Ever alert for any emer­gency

FrontLine - - INTERVIEW -

the Emer­gency Medicine De­part­ment of the In­sti­tute of Emer­gency Medicine (IEM), Meenakshi Mis­sion Hos­pi­tal and Re­search Cen­tre (MMHRC), Madurai, on a bed in the re­sus­ci­ta­tion bay in Pri­or­ity 1 sec­tor, lay 26­year­old T. Sha­jan. He is on an ar­ti­fi­cial ven­ti­la­tor. Dr Naren­dra Nath Jena, Di­rec­tor and Head, IEM, said: “We have saved his life. His con­di­tion is sta­ble now. He met with an ac­ci­dent when he was rid­ing a mo­tor­cy­cle with­out wear­ing a hel­met. He was brought here a few hours ago. If he had not reached here on time, he would have suf­fered hy­poxia. His blood pres­sure is sta­ble now.”

Sha­jan had suf­fered head in­juries and was fighting for his life when he was brought here. He was un­con­scious. In no time, doc­tors and paramedics of the IEM rushed to at­tend to him and saved his life. When a per­son is brought to the Emer­gency Medicine ward, he is ad­mit­ted to Pri­or­ity 1, Pri­or­ity 2 or Pri­or­ity 3 sec­tors, de­pend­ing on his/her con­di­tion. Per­sons with se­ri­ous in­juries are ad­mit­ted to Pri­or­ity I ward, those with mod­er­ate in­juries to Pri­or­ity 2 and those with mild in­juries to Pri­or­ity 3.

“The In­sti­tute of Emer­gency Medicine is a unique de­part­ment. It is a hos­pi­tal within a hos­pi­tal,” said Dr Jena, a renowned spe­cial­ist in emer­gency medicine who has been trained in sur­gi­cal, med­i­cal, or­thopaedic and pae­di­atric emer­gen­cies at the Chris­tian Med­i­cal Col­lege, Vel­lore. He called the IEM “the front door to the hos­pi­tal”. Whether a per­son has been griev­ously in­jured in any ac­ci­dent or has suf­fered a heart at­tack, a car­diac fail­ure, trauma, stroke, has con­sumed poi­son, fallen from a height, has been bit­ten by a snake or is the vic­tim of a nat­u­ral dis­as­ter, he or she is first brought to the Emer­gency Medicine De­part­ment. (Gov­ern­ment hos­pi­tals call it the “ca­su­alty” de­part­ment.) Doc­tors from var­i­ous spe­cial­ties get to­gether to treat the pa­tient. The pa­tient is then sent to the proper de­part­ment for more treat­ment.

The first one hour is called the golden hour and the first 10 min­utes the plat­inum pe­riod. It is called “life­sav­ing time”. Dr Jena said: “If a per­son has suf­fered a heart at­tack, stroke or trauma or has been bit­ten by a snake, and he is not given proper treat­ment within this time frame, he will die. If a per­son has suf­fered a car­diac ar­rest, the first three to four min­utes are cru­cial, for his heart stops, his pulse drops and he be­comes un­con­scious. He has to be given car­dio pul­monary re­sus­ci­ta­tion.”

If a per­son has suf­fered head in­juries or tho­racic in­juries, or a pelvis frac­ture or ab­dom­i­nal trauma, the emer­gency doc­tor will re­sus­ci­tate him. If this was not done, most of the pa­tients would die, he said. He quoted the World Health Or­gan­i­sa­tion as say­ing that 80 per cent of the peo­ple who were caught in these sit­u­a­tions in In­dia did not get treat­ment within the golden hour.

The Emer­gency Medicine De­part­ment has ed­u­cated man­power who are trained and skilled in pro­vid­ing emer­gency health care. Its doc­tors are equipped with life­sav­ing skills. The wait­ing time is zero. The de­part­ment has ded­i­cated stroke, car­diac and trauma teams, a state­of­the­art 20­bed emer­gency room, an ad­vanced re­sus­ci­ta­tion area, a pae­di­atric emer­gency bay and ven­ti­la­tor fa­cil­i­ties. Every year the IEM treats sev­eral thou­sand most crit­i­cally and se­ri­ously in­jured pa­tients from nearby dis­tricts.

For­mer Pres­i­dent A.P.J. Ab­dul Kalam in­au­gu­rated the IEM on Fe­bru­ary 13, 2015. It is called an in­sti­tute be­cause it has ac­tive aca­demic pro­grammes.

Dr Jena said the MMHRC is “a pioneer in emer­gency medicine” in south­ern Tamil Nadu. “We are the big­gest Emer­gency Medicine De­part­ment in the whole of south­ern Tamil Nadu. When it was es­tab­lished, it had four doc­tors. It now has 40 doc­tors,” he said. In every shift, 10 doc­tors work un­der an ex­pe­ri­enced emer­gency medicine physi­cian.

A Spe­cial Cor­re­spon­dent

DR NAREN­DRA NATH JENA, Emer­gency Medicine. Head, Ac­ci­dent and

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