‘Trauma centre services not of first order’

Casualty treatment does not match level-1 trauma centre, befitting KGMU

LUCKNOW: Treatment at the King George’s Medical University (KGMU) trauma centre is not of the first level as it should have been according to the medical university’s reputation, the hospital advisory committee has said.

“The level of care being provided in the trauma centre casualty does not match level-1 trauma centre, befitting the reputation of the KGMU. At times it is highly compromised as the casualty is managed mostly by non PG residents,” the committee pointed out in its recent meeting. The committee further added, “They are not skilled to provide emergency care. Majority of them has not done ATLS/BLS/ ACLS course and has no concept of triage.”

ATLS/BLS/ACLS are life saving courses that improve clinical skill. Triage is a concept that helps choose the most serious ones from among a set to be attended first. Hence the one with most severe injury will be attended first in the casualty ward. The minutes of the meeting were circulated to the HoDs recently. The non PG residents are expected to have the same skill as PG residents, but the former lack teaching experience.

The committee further observed that non PG residents were not trained in emergency procedures like intubation. This is required frequently for patients coming to the trauma centre. Also help from the anaesthesia/ENT residents was also

not forthcoming, observed the committee.

“Thus the concept of ‘golden hour’ is totally diluted. During the day the situation is somehow managed by CMO but the level of management becomes chaotic after the CMO leaves,” said the committee.

For improving the situation, the committee suggested that senior residents (SRs) should play a bigger role in managing things and the senior faculty should start round from casualty so that if any case is pending it is managed. Also the casualty should be managed by a polytrauma team consisting of SRs of medicine, emergency medicine, surgery/trauma surgery, orthopaedics and anaesthesia.

Priority patient’s call should be attended in 15-minutes and other cases in half hour, and if this was not done there should be disciplinary action, suggested the committee. Dr Santosh Kumar, spokesperson, KGMU said, “The medical university will initiate steps to address the issues and first the doable measures will be introduced to improve services.”