Ever alert for any emergency
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