graft 55%, Cardiac Cath Labs 30% and interventional radiology 40%.
Dr Purohit revealed in his report that most of the hospitals did not have a dedicated blood bank in the emergency department, nor an existing standard protocol for massive blood transfusion. It also said that the patient disposition time for the sickest group (red zone) was high at government medical colleges 90 minutes vis-a-vis private hospitals 15 minutes.
The reasons for this delay amongst others were due to: high patient load, lack of in-house specialists in the ED, need for multiple cross referrals, with an overarching lack of a dedicated department for emergency services, it added.

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