The public and private hospitals render services like medical, surgical, orthopedic, cardiac and all other services if emergency round the clock

1. MANAGEMENTOFNURSINGSERVICESIN
HOSPITALANDCOMMUNITY-
EMERGENCY AND DISASTER MANAGEMENT
KULDEEP VYAS
ASST.PROF
HOD –COMMUNITY HEALTH NURSING
DSSNI

2. -The public and private hospitals render services like medical,
surgical, orthopedic, cardiac and all other services if
emergency round the clock
-THEY CARE TAKE THE PATIENTS
*WHO ARIVE BY SELF
*BROUGHT BY RELATIVES
*BROUGHT DUE TO RAD TRAFFIC ACCIDENTS
*BROUGHT DUE TO ACCIDENT FALLS AND POISIONING
-Prompt and effective services are to be provided to the
patients because mostly the patients brought are in a life
threatening situation like
*INJURIES-ACCIDENTS,SUICIDAL AND HOMICIDAL
*BURNS-ACCUDENTAL,SUICIDAL AND HOMICIDAL
*POISIONINGS
*SUDDEN ILLNESS
*ACUTE EXACERBATION OF AN EXISTING ILLNESS

3. FUNCTIONS OF EMERGENCY CARE/CASUALITY
IMMEDIATE
RESUSCITATION
CARRING OUT
MEDICO LEGAL
FORMALITIES
ORGANIZING
MANPOWER
SUPPLIES
DISASTER
PREPAREDNESS
MAINTAINING
UPTO DATE LIST
CARRING ON NON
EMERGENCY
SERVICES

4. SITE,AREA AND DESIGN OF EMERGENCY /CASUALITY
-SITUATATED ON THE GROUND FLOOR
-AT THE ENTRANCE ONLY
-IT SHOULD HAVE A PROPER SIGN BOARD WHICH CAN BE ILLUMINATED
-IT SHOULD BE AWAY FROM OTHER DEPARTMENTS
-IT SBETTER TO HAVE 3 SEPARATE DOORES LIKE FOR EMERGENCY,OPD,IPD.
IMPORTANT AREAS ESSENTIAL FOE EFFECTIVE FUNCTIONING OF CASUALITY SERVICES:-
1.RECEPTION COUNTER
2.WAITING AREA FOR RELATIVES
3.SPACE FOR TROLLEYS AND WHEEL CHAIRS
4.ROOM FOR TROLLEY/STRECTCER BOYS AND AMBULANCE DRIVER
5.SPACE FOR SEQURITY STAFFF AND CONSTABLE
6.SPACE FOR ADMINISTRATIVE MEDICAL OFFICER/NIGHT SUPERVISOR
7.SPACE FOR PATIENT BROUGHT DEAD.
FACILITIES FOR MANAGEMENT:-
ONCE A PATIENT HAS ENTERES THE EMERGENCY UNIT THE STAFF AOR THE DUTY
DOCTOR SHOULD ATTEND OR START THE SERVICES FOR THAT THE FACILITIES
REQUIRED ARE AS FOLLOWS
1.AN EXAMINATION ROOM
*2-3 EXAMINATION TABLES WITH ADVANCED CARDIAC FIRST AID KIT
*TABLES ARE SEPERATED WITH SCREENS

5. SITE,AREA AND DESIGN OF EMERGENCY /CASUALITY
2.A TREATMENT ROOM:-
*MINOR ROCEDURES
3.AN OBESRVATION AREA:-
*4-8 BEDS ATLEAST
*PATIENTS REORTS AWAITED
*PATIENTS NEED SPECIALITY CONSULTATION
*PATIENTS NEED ADMISSION/SHIFTING TO OTHER DEPARTMENT
*STABLE AND READY TO LEAVE TO HOME
4.STORAGE SPACE:-
*LINEN
*DRUGS,DRESSING MATERIAL
*IV FLUIDS
*EQUIPMENT
5.SPACE :-
*FOR BIOMEDICAL WASTAGE
6.FIXTURES:-
*ELECTRICAL JUNCTION BOX
*GENERATOR
*OXYGEN CYLINDERS AND SUCTION
7.OTHER SUPPORT DEVICES:-ALL OTHER DEPARTMENTS(RADIOLOGY,BLOOD
BANK,CHEMO,DIALYSIS,OT,LABORATORY.)

6. BEHAVIORAL
SYMPTOMS
PARAMEDICAL
STAFF LABOUR STAFF
NURSING
STAFF
SPECIALIST
DOCTORS
CASUALITY
OFFICERS
SENIOR
PHYSICIAN
PERSONNEL INVOLVED IN EMERGENCY CARE

7. ⦁ POOR UPKEEP OF PREMISIS
⦁ POOR LEVEL OF CEANLINESS
⦁ SHORTAGE OF DOCTORS ON DUTY
⦁ LONG WAITING HOURS DUE TO MORE INCOME OF
PATIENTS,INADEQUATE STAFF,LATE REPORTS,DELAYED
SPECIALITY OPINION
⦁ POOR PUBLIC RELATIONS
⦁ SHORTAGE OF SUPPLIES
⦁ UN NECESSARY ADMISSION OF THE PATIENT FOR
LONGER DURATION.
⦁ DELAYED LEGAL FORMALITIESOR DOCUMENTATION

8. 1.SECURITY:-
ALLTHE
EQUIPMENTS
AND THE
DRUGS AND
SUPPLIES HAVE
TO KEPT UNDER
SEQURITY
SUPERVISION
AND SHOULD
ALLOW LIMITED
ACCESS TO THE
PATIENTS AND
THE PATIENTS
ASWELL AS TO
THE OTHER
DEPARTMENTS
ALSO
2.TRAFFIC
CONTROL:- THE
PATIENT
RELATIVES ARE
A REAL
PROBLEM AT
THE CAUSALITY
UNIT. THE
HOSPITAL
MANAGEMENT
MUST MAKE
SURE THAT
THEY WILL NOT
ENTER IN TO
THE TRIAGE
WHICH MAKES
THE HARMONY
OF THE
HOSPITAL
DISTRUB.
3.TRIAGE:-THE
EMERGENCY
CONDITIONS
ARE TO BE
SORTED OUT
ALONG WITH
THE CAUSE OF
THE
EMERGENCY
PROBLEM AND
HAVE TO SAVE
THE PATIENTS
LIFE.FOR THAT
IT’S THE
RESPONSIBILITY
OF THE HEAD
NURSE TO KEEP
ALL THE
SUPPLIES
READY
4.COMMUNICA
TION:-TO
PROVIDE
QUALITY CARE
AND TO SAVE
THE PATIENTS
LIFE
COMMUNICATI
ON HAS TO BE
MAINTAINED
CLEARLY WITH
ALL THE
DEPARTMENTS
.ALL THE
DOCTORS
SHOULD DE
AVAILABLE ON
LINE ROUND
THE CLOCK
5.AVAILABILITY
OF ALL
MEDICAL
SUPPLIES:-WE
HAVE TO KEEP
ALL THE
EMERGENCY
SUPPLIES
,DRESSING
MATERAIL
READY AND
REGULAR
INTENDING OF
DRUGS IS ALSO
MADE
6.MEDICO
LEGAL ISSUES:-
*NEGLIGENCE
*CONSENT TO
TREATMENT
*INTOXICATED
PATIENT
*PRISIONERS
*MEDICAL
RECORDS
*REPORTING TO
AUTHORITIES
*CLLECTION OF
BLOOD FOR
BLOOD
ALCOHOL
LEVEL
*ABANDONMENT

9. ⦁ DISASTER ISA NATURAL DAMAGE OCCURING TO THE PEOPLE IN THE COMMUNITY
AND ENVIRONMENT CAUSING COMPLICATIONS AND ALTERNATING THEIR NORMAL
LIFE.TO HANDLE SUCH CASES A COMBINED TEAM FORCE ISREQUIRED SUCH AS
PEOPLE DRAWN FROM CIVIL DEFENCE,FIRE RESCURES,GOVERNMENT,NON
GOVERNMENT OFFICIALS AND VOLUNTARY ORGANIZATIONS.
⦁ DEFINITIONS:-
⦁ IT IS A DESTRUCTIVE EVENT THAT CAUSES LOSS OF HUMAN LIFE,AFFECTING THE
HEALTH OF THE HUMANS AND CAUSING FINANCIAL LOSS.
⦁ TYPES OF HAZARDS:-(SHOULD BRIEF EACH TYPE)
1.UNEXPECTED ONSET OF HAZARDS/NATURAL DISASTERS:-
*EARTHQUAKE
*FLOODS
*DROUGHT
*VOLCANIC ERUPTIONS
*TROPICAL CYCLONES
2.MAN MADE ENVIRONMENTAL HAZARDS:-
*NUCLEAR WAREFARE-BLAST,HEAT AMD RADIATIONS
*BIOLOGICAL WARFARE
*CHEMICAL WARFARE
*CONVENTIONAL WARFARE
3.INDUSTRIAL AND TECHNOLOGICAL HAZARDS
4.WARS AND CIVIL STRIFIES
5.EPIDEMIC HAZARDS

10. NATIONAL LEVEL
ORANIZATION
STATE LEVEL
ORGANIZATION
COMMUNITY LEVEL
HELPERS
DISTRICT LEVEL
ORGANIZATION
HEALTH SECTOR
DISASTER
MANAGEMENT

11. IMMEDIATE RELIEF SERVICES
GOVT AND ORGANIZATIONS
HUMAN RIGHTS
ALTERNATIVE CARE
ACCOUNTABILITY SYSTEM
SOCIAL JUSTICE AND EQUITY
RELIEF DEVELOPMENT PLANNING

12. CLINIAL ISSUES
INVOLVEMENT OF
VOLUNTARY WORKERS
EMERGENCY LIGHTS
FRIENDS AND RELATIVES
DISPOSAL OF DEAD
PRESS AND BROADCASTING
SERVICES
PATIENTS BELONGINGS
DONATION OF FOOD,CLOTH
AND DRUGS
BLOOD DONATION ACTIVITY
CROWD CONTROL
DOCUMENTATION
AMBULANCE SERVICES
COMMUNICATION
POLICE DOCUMENTATION
VIP VISITS UNNECESSARY CROWDING