ABHAY RANJAN Hospitaltrainingreport.pdf

A Report File on
“Hospital Training”
Submitted in Partial Fulfillment of the Requirements for the Degree of
BACHELOR OF PHARMACY
By
ABHAY KR RANJAN
Roll No. 2109920500002
VISHWANATH Institute of Pharmacy
RAIPUR GHAZIPUR
College code: 992
To
DR. A.P.J. ABDUL KALAM TECHNICAL UNIVERSITY
LUCKNOW
SESSION : 2023 - 2024
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HOSPITAL TRANING REPORT
1. ACKNOWLEDGEMENT
The training opportunity I had with Pt.deendyal Upadhyay Govt.Hospital
Varanasi was a great chance for learning and professionals development.
Therefore I consider myself as a very lucky individual as I was provided with an
opportunity to be a part of it . I am also grateful for having a chance of so
wonderful people and professionals who led me though this training period.
I am using this opportunity to express my deepest gratitude and special thanks to
Vishwanath Institute of Pharmacy, Raipur, Ghazipur .who is spite of being
extraordinarily busy with their duties gave us an opportunity so that we could
learn something so important .
I express my deepest thanks to Dr. Prem Prakash Sir, Medical
Superintendent and Dr. Shivesh Jaishwal Sir, Medical officer of Pt.deendyal
Upadhyay Govt.Hospital Varanasi for taking part in useful decision and giving
necessary advices and guidance and arranged all facilities to make life easier I
choose this moment to acknowledge his contribution gratefully.
It is my radiant sentiment to place on record my best regards, deepest sense of
gratitude to Mr. Muneer Ahamad Sir , Pt.deendyal Upadhyay Govt.Hospital Varanasi
for their careful and precious guidance which were extremely valuable for my
study both theoretically and practically.
I would like to thanks Miss.Pooja Singh (HOD) and Dr.Sunil Chaudhary
(Project guide) for the continues guidance and for giving me the opportunity to
completemy internship from Pt.deendyal Upadhyay Govt.Hospital Varanasi.
I perceive as this opportunity as a big milestone in my career development I will
strive to use gained skills and knowledge in best possible way, and I will continue
to work on their improvement.
Thanking you!
Abhay kr Ranjan
B.Pharm 3rd
Year
Roll No. :-2109920500002
VISHWANATH INSTITUTE OF PHARMACY (992) B.PHARM 3RD YEAR
1

2. DECLARATION
I hereby declared this training report entitled “Hospital Training Report’’ for
the award of Bachelor of pharmacy from Dr .APJ Abdul Kalam Technical
University, Lucknow. This training report, submitted by me in practical
fulfillment for the requirement of Bachelor Degree in Hospital traning from
Vishwanath Institute of Pharmacy with the collaboration of Dr. A.P.J Abdul
Kalam Technical University (AKTU) is the result of my original and
independent research work carried out under the supervision and guidance from
vishwanath Instituteof Pharmacy.
I further declare this project work or any part of these has not been submitted by
me anywhere for the award of any degree or other similar title before & embodies
result of my original work and the contents of the case study do not from the
basis for the award of my other degree.
Name : ABHAY Kr RANJAN
Roll No : 2109930500002
Duration of Training : 45 days
Signature of Student
2

3. CERTIFICATE
This is to certify that Abhay Kr Ranjan, has carried out hospital training for
the award of Bachelor of pharmacy from Dr. A.P.J. Abdul Kalam Technical
University, Lucknow under Pt.deendyal Upadhyay Govt.Hospital Varanasi. The
hospital training report prepared by the student himself and the contents of the
training report do not form the basis for the award of any degree to the candidate
or to anybody else from this or any other university.
The Duration of this Hospital training is 45 days from 23- August-2023 to 06-
Oct-2023.
SUPERVISOR HEAD OF DEPARTMENT
Ms. Shivam Patel Dr. Sunil chaudhary
Internal Examiner Professor
vishwanath Institute of Pharmacy Vishwanath Institute of Pharmacy
Place : Raipur
Date : 16-11-2023
3

3(I). CERTIFICATE
This is to certify that Abhay kr Ranjan, has carried out hospital training for the
award of Bachelor of pharmacy from Dr. A.P.J. Abdul Kalam Technical
University, Lucknow under Pt.deendyal Upadhyay Govt.Hospital Varanasi. The
hospital training report prepared by the student himself and the contents of the
training report do not form the basis for the award of any degree to the candidate
or to anybody else from this or any other university.
The Duration of this Hospital training is 45 days from 23- August-2023 to 06-
Oct-2023.
Signature of External Examiner
Date :
4

CONTENTS
S.NO HEADINGS PAGE. NO
1. Acknowledgement 1
2. Declaration 2
3. Certificate 3-5
4. CMO Office Letter 6
5. Vision 8
6. Objective of Hospital Training 9
7. Executive Summary 10
8. About Hospital 11 - 12
9. Different department in hospital 13 - 15
10. Registration Desk 16 - 19
11. Prescription 20 - 25
12. Out Patient Department 26 - 28
13. General Ward 29 - 32
14. Emergency Department 33 - 37
15. Pharmacy Department 38 - 42
16. First Aid Treatment 43 - 47
17. Route of Administration 48 - 52
18. Injection 53 - 63
19. Dressing 64 – 66
20. Pathology & Blood bank 67 – 70
21. Ophthalmoscopy room 71 – 73
22. Maternity Ward 74 – 76
23. Store room 77 – 78
24. Vaccination room 79
25. Hospital waste management 80 – 83
26. Summary 84
27. Observation 85
28. Conclusion 86

4. VISION
The vision of Hospital training is to study the organization of various
departments, the working and development of the organization the present status
of the hospital and future prospects of the organization . To promote civic sense
and shoulder the responsibilities with full potential by being a ultimate healthcare
Professional and a Responsible Pharmacist.
The overall objectives of the study :
1. To study the hospital structure.
2. To know about its products and service activities.
3. To know the different functions of all the departments.
4. To know the responsibilities of top management and how to execute
responsibility.
5. To analyse the working hospital using by analysis of various department.
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6. OBJECTIVES OF HOSPITAL TRAINING
1. Hospital training is an observational oriented procedure in which a person is
able to learn practically from their theoretically knowledge.
2. Hospital training helps to study closely the ground level problems regarding
their job profile.
3. Hospital training provides practical knowledge to the students.
4. Hospital training promotes an environment in which student are induced to
adapt themselves quickly to changed circumstances.
5. Hospital training puts the students in real life situations.
6. Hospital training removes the hesitation of the students regarding their
working skills and personality development.
7. Objective of this Hospital is to provide adequate care and treatment to its
patients free of costs (within the limits imposed by scarce resources).
8. Its principal product is medical, surgical and Nursing Service to the patients
and its central concern is the life and health of the patients
9. Hospital Training serve as a source of information on drug utilization.
10.Hospital Training play organize and implement the policies of the pharmacy.
11.Hospital Training maintain strict inventory of all items received and issued.
12.Hospital Training engage in public health activities to improve the well-being
of the population.
9

7. EXECUTIVE SUMMARY
As a part of a special internship program, I was allowed to get hands on
experience of working with trained professionals of the hospital training and
learning about the nuances of handling and managing operations in the
Pharmacy Department & Dialysis Department.
Throughout my training period in Pt.deendyal Upadhyay Govt.Hospital
Varanasi, I have learnt floor auditing. I have checked every patient's file,
whether all the documents were properly arranged according to the NABH
guidelines or not. I also learnt "nursing educational" part, whether they gave the
exam or not, whether they attain respective classes or not. I have done time
motion study in the dialysis department, the average time of stay of the patient,
how much time the techniciantook for priming, how much time the nurses took
for dressing.
Lastly, to summarize, my overall experience has been a very fruitful one. It was
a good learning experience for me and gave me the first exposure to gain
knowledge about the working of the hospital training.
AXIS INSTITUTE OF PHARMACY (1137) B.PHARM 3RD YEAR

8. ABOUT HOSPITAL
1. Hospitals are centers of treatment . people from all corners of the society
and all walks of life coverage here to cure themselves of their diseases.
2. I did my hospital training Pt.deendyal Upadhyay Govt.Hospital Varanasi
(U.P).
3. They are one of well known government Hospitals in Pandeypur
Varanasi. Backed with a vision to offer the best in patient care and
equipped with technologically advanced healthcare facilities, a team of
well trained medical staff ,non- medical staff and experienced clinical
technicians work.
4. It is centre for all types of medical facilities .
5. This training also made me realize the importance of hospitals for people
and how it affects even the day-to-day lives of them .
6. Not only the patients but also the people working in the hospital are truly
dependent on it.
7. This training report comprises of the whole summary of my training in
this hospital and what I learned from that. what I learned from that.
8. Hospitals consist of departments, traditionally called wards, especially
when they have beds for inpatients, when they are sometimes also called
inpatient wards.
9. Hospitals may have acute services such as an emergency department or
specialist trauma center, burn unit, surgery, or urgent care.
10.These may then be backed up by more specialist units such as the
Following:
 Emergency department
 Pharmacy unit
 Pathology department
 OPD (Out patient department)
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Fig no. 1: Hospital Front View
11.Hospital, an institution that is built, staffed, and equipped for the diagnosis
of disease; for the treatment, both medical and surgical, of the sick and the
injured; and for their housing during this process.
12.Hospitals have long existed in most countries. Developing countries, which
contain a large proportion of the world’s population, generally do not have
enough hospitals, equipment, and trained staff to handle the volume of
persons who need care.
13.Thus, people in these countries do not always receive the benefits of modern
medicine, public health measures, or hospital care, and they generally have
lower life expectancies.
14.Hospitals may be compared and classified in various ways: by ownership
and control, by type of service rendered, by length of stay, by size, or by
facilities and administration provided. Examples include the general
hospital, the specialized hospital, the short-stay hospital, and the long-term-
care facility.

OSPITAL TRANING REPORT
9. DIFFERENT DEPARTMENT IN
HOSPITAL
A hospital is a health care institution providing patient treatment with specialized
medical and nursing staff and medical equipment.
Hospitals consist of departments, traditionally called wards, especially when they
have beds for inpatients, when they are sometimes also called inpatient wards.
Hospitals may have acute services such as an emergency department or specialist
trauma center, burn unit, surgery, or urgent care.
These may then be backed up by more specialist units such as the Following:
1. Emergency department
2. Pharmacy unit
3. Pathology department
4. OPD (Out patient department)
5. Ophthalmoscopy Room
6. Obstetrics and gynaecology & colloquially
7. Maternity ward
8. Store Room
Fig no. 2: Waiting Area
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 Approvels :
1. Building build under strict guidance for complete compliance of NABH,
NABL and even international approved JCI norms.
2. Corporate tie up with client like CGHS, ECHS and TPA approval.
3. Tie up with insurance company under approval to give maximum
advantage to the patients.
(I). Facilities provided by Hospital :
1. 24*7 Emergency :
 Providing services for all the time. In order to prioritize treatment for most
sick patients, EDs use a tool called Triage which means sorting out. Those
patients needing immediate life-threatening measures are treated first.
 Those with minor ailments may have to wait. After resuscitation and initial
stabilization patients are either admitted to the indoor area or discharged to
home with a prescription.
 A good ED is equipped with monitors, point-of-care diagnostics, essential
drugs, and other equipment needed for high-quality medical care to the
patient.
 ED works in close association with other departments like radiology,
laboratory, blood bank, etc.
 Emergency Physicians are well supported by other clinical specialists for
optimum care of the patient. EDs also provide initial critical care for
patients waiting for ICU transfer. Accreditation with International and
national bodies such as JCI and NABH, ensures that the quality of care is
maintained by the ED.
 Many of the illnesses like stroke and heart attack need time-critical
interventions.
 EDs ensure that an early diagnosis and interventions are performed in this
critical time.
 EDs cater to medical emergencies like poisonings, complications of
diabetes, respiratory failure, kidney failure, foreign body
obstructions, abnormalities of cardiac rhythm, etc.
 Surgical emergencies such as road traffic accidents, assaults, burns, acute
pain in abdomen, blockage of blood supply to limbs, bleeding or
perforation of intestines, etc.
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 A well-designed and staffed Emergency Department is capable of
providing good quality emergency care to not only adults but special
population groups such as children, pregnant females, or old age patients.
2. 24*7 Ambulance services :
 24/7 Ambulance services provided. Specially trained people called
emergency medical technicians, or EMTs, ride in ambulances.
 They give sick or injured people emergency medical care before they reach
the hospital.
 Ambulances have many types of equipment that are used to move and to
treat patients.
 Equipment for moving patients includes stretchers and cots with wheels.
 An ambulance’s medical equipment helps to treat breathing problems,
heart attacks, broken bones, and burns right away.
3. 24*7 Patient Admission :
 Patient Reports To The Reception Of The Hospital.
 Front Office Executive Enquires About The Patient’s Problem.
 Front Office Executive Refers The Patient To The Concerned
Department/Doctor.
 Patient Reports There, And Concerned Doctor Investigates The Patient’s
Case History.
 If Required, Patient Is Advised For Admission In The Hospital. In Case Of
Admission, The Patient Is Being Sent To Emergency Department For
Initial Assessment By The CMO From Where He/ She Gets The
Admission Request Form.
 Along With the Admission Request Form Patient’s Attendant Is Being
Referred to Admission & Registration Counter.
 Except For Emergency Cases, Admission to the Hospital is Done Once It
Is Being Recommended by The Specialist During the Patient’s Outpatient
Consultation.
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10. REGISTRATION DESK
1. A Registration desk is an important part of a hospital.
2. The registration desk is often the first contact between the patients and
visitors with the hospital.
3. Anxious patients are welcomed at the registration desk.
4. Registration desk personnel helps patients and visitors to find their way
around the hospital. Complete and accurate patient registration is crucial to
a medical practice's bottom line.
5. Because circumstances and policies change often, staff should confirm and
update patient demographics and insurance information at each visit.
6. Registration provides greater protection for the public.
7. Members of the public can have confidence in knowing that a
professional's standing and qualifications have been independently
verified.
8. Registration is the process by which a company files required documents
with the Securities and Exchange Commission (SEC), detailing the
particulars of a proposed public offering.
9. The registration typically has two parts: the prospectus and private filings.
10.All the non-emergency patients who visit the hospital for the first time (for
Out-Patient consultation, Admission) shall get registered at the registration
counter
11. Patient registration is a complex process that requires a considerable
amount of preliminary patient data input, including.
12. Collection of patient demographic information, including personal and
contact information. Patient referral or appointment scheduling.
13. Registration is the process by which a company files required documents
with the Securities and Exchange Commission (SEC), detailing the
particulars of a proposed public offering.
14. Registration desk personnel helps patients and visitors to find their way
around the hospital.
15. Complete and accurate patient registration is crucial to a medical practice's
bottom line. Because circumstances and policies change often, staff should
confirm and update patient demographics and insurance information at
each visit.
16

16. Registration provides greater protection for the public. Members of the
public can have confidence in knowing that a professional's standing and
qualifications have been independently verified.
(I). Information to be collected at the time of registration :
Following information must be collected from the patient through registration
form –
1. Name
2. Date of Birth
3. Gender
4. Name of guardian (in case the patient is a minor)
5. Relationship with the patient
6. Address
7. Contact number
8. Email address
9. Occupation
10.Health Insurance details (If applicable)
11.Referring doctor’s name (If applicable)
12.For contacting during emergency
 Name of person
 Relationship
 Contact number
(II). Information to be provided to a patient getting registered :
1. Patient getting registered must be informed that this is a one-time
registration and will remain valid for the lifetime.
2. He/she should be told about the unique identification number and that it
can be used to access the hospital’s services in future.
3. He/she shall also be informed about how his/her registration details can be
retrieved other than UIN.
(III). Registering an unidentified patient :
1. In case an identified patient is brought to the hospital (such as an
unconscious patient brought by strangers), an incomplete registration shall
be done by entering the name as ‘Unidentified’ followed by a serial
number.
VISHWANATH INSTITUTE OF PHARMACY (992) HOSPITAL TRANING REPORT

2. For example, first unidentified patient shall be written as ‘unidentified-1’
next one as ‘unidentified-2’ and so on.
3. A UIN will still be generated for that patient and healthcare services can
be provided.
4. The incomplete registration shall be completed as soon as identification
details of the patient become available.
(IV). Retrieving the details of a registered patient :
1. UIN can be used for retrieving the details of the patient in any department
of the hospital.
2. However, if the patient has forgotten his/her UIN, the same can be
retrieved from the HIS, by entering other details of the patient such as
name, date of birth, contact number etc.
(V). Confidentiality of Information :
1. The information collected at the time of registration is private information
of the patient and shall be kept confidential.
2. This is an important part of fulfilling patients' rights.
3. The information shall only be used for the purpose of providing healthcare
services.
4. The access of the patients’ information will only be given to specific
departments and staff.
5. This data shall not be revealed to anyone from outside of the hospital. In
certain circumstances, such as legal authorities requesting for information,
the facility head (or a designated authority) shall take the decision.
(VI). Modifications in details collected during registration :
1. Once the registration is completed, any modification in the information
collected shall generally not be done.
2. However, in certain cases, such as spelling mistake in the name, or a
correction required for insurance claim processing, the facility head (or a
designated authority) shall take a decision on a case to case basis, after
assessing the evidence for modifying information.
3. If modifications are made, a track of all modifications shall be maintained.
(VII). Registration record :
1. As the registration is for the lifetime the registration details shall be saved
and stored for the lifetime in HIS.

2. The registration form filled and signed by patient shall be stored for at least
one year after which it can be discarded through shredding.
3. Patient registration forms are used to register patients for procedures
offered at medical facilities.
4. Whether you need to register new patients for your hospital, clinic, health
center, or private practice, our free Patient Registration Forms will
streamline the registration and onboarding process by seamlessly gathering
patient information online.
5. Simply customize any of the free templates below to match your medical
facility, and you’ll be registering new patients in no time.
6. Patients will be able to provide their personal information, provide
emergency contact numbers, write down their medical histories, attach
files, and submit payments all at once.
7. Submissions will be stored safely in your secure Jot form account, easy for
you and your staff to access from any device.
Fig no. 3: Registration Desk
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11. PRESCRIPTION
1. A prescription contains handwritten instructions for the dispensing and
administering of medications.
2. It can be more than an order for drugs as it can also include instructions for
a therapist, the patient, nurse, caretaker, pharmacist or lab technician for
orders for lab test, x ray, and other assessments.
3. Prescription is defined as a written, printed or in any other form document
issued by a Registered Medical Practitioner or any other licensed
practitioners e.g. Dentist, Veterinarian, BAMS etc which directs or instruct
to a Registered Pharmacist to compound and/or dispense a specific type
and quantity of preparation or prefabricated drug to a Patient or his/her
caretaker.
4. Prescription is a way of communication between physician and pharmacist
in which physician and other healthcare professionals authorized
pharmacist to dispense or compound a specific prescription drug for a
specific patient or caretaker. It is often abbreviated ℞ or Rx.
5. Prescriptions may be entered into an electronic medical record system and
transmitted electronically to a pharmacy.
(I). Under Drug and Cosmetic Act, 1945, A Prescription should have
following particulars :
1. Be in writing and be signed by the person giving it with his usual signature
and be dated by him.
2.
veterinary use.
3. Indicate the total amount of the medicine to be supplied and the dose to be
taken.
(II). Contents of the Prescription :
1. Prescribers office information: Name, qualification, address & Regn. No.
2. Patient information: Name & address, Age, Sex, Ref. No.
3. Date
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Specify the name and address of the person for whose treatment it is given,
or the name and address of the owner of the animal if the drug is meant for

4. Rx Symbol (Known as Superscription Part)
5. Medication Prescribed (Known as Inscription Part)
6. Dispensing directions to Pharmacist (Known as Subscription Part)
7. Directions for patient to be placed on label
8. Refill, Special labeling and /or other instructions
9. Prescriber’s signature and license (or) Drug Enforcement Agency (DEA)
number as required.
(III). Section of Prescription :
1. Superscription :
 The heading with the date and the patient’s name, address, age etc.
 This is derived from the Latin word ‘recipe’ which means to take.
 Instruction is given to the pharmacist as well as the patient to take the
medicine as prescribed.
2. Symbol Rx :
 The Rx stands for “recipe” which in latin mean “to take”.
 The symbol is actually the Roman capital letter R which stands for
recipere.
 The word recipere is an imperative form of the verb ‘recipe’.
 So the entire symbol originates from the word ‘recipient’, making the
symbol Rx a command, an instruction to ‘take this’ medicine.
3. Inscription :
 The information about medication. It has the name of ingredients and the
amount needed.
 It includes the main ingredient, anything that helps in the action of the drug,
something to modify the effects of the main drug, and the “vehicle” which
makes the medicine more pleasant to take.
4. Subscription :
 The subscription section tells the pharmacist how to dispense the drug. this
will have instruction on compounding the drug and the amount needed.
 These are instructions given to the pharmacist for dispensing the number
of doses to the patient and how the medicine has to be taken before meal
or after the meal.
21

5. Signature :
 The signature has the directions that are to be printed on the medicine. The
word “sig” mean write on “label”.
 The signature does not refer to the prescriber’s signature but it is derived
from the Latin word ‘Signature’ which means ‘let it be labeled’.
 It is the part of the prescription where the prescriber instructs the
pharmacist what he wishes to be written on the label of the dispended
product.
(IV). Handling of a Prescription :
The following procedures should be adopted by the pharmacist while handling
the prescription for compounding and dispensing:
1. Receiving
 The prescription should be received from the patient by the pharmacist .
2. Reading and checking of prescription
 A brief examination of each prescription should be made immediately on
receiving it from the patient .
 Every prescription should be read and understood completely before
compounding it. Every word and abbreviation must be interpreted
correctly.
3. Collection of material and weighing
 Material to be used in compounding the prescription should be collected
on the left hand side of the balance and arrange in order in which they are
to be mixed .
 The material which are weighed should be shifted to right hand side of the
balance
 The label of every stock bottle should be read at least 3 times , when taken
from shelf or drawer, when content is removed or weighed and when
container are returned to proper place.
4. Compounding
 Most important phase in handling the prescription .
 In this proper drug is dispensed in suitable form .
22

 It can be achieved only if accuracy is maintained in preparation of
medication .
 Only one prescription should be handled at once. Attention should not be
diverted while compounding .
5. Finishing
 The compounded medicament should be filled in suitable container.
 Various types of container used in pharmacy are for filling unit dosage
form such as capsule , tablet, wide mouth bottle for filling liquid dosage
form ,ointment jars, dropper bottles for eye drops.
 The container available in various shapes , size and colors made up of glass
and plastics or suitable metal .
 The container are suitably labeled with good quality paper and adhesive
should be used for proper labeling size of label should be as per size of
container and include information that are mentioned below :
a. Name of prescription
b. Name of patient’s age , sex
c. Registration number
d. Date of dispensing
e. Direction for use and intake of medication
f. Expiry date
g. Storage condition
h. Name and address of the pharmacy
(IV). Error In Prescription :
1. Abbreviation :
 In most of the prescriptions, abbreviated terms are used by the prescriber
that leads to major errors during interpretation by the pharmacists.
 For example: ‘SSKI’ is the abbreviated term of ‘Saturated Solution of
Potassium Iodide’.
 It is preferable to avoid these types of misleading abbreviations.
2. Names of Drugs :
 Names of some drugs (especially the brand names) either looks or sounds
like.
23

 So any error in the name of a drug will lead to major danger to the patient.
e.g. Althrocin – Eltroxin, Acidin – Apidin etc
3. Strength of the Prescription :
 Drugs are available in the market in various strengths. So a drug must not
be dispensed if the strength is not written in the prescription.
 For example, Paracetamol tablet 500 mg should not be dispensed when no
strength is mentioned in the prescription.
4. Dosage form of the drugs prescribed :
 Many drugs are available in more than one dosage form e.g. liquid, tablets,
injections, or suppositories.
 The dosage form intended for the patient must be mentioned in the
prescription to reduce ambiguity.
5. Dose :
 If an unusually high or low dose is mentioned in the prescription then it
must be consulted with the prescriber.
 Sometimes a sustained-release (SR) dosage form is prescribed thrice or
more times daily.
 Sustained Release dosage forms should be given once or twice a day.
6. Instructions to the Patient :
 Sometimes the instruction for a certain preparation is either omitted or
mentioned partially.
 The quantity of the drug to be taken, the frequency and timing of
administration, and the route of administration should be mentioned clearly
so that it is easy for patients to take medicine.
7. Incompatibilities :
 It is essential to check that there are no pharmaceutical or therapeutic
incompatibilities in the prescription.
 If more than two medicines are prescribed then the pharmacist must see
whether their interactions will produce any harm to the patient or not.
Certain drugs have interactions with food.
 The pharmacist has to advise the patient about it. For example, Tetracycline
should not be taken with milk or antacid.
24

Fig no. 4: Prescription

12. OPD (OUT PATIENT DEPARTMENT)
1. An out patient department is the part of hospital designed for the treatment
of outpatients.
2. This department provides diagnosis and care for patients that do not need
to stay overnight.
3. It is an important part of the overall running of the department.
4. The outpatient department will usually be on the ground floor of the
hospital.
5. Wheel chairs and stretchers are available for non-ambulatory patients.
6. Close at hand will be X-rat facilities, laboratories, the medical record office
and a pharmacy.
7. In the main waiting area there are a range of facilities for the patients and
their families including toilets, public telephones, canteen, and water
dispenser.
8. Some of the hospitals have no separate department for outpatients, so they
may be treated in same department as patients that stay overnight.
9. In distric govt Hospital the timing for OPD is 10:00 AM to
2:00 PM. 10.The abbreviation OPD stands for outpatient
department.
11. In this area of a hospital, patients that need medical assistance are attended
to.
12. People must pay consultation fees, and the doctor will come to the patient
to perform the required examination.
13. Based on the patient's health, the doctor evaluates the patient, does the
appropriate tests, and then prescribes medication and treatment.
(I). The services provided by OPD are mentioned below:
1. Consultation Chambers:
 Consultation chambers are a department of OPD, where patients are given
information about medical, surgical, dietetics, by experts.
2. Examination Rooms:
 The examination rooms are the departments where the patients are
examined to detect the disease of patients.

3. Diagnostics:
 The samples of Radiology, Pathology, Microbiology, and other clinical
services are collected in the diagnostics department.
4. Pharmacy:
 Pharmacy department comes under OPD where medicines are provided to
the patients.
5. Prevention and wellness :
 OPDs provide guidance to the patients for overall wellness and prevention
of health issues.
 Doctors guide patients to maintain a healthy weight, improve sleep,
balance sugar levels, etc.
6. Diagnosis :
 OPD is the first place where the patient and doctor meet and discuss the
patient's health condition.
 After discussing the issue, the doctor suggests the necessary tests for the
patient.
 The lab tests and MRI scans are conducted in the OPD.
7. Treatment :
 Treatment and minor surgeries can be done in the outpatient department.
 Modern OPD has all the necessary equipment to treat a patient.
 Surgeries such as cuts, wounds, etc., can be easily handled in the modern
OPD.
(II). Importance of OPD in Healthcare Systems :
1. An Outpatient Department is at the entrance of any hospital. It acts as the
first place where the patients and doctors communicate.
2. It is a crucial link between the patients and the healthcare system and is
hence inseparable.
3. It is vital in preventing diseases and ensures fast recovery of the patient.
4. It controls the number of patients in the inpatient ward by providing small
surgeries and treatments.
5. It evaluates the patients, and only those who require a bed or special care
are shifted to the inpatient ward. Thus, saving the number of occupied beds.
27

 Generally, people that visit for the first time and have minor health are
treated in OPD.
 Doctors conduct tests, provide consultancy, and give prescriptions to the
patient in the OPD.
Fig no. 5: Out Patient Department Room
28

13. GENERAL WARD
1. A general ward is a large room where people who need medical treatment
stay in general ward.
2. General wards have a cubicle room having eight to ten patients bed and
toilet in wings of the ward.
3. These wards are fully equipped nursing station, attendant couch, qualified
dietitian for diet advice and diet service.
4. In general ward, those patients are only stay who is not suffered from any
chronic disease.
5. People are transferred from the intensive care unit to a general ward when
medical staff decide that they no longer need such close observation and
one-to-one care.
6. General Ward means a Hospital room for the Insured Person’s use during
the Confinement that is a room with more than two patient beds (not
including any companion bed) and one adjoining bathroom.
7. The room has to be air-conditioned. General Ward is defined as a hall that
accommodates up to ten patients.
8. General ward is a common unit where patients who are admitted share the
same room.
9. The ward is equipped with health monitoring systems with one-to-one care
assistance for patients as required.
10.Facilities are catered as per patient's diagnosis, age, comfort and other
essential factors.
11.At most of the medical facilities, there are separate male and female
general wards. Wards for female patients follow guidelines that are
independent from the other types of general wards.
12.To accompany female patients, only female family members or friends are
allowed to wait at the healthcare facility.
13.All the wards are provided with central oxygen, central suction, crash cart,
resuscitation kit, portable suction apparatus and oxygen cylinders, pulse
oximeter, glucometer, etc.
14.Qualified teaching staff, residents and sufficient nursing staff are working
round the clock to monitor and provide care to the patients.
29

15.These wards are fully-equipped nursing station, Attendant couch, Qualified
dietitian for diet advice and diet service.
16.In general ward, those patients are only stay who is not suffered from any
chronic disease.
(I). This list of medical equipment which are allowing hospitals to
afford to carry reserves for general ward :
1. Hospital Stretchers :
 Transporting patients is very important when dealing with emergencies.
 This piece of equipment is an absolute must-have for hospitals to keep on
hand as patients route through their care.
2. Defibrillators :
 Commonly used in life-threatening situations such as cardiac arrhythmias
or tachycardia, defibrillators restore normal rhythm to the heart.
 They’re essential tools that a hospital always needs backups.
3. Anesthesia Machines :
 Anesthesia machines are designed to provide an accurate and continuous
supply of medical gases to maintain a proper level of anesthesia to a
patient.
 Modern anesthesia machines include added tools such as a ventilator,
suction unit, and patient-monitoring devices.
4. Patient Monitors :
 Patient monitors are standard pieces of medical equipment that keep
accurate track of a patient’s condition and state of health during and after
surgery.
 They are necessary for adult, pediatric & neonatal patients.
5. Sterilizers :
 Hospital sterilizers kill all forms of microbial life including fungi, bacteria,
viruses, spores, and all other entities present on surgical tools and other
medical items.
 An autoclave sterilizes equipment and supplies using high-pressure
saturated steam for a short period of time.
30

6. EKG/ECG Machines :
 Electrocardiogram (EKG) machines record the electrical activity of the
heart over a period of time and allow health care providers to monitor the
overall rhythm of the heart and identify any abnormalities.
7. Surgical Tables :
 Surgical tables are necessities for a hospital.
 For patient preparation, surgical procedures and recovery, these pieces of
equipment are essential.
8. Blanket and Fluid Warmers :
 Body temperatures that are not maintained during surgery can lead to post-
surgical complications such as perioperative hypothermia, prolonged
hospitalization and recovery, and an increase in the risk for infection.
That’s why blanket warmers and fluid warmers are so essential for
hospitals to have.
9. Electrosurgical Units :
 An electrosurgical unit is used in surgery to cut, coagulate, or otherwise
alter tissue, often to limit the amount of blood flow to an area and increase
visibility during a surgery.
 This equipment is crucial to cauterizing and minimizing blood loss during
surgery.
(II). Facility requirements in general ward :
1. Each protective environment room shall have an area for hand-washing,
gowning, and storage of clean and soiled materials located directly outside
or immediately inside the entry door to the room.
2. Patient bathing and toilet facilities. Separate toilet, bathtub (or shower),
and hand-washing stations shall be directly accessible from each protective
environment room.
3. Rooms shall have a permanently installed visual mechanism to constantly
monitor the pressure status of the room when occupied by patients
requiring a protective environment. The mechanism shall continuously
monitor the direction of the airflow.
4. Central or point-of-use HEPA (99.97% efficiency) filters capable of
removing particles 0.3 μm in diameter for supply (incoming) air.
31

5. Ventilation to maintain >12 ACH
6. Directed air flow: air supply and exhaust grills located so that clean, filtered
air enters from one side of the room, flows across the patient’s bed, exits
on opposite side of the room
7. Positive room air pressure in relation to the corridor. Pressure differential
of ( >2.5 Pa / 0.01” water gauge)
8. Monitor and document results of air flow patterns daily using visual
methods (e.g., flutter strips, smoke tubes) or a hand held pressure gauge
9. Protective environment room(s) shall have self-closing devices on all room
exit doors.
10.Maintain back-up ventilation equipment (e.g., portable units for fans or
filters) for emergency provision of ventilation requirements for PE areas
and take immediate steps to restore the fixed ventilation
11.Protective environment rooms have special requirements and
considerations during renovation and construction.
12.Protective environment room perimeter walls, ceiling, and floors,
including penetrations, shall be sealed tightly so that air does not infiltrate
the environment from the outside or from other spaces.
a. Proper construction of windows, doors, and intake and exhaust ports
b. Ceilings: smooth, free of fissures, open joints, crevices
c. Walls sealed above and below the ceiling
d. If leakage detected, locate source and make necessary repairs
Fig no. 6: General Ward
32

14. EMERGENCY DEPARTMENT
1. An Emergency Department (ED), also known as an Accident and
Emergency department (A&E), Emergency Room (ER) and Casualty
Department (CD).
2. It is a medical treatment facility specializing in emergency medicine.
3. The emergency department is usually found in a hospital or other primary
care center.
4. Due to the unplanned nature of patient attendance, the department must
provide initial treatment for a broad spectrum of illnesses and injuries,
some of which may be life threatening and require immediate attention.
5. In some countries, emergency departments have become important entry
points for those without other means of access to medical care.
6. The emergency departments of most hospitals operate 24 hours a day,
although staffing levels may varied in an attempt to reflect patient volume.
7. Hospital emergency rooms have served a growing number of people whose
disorders ordinarily do not require immediate attention.
8. Many people, especially those in low-income sections of large cities, find
it difficult to get affordable medical care when they need it and therefore
go to emergency rooms with minor illnesses, including colds. As a result,
the emergency departments are frequently overcrowded.
(I). Roles played by an ED of a hospital:
1. Emergency Department is a session where patient’s vital statistics are
taken
 The first place to go when a person is suffering from a serious illness is
the emergency department of a hospital.
 This is where vital statistics with regards to the person’s health are taken.
 Signs such as blood pressure, body temperature, and whatnot are
documented.
 The doctors and nurses at this department are highly trained to deliver
such services in a timely manner.
33

2. Administration of drugs to the patients :
 After proper examination of the ill individual, ED is also where the
administration of drugs to the patient is carried out.
 Once the doctor on duty has prescribed some drugs based on what is
happening to an individual, the next thing is for the nurses to administer
these drugs.
3. Patients monitoring :
 Another important function of the emergency department in a hospital is
the monitoring of patients’ improvement.
 Though the role of overseeing the patients at all times rests mainly on the
nurses on duty.
 The doctor also comes in periodically to check what improvements have
been recorded compared to the last time of visit.
4. Charting and Discharging :
 While the patient is in the ED of a hospital, the person’s personal
information and medical history are all charted up.
 The reason for taking in all of this information is to give accurate
information to medical personnel that may be in charge of taking care of
the patient if the need arises.
(II). Most people go to EDs with conditions that include:
muscles, ligaments and tendons.
 This is the most common type of injury resulting from a car accident.
 Soft tissue injuries can take many forms.
2. Physical assaults or falls :
 Physical assault means threatening or causing physical harm or engaging
in other conduct that threatens or endangers the health or safety of any
person.
34
1. Injuries from accidents :
 A soft tissue injury is damage to the body’s connective tissue, which means

3. Heart attack and stroke :
 A heart attack occurs when blood flow to a part of the heart is blocked,
usually by a blood clot.
 Without oxygenated blood, the heart muscle begins to die.
 A stroke is a brain attack, cutting off vital blood flow and oxygen to the
brain.
 Stroke happens when a blood vessel feeding the brain gets clogged or
bursts.
point scale with 1 being the least and 10 being the most pain.
5. Problems with breathing or bleeding :
 Breathing problems are when you feel you can’t get enough air, your chest
feels very tight, you are breathless or you feel like you’re being suffocated.
 You might feel short of breath if you are obese or if you have just done
some strenuous exercise.
 It can also happen in extreme temperatures or if you are at high altitude.
6. Broken bones :
 A bone fracture is the medical definition for a broken bone. Fractures are
usually caused by traumas like falls, car accidents or sports injuries.
 But some medical conditions and repetitive forces (like running) can
increase your risk for experiencing certain types of fractures.
7. Loss of consciousness :
 A loss of consciousness occurs when not enough blood reaches the brain
and corresponds to a loss of awareness of oneself and one’s surroundings.
 In most cases it is due to a particular situation; upon receiving bad news,
extreme pain, fear of needles, etc.
 If a patient with a heart or neurological disease, or who takes certain
medicines, loses consciousness, call emergency services immediately.
8. Worsening of a serious illness :
 Serious illness means an accident, injury, illness, disease, or physical or
mental condition that: poses imminent danger of death.
35
4. Severe pain :
 means a level of pain reported by a patient of 8 or higher based on a 10-

 Requires inpatient care in a hospital, hospice, or residential medical
facility; or requires continuing in-home care under the direction of a
physician or health care provider.
9. Drug overdoses or poisoning :
 A person can get drug poisoning by taking the wrong drug combination,
expired medications, overdose of prescribed drugs, illegal/illicit drugs, and
over the counter drugs.
 The effect of the poisoning will be different depending on how the person
takes the drug and the kind of drug.
10.Allergic reactions :
 During a reaction, your immune system releases antibodies.
 These are proteins that deliver a message to cells: Stop that substance! The
cells then send out histamine, which causes blood vessels to expand, and
other chemicals, and these trigger the allergy symptoms.
11.Pregnancy complications :
 Complications can arise in pregnancies for many reasons.
 Sometimes a woman’s existing health conditions contribute to problems.
 Other times, new conditions arise because of hormonal and body changes
that occur during pregnancy.
12.Mental illness :
 Mental illness, also called mental health disorders, refers to a wide range
of mental health conditions — disorders that affect your mood, thinking
and behavior.
 Examples of mental illness include depression, anxiety disorders,
schizophrenia, eating disorders and addictive behaviors.
13.Burns :
 Burns are tissue damage that results from heat, overexposure to the sun or
other radiation, or chemical or electrical contact.
 Burns can be minor medical problems or life-threatening emergencies.
 Many of the direct health effects of a burn are secondary to disruption in
the normal functioning of the skin.
 They include disruption of the skin's sensation, ability to prevent water loss
through evaporation, and ability to control body temperature.
36

 Many of the direct health effects of a burn are secondary to disruption in
the normal functioning of the skin.
 They include disruption of the skin's sensation, ability to prevent water loss
through evaporation, and ability to control body temperature.
Fig no. 7: Emergency Ward
37

15. PHARMACY DEPARTMENT
1. Hospital pharmacy can usually be found with in the premises of the
hospital.
2. Hospital pharmacy usually stock a large range of medications including
more specialized and investigational medications ( medicines that are
being studied but have not been approved),then would be feasible in the
community setting.
3. Hospital pharmacies typically provide medications for the hospitalized
patients only and are not retail establishments.
4. They typically do not provide prescription service to the public.
5. Some hospitals do have retail pharmacies with in them, which sell over the
counter as well as prescription medications to the public, but these are not
the actual hospital pharmacy.
6. Hospital pharmacy ( Dispensary ) is a specialized field of pharmacy that is
integrated into the care of a medical center.
7. These include centers such as a hospital, outpatient clinic, drug-
dependency facility, poison control center, drug information center of
residential care facility.
8. The profession involves choosing, preparing, storing, compounding and
dispensing medications for patients in a medical environment.
9. Another important area is the provision of advice to both patients and other
health professionals about the safe and effective use of medicine.
Fig no. 8: Pharmacy Department
38

(I). Aims of Hospital Pharmacy :
1. The primary mission of hospital pharmacy is to manage the use of
medications in hospitals and other medical centers.
2. Goals include the selection, prescription, procuration, delivery,
administration and review of medications to optimize patient outcomes.
3. It is important to ensure that the right patient, dose, route of administration,
time, drug, information and documentation are respected when any
medication is used.
(II). The duties and responsibilities of a hospital pharmacist are
given below:
1. Compounding and dispensing for indoor and outdoor patient departments.
2. Preparation and sterilization of injectable medications
3. Filing and labeling of medical stocks
4. Proper maintenance of records (especially narcotic medications)
5. Maintaining sufficient stock of emergency medicines
6. Conducting quality check of the source of purchase (medicines, antibiotics,
biological products and other pharmaceutical items)
7. Sharing details of medicine to doctors, specialists, interns, and nurses.
8. Planning and executing the pharmacy & therapeutic committee.
9. Ensuring that the supply of medicines is within the law
10.Making sure that the prescribed medications are suitable for the patients
11.Advising patients according to their symptoms (how & when to take them,
possible reactions, pre-allergy information, answering patient’s doubts and
so on).
12.Supporting patients to make healthier choices, directing them towards
nutritious diet and suitable exercises.
(III). Role of Hospital Pharmacist:
The role of the hospital pharmacist is varied and may include various tasks
including:
1. Devising specific medication plans that are individualized for patients.
2. Assisting physicians and other health professionals to make drug-based
decisions.
3. Compounding medications for use in the hospital.
4. Helping patients to understand their medications and how to take them.
39

5. Conducting clinical trials to uncover new or modified treatments for rare
diseases.
6. Providing medicines in emergency situations.
7. Assisting in specialized medical care, such as for cancer patients.
(IV). Compounding Pharmaceuticals:
Hospital pharmacists are responsible for the compounding of many
pharmaceutical products for patient administration.
1. Some of these formulations need to be sterile, such as when they are given
in total parenteral nutrition (TPN) or for other drugs given intravenously,
such as some antibiotics and chemotherapeutic agents.
2. This process is complex and requires pharmacists to be highly trained in
the production of quality goods, in addition to adequately equipped
facilities.
(V). Drugs Dispensing Procedure:
Drugs dispensing is often portrayed as merely being the process of giving a drug
product to a patient in the hospital.
1. Ensure that the prescription has the name and signature of the prescriber
and the stamp of the health centre.
2. Ensure that the prescription is dated and has the name of the patient.
3. If the prescription has not been written in a known (local)health centre, the
prescriber of the centre should endorse it.
4. Avoid dispensing without a prescription or from an unauthorized
prescriber.
5. Check the name of the prescribed drug against that of the container.
6. Check the expiration date on the container.
7. Calculate the total cost of the drug to be dispensed on the basis of the
prescription where applicable.
8. Inform the patient about the cost of the drug.
9. Issue a receipt for all payments.
40

(VI). Correct drug dispensing :
Dispensed drug should be appropriately labelled, so that the patient can benefit
optimally from the use of the drug.
1. The right patient is served.
2. A desired dosage form of the correct drug is given.
3. The prescribed dosage and quantity are given.
4. The right container that maintains the potency of the drugs is used.
5. Expired drugs should not be dispensed.
6. The container is appropriately labelled.
7. Clear instructions are delivered verbally to the patient.
(VII). Suggestions for some Common Drug:
1. Antacid Tablet : Do not swallow but chew it
2. Diazepam : This drug may cause drowsiness so do not work with
dangerous machinery and do not drive a heavy vehicles and do not drink
alcoholic beverages.
3. Tetracycline : Do not take this medication with milk or antacid.
4. Phenolphthalein : This laxative may colour the urine and feces pink
5. Bisacodyl : Do not take this medication with milk or antacid / Do not
chew the tablet.
6. Phenytoin : Expose yourself to sunlight in the morning.
7. MAO inhibitors : Avoid cheese, chocolate, alcoholic beverages and liver
or yeast extract.
8. Aspirin : Do not take on empty stomach.
9. Ampicillin : This medicine should be taken one hour before meal or
two hour after meal. This drug sometimes causes diarrhea, call your doctor
if it becomes severe. Complete the course of drug otherwise reoccurrences
of disease take place.
10.Boric Acid : Contraindicated in children under 12 years old. Not for
internal use.
11.Antidiadetic drug : Avoid alcoholic beverages while on drug therapy.
12.Diphenhydramine : It may cause sedation
13.Haematinics : It may create metallic taste in mouth
14.Castor oil : Avoid in Pregnancy
15.Reserpine/ Tolbutamide : Do not take with meals
41

(VIII). The various drugs which are being distributed are:
1. Alusil-C - Antacid chewable tablets
2. Paracetamol tablets and suspension
3. Calcium tablets
4. B-complex tablets
5. Doxycyclin capsules
6. Diclofenac sodium tablets
7. Tramadol tablets
8. Atenolol tablets
9. Levofloxacin capsules
10. Montelukast tablets
11. Aceclofenac tablets
12. Salbutamol Sulphate Tablets
13. Multivitamin capsules
14. Dexamethasone tablets
15. Betamethasopne tablets
16. Theophylline tablets
17. Vitamin c tablets
18. Oflaxacin tablets
Fig no. 9: Medicine Dispensing Room
42

16. FIRST AID TREATMENT
1. First aid is the aissistance given to any person suffering a sudden illness
or injury with care provided to preserve life, prevent the condition from
worsening , and her to promote recovery.
2. It includes initial intervention in a serious condition prior to professional
medical help being available, such as performing CPR while awaiting an
ambulance, as well as the complete treatment of minor conditions, such as
applying a plaster to cut.
3. First aid generally performed by the layperson , with many people trained
in providing basic level of first aid , and others willing to do so from
acquired knowledge mental health.first aid is an extension of the concept
of first aid to mental health .
4. There are many situations that may require first aid, and many countries
have legislation, regulation, or guidance, which specifies a minimum level
of first aid provision in certain circumstances.
5. This can include specific training or equipment to be available in the
workplace (such as an automated external defibrillator),
6. The provision of specialist first aid cover at public gatherings, or
mandatory first aid training within schools.
7. First aid, however, does not necessarily require any particular equipment
or prior knowledge, and can involve improvisation with materials available
at the time, often by untrained people.
8. First aid is as easy as ABC – Airway, Breathing and CPR
(cardiopulmonary resuscitation).
9. First aid is the support given to a casualty or a sick person for any injury
or sudden illness before the arrival of an ambulance.
10.A qualified paramedical or medical person or before arriving at a facility
that can provide professional medical care.
11. First Aid is not about giving medicine or diagnosing a condition.
12. As a consequence of disaster emergencies or accidents people suffer
injuries which require urgent care and transportation to the nearest
healthcare facility.
43

(I). Aim Of First Aid :
The primary goal of first aid is to prevent death or serious injury from worsening.
The key aims of first aid can be summarized with the acronym of 'the three Ps'.
1. Preserve life:
 The overriding aim of all medical care which includes first aid, is to save
lives and minimize the threat of death.
 First aid done correctly should help reduce the patient's level of pain and
calm them down during the evaluation and treatment process.
2. Prevent further harm:
 Prevention of further harm includes addressing both external factors, such
as moving a patient away from any cause of harm, and applying first aid
techniques to prevent worsening of the condition, such as applying
pressure to stop a bleed from becoming dangerous.
 First aid also involves trying to start the recovery process from the illness
or injury, and in some cases might involve completing a treatment, such as
in the case of applying a plaster to a small wound.
 Note : It is important to note that first aid is not medical treatment and
cannot be compared with what a trained medical professional provides.
First aid involves making common sense decisions in the best interest of
an injured person.
(II). First Aid Kit :
 A first aid kit consists of a strong, durable bag or transparent plastic box.
 They are commonly identified with a white cross on a green background.
 A first aid kit does not have to be bought ready-made.
 The advantage of ready-made first aid kits are that they have well
organized compartments and familiar layouts.
44
3. Promote recovery:

(III). Items in first aid kit :
First Aid Kits for the Workplace lists the following items-
1. Information leaflet
2. Medium sterile dressings
3. Large sterile dressings
4. Bandages
5. Triangular dressings
6. Safety pins
7. Adhesive dressings
8. Sterile wet wipes
9. Microporous tape
10.Nitrile gloves
11.Face shield
12.Foil blanket
13.Burn dressings
14.Clothing shears
15.Conforming bandages
16.Finger dressing
17.Antiseptic cream
18.Scissors
19.Tweezers
20.Cotton
(IV). Essential Content of the First Aid Box and their Uses
1. A box of adhesive dressing (Plasters) of different sizes for covering small
wounds.
2. A roll of plaster (Cloth backed, plasticized or micro-pore tape). Blunt-
ended scissors for cutting bandage of plaster.
3. Antiseptic lotion to use with the cotton wool and antiseptic wipes.
4. Cotton wool for cleaning cuts and gauzes.
5. Some triangular bandages to several safety pins for making a sling or
emergency bandage.
6. Sterile dressings (field dressings) of various sizes for covering wounds.
Sterile eye dressings with bandage attached for eye injuries.
7. Aspirin or paracetamol preferably sealed in foil to give longer life.
8. Anti histamine cream for insect bites and stings.
9. Tweezers for removing splinters.
45

10.Tubular gauze bandages for finger injuries and applicator tongs.
11.Two or three crepe or conforming bandages for sprains and for wounds in
awkward places such as elbows and ankles
(V). First Aid Services :
1. Some people undertake specific training in order to provide first aid at
public or private events, during filming or other places where people
gather.
2. They may be designated as a first aider, or use some other title.
3. This role may be undertaken on a voluntary basis with organizations such
as the Red Cross and St. John Ambulance or as paid employment with a
medical contractor.
(VI). Benefits of Learning Basic First Aid :
1. It helps your workplace meet with health & safety standards.
2. Most first aid training courses include only one day training sessions.
3. It will help you stay calm & provide medical assistance.
4. Initial medical assistance will help the patient and avoid further
complications.
5. In some case they can help save a person’s life.
46

Fig no. 10: Essential content for fisrt aid box
47

17. ROUTE OF ADMINISTRATION
Route of Administration
Local
Parenteral
Fig no.11 : Route of Administration
1. The route of drug administration is simply defined as the path by which a
drug is taken into the body for diagnosis, prevention, cure or treatment of
various diseases and disorders.
2. For a drug to produce its desired therapeutic effect, it must come in contact
with the tissues of organs and cells of tissues by one way or the other; and
for this to take place the drug must be administered in the appropriate
manner.
3. The route of administration of a medication directly affects the drug
bioavailability, which determines both the onset and the duration of the
pharmacological effect.
4. The choice of route of administration may be influenced by many factors
among which include:
5. Enteral route involves absorption of the drug via the gastrointestinal tract
and includes oral, sublingual, and rectal administration.
48
Enteral
1. Skin topical
2. Intranasal
3. Ocular drops
4. Inhalational
5. Transdermal
6. Mucosal-
throat, Vagina,
Mouth, Ear
Systemic
1. Oral
2. Sublingual
3. Rectal
1. Intravenous
2. Intramuscular
3. Subcutaneous
4. Intra-arterial
5. Intra-articular
6. Intradermal

6. Parenteral route, on the other hand, refers to any routes of administration
that do not involve drug absorption via the gastrointestinal tract (par =
around, enteral = gastrointestinal), including injection routes (e.g.,
intravenous route, intramuscular route, subcutaneous route etc.),
inhalational and transdermal routes.
(I). Different routes of drug administration :
The main routes of drug administration include:
1. Oral route :
 This is the most frequently used route for drug administration. When
possible, it is the first choice for the administration of drugs, since it is both
convenient and economical.
 Drugs administered orally are placed in the mouth and swallowed.
 Most drugs that are given orally are absorbed into the circulation from the
gastrointestinal tract very efficiently within the limits of the
physicochemical properties of the drug concerned.
 Certain drugs are taken orally for their local effects within the bowel e.g.,
antacids for heartburn and ezetimibe for the reduction of cholesterol
absorption.
 Oral agents must be able to withstand the acidic environment of the
stomach and must permeate the gut lining before entering the bloodstream.
 The most popular oral dosage forms are tablets, capsules, suspensions,
solutions, and emulsions.
2. Sublingual/ Buccal route :
 In this route of administration, the drug is placed under the tongue
(sublingual route) or between gums and inner lining of the cheek (buccal
route).
 In both cases, the drug is allowed to dissolve, avoiding swallowing as far
as possible.
 The drug is rapidly absorbed through the mucosa into circulation, thereby
bypassing the portal circulation and, thus, the first-pass metabolism in the
liver.
 Sublingual and buccal routes are of value when the medication concerned
is destroyed or partially inactivated in the stomach if swallowed and when
a more rapid action is required.
 These routes however are not suitable for bitter preparations.
49

 Examples of drugs administered through sublingual and buccal routes are
nitro-glycerine (glyceryl trinitrate), buprenorphine, and desamino-
oxytocin.
3. Rectal route :
 Medications are sometimes ordered to be administered by rectal route.
 The rectal mucosa is capable of absorbing many soluble drugs into the
circulation.
 Rectal medication may be in suppository form or in liquid form to be
administered as a retention enema.
 Unlike the oral route, drugs with irritant or unpalatable nature can be
administered through the rectum.
 Rectal route can also be preferred when the patient has persistent vomiting
or is unable to swallow.
 Also, this route can be used for systemic drug administration in addition to
the local administration.
4. Topical route :
 Drugs are applied topically, that is to the skin or mucous membrane of the
eye, ear, nose, mouth, vagina, etc., mainly for local action.
 This route provides a high local concentration of the drug without affecting
the general circulation.
 However, drugs that are absorbed into the circulation after local
administration may then have systemic effects.
 Drugs for topical applications are usually available as creams, ointments,
liniments, and drops.
5. Trans dermal route :
 The transdermal route is commonly referred to as “the patch” because the
medication is contained in a patch that is absorbed through the skin.
 Drugs administered through this route must be highly lipophilic.
 Absorption via this route is slow but conducive to producing long-lasting
effects.
 Special slow-release matrices in some transdermal patches can maintain
steady drug concentrations that approach those of constant IV infusion.
50

 Transdermal patches also provide less absorption problems in the
gastrointestinal tract that are commonly experienced by patients who
take oral medications.
 Drugs administered through this route include fentanyl patches for severe
pain management, nitroglycerin transdermal patch used to prevent
episodes of angina in people who have coronary artery disease, nicotine
patches for cessation of smoking, etc.
6. Inhalational route/ pulmonary route :
 Drug delivery by inhalation is a common route, both for local and for
systemic actions.
 This delivery route is particularly useful for the direct treatment of
asthmatic problems, using both powder aerosols (e.g. salmeterol
xinafoate)
 Pressurized metered-dose aerosols containing the drug in liquefied inert
propellant (e.g. salbutamol sulphate inhaler).
 Drugs may be inhaled as gases (e.g., nitrous oxide) and enter the
bloodstream by diffusing across the alveolar membrane.
 This is the method of administration of volatile anesthetics such as ether,
halothene, and methoxyflurane.
 The lungs provide an excellent surface for absorption when the drug is
delivered in gaseous, aerosol mist or ultra-fine solid particle form.
 This results in rapid onset of action.
 Another advantage is that plasma concentration can be rapidly adjusted as
well.
7. Systemic route :
 This is the second commonest route of drug administration.
 They mainly involve introducing the drug in form of solution or suspension
into the body at various sites and to varying depths using syringe and
needle.
 Thus administration involves risk of infection, pain, and local irritation.
51

Fig no. 12: Different route of Administration
52

18. INJECTION
1. Injections, also known as shots, deliver liquid medications, fluids, or
nutrients directly into a person’s body.
2. A healthcare professional can use injections to administer vaccines and
other types of medications into a person’s vein, muscle, skin or bone.
3. Several different types of injections exist, depending on the purpose of the
medication or substance in the shot.
4. A healthcare professional can inject many medications into many parts of
the body.
5. They will decide the most appropriate route of access depending on the
situation.
6. Most injections consist of needle and syringe.
7. A doctor may also use a newer device, such as auto and jet injection.
8. Doctor will decide the most appropriate route of access depending on the
situation.
9. An injunction is a legal ruling by a judge that mandates an individual or
other entity to either stop or start some action.
10.The three main instances of an injunction are restraining orders,
preliminary (temporary) injunctions, and permanent injunctions.
11.Cease and desist orders are a common type of injunction that demands an
individual or entity to stop some activity.
12.Injunctions are also used by a court when monetary restitution isn't
sufficient to remedy the harm. For example, in addition to making a
financial judgment against a defendant, a court might issue a permanent
injunction ordering that the defendant does not participate in a certain
activity or business.
13.All injections are considered forms of parenteral adminiseration, which
avoids the first pars metabolism which would potentially affect a
medication absorbed through the GI tract.
(I). Parental routes of administration
An injection is an infusion method of putting fluid into the body , usually with a
syringe and a hollow needle which is pierced through the skin to a sufficient depth
for the material to be administered into the body.
1. Intradermal injection :
53

 Intradermal injection of small amounts of material into the corium or
substance of the skin done in diagnostic procedures and in administration
of regional anesthetics, as well as in treatment procedures.
 In certain allergy tests, the allergen is injected intracutaneously.
 In this, medication is delivered directly into the dermis, the layer just below
the epidermis of the skin.
 The injection is often given at a 5 to 15 degree angle with the needle placed
almost flat against the patient’s skin.
 Absorption takes the longest as compared to the parenteral routes.
 This route is often used for sensitivity tests like tuberculin and allergy tests
and local anaesthesia test.
 Common sites of this are forearm and lower back.
Fig no. 13: Intradermal Injection
2. Intramuscular injection :
 Intramuscular injection injection into the muscle of the upper arm , thigh
or buttock at 900
angle.
 Intramuscular injections are given when the substance is to be absorbed
quickly .
 They should be given with the extreme care , especially in the buttock ,
because the sciatic nerve may be injured or a large blood vessel may be
entered if the injection is not made correctly into the upper , outer quadrant
of the buttock.
54

 The speed of absorption from site of injection is dependent on the vehicle
used, absorption is quick from aqueous solutions and slow from oily
preparations.
 Absorption is complete, predictable and faster than subcutaneous route.
Fig no. 14: Intramuscular Injection
3. Subcutaneous injection :
 Subcutaneous injection made into the subcutaneous tissues.
 Although usually fluid medications are injected, occasionally solid
materials such as steroid hormones may be injected in small, slowly
absorbed pellets to prolong their effect.
 Subcutaneous injections may be given wherever there is subcutaneous
tissue, usually in the upper outer arm or thigh.
 This method is particularly useful when continuous presence of the drug in
the tissues is needed over a long period.
 The usefulness of this method is enhanced by the use of depot preparations
from which the drug is released more slowly than it is from simple solution
rosis (deadening of tissues) at the site of injection. E.g. Insulin
55

Fig no. 15: Subcutaneous injection
4. Intravenous injection :
 Intravenous is a term that means “into the vein” Intravenous medication
administration occurs when a needle is inserted into a vein and medication
is administered through that needle.
 the needle is usually placed in a vein near the elbow, the wrist , or on the
back of the hand different sites can be used if necessary.
 Drug solution is injected directly into the lumen of a vein so that it is diluted
in the venous blood.
 The drug is carried to the heart and circulated to the tissues.
 Drugs in oily vehicle or those that cause haemolysis should not be given
by this route.
 Since the drug is introduced directly into the blood, the desired
concentration of the drug is achieved immediately which is not possible by
any other procedure.
 This route is of prime importance in emergency.
 Also certain irritant drugs could be given by this route.
 Also this is the only route for giving large volume of drugs. Eg- Blood
transfusion.
 The injection is often given at 25 degree.
56

Fig no. 16: Intravenous Injection
5. Intrathecal Injection:
 Blood brain barrier often prevents the entry of certain drugs into the central
nervous system.
 Thus when local and rapid effects of drugs on meanings are desired the
drugs are injected to the Subarachnoid space and effects of the drugs are
then localized to the spinal nerves and meanings e.g. intrathecal injection
of streptomycin in tuberculosis and meningitis used to be used by this route
but with the invention of third generation cephalosporin’s it is not used any
more to treat these conditions.
 The injection of local anesthetics for the induction of spinal anesthesia is
given by this route. Eg- spinal anasthetics.
57

Fig no. 17: Intrathecal Injection
6. Intraperitoneal Injection:
 The peritoneum offers a large absorbing surface area from which the drugs
enter the circulation rapidly but primarily by way of portal vein.
 Hence first pars effect not avoided.
 This is probably the most widely used route of drug administration in
laboratory animals.
 In humans, it is very rarely employed due to the dangers of infection and
injury to viscera and blood vessels. Eg. Peritoneal dialysis in case of renal
insufficiency.
Fig no. 18: Intraperitoneal Injection
58

7. Intra cardiac Injection:
 Injection can be applied to the left ventricle in case of cardiac arrest.
 The goal of the procedure is to administer epinephrine rapidly to improve
the likelihood of achieving a return of spontaneous circulation (ROSC).
 This is typically performed on patients in cardiac arrest with dysrhythmias
such as asystole, pulseless electrical activity, or ventricular fibrillation.
Fig no. 19: Intra cardiac injection
8. Intra – articulate Injection:
 This route involves injection into the joint cavity.
 Corticosteroids may be injected by this route in acute arthritis.
 Corticosteroids (steroids), local anesthetics, hyaluronic acid, and Botox are
the most common substances injected into joints for this treatment.
59

Fig no. 20: Intra – articulate Injection
18(I). VARIOUS INJECTIONS
Fig no. 21: Various types of Injections
1. Avil Injection :
 Primarily used to treat a allergic reaction caused by insect bites/stings,
certain medicines, or hives (rashes, swelling, etc.).
 It is also used in the prevention and treatment of nausea, vomiting and
dizziness due to inner ear disorders (eg. Meniere's disease) and travel
sickness.
60

2. Coramine Injection :
 Coramine is a stimulant which mainly affect the respiratory cycle.
 Nikethamide is a stimulant which mainly affects the respiratory cycle.
Widely known by its former trade name of Coramine.
 It was used in the mid-twentieth century as a medical countermeasure
against tranquilizer overdoses, before the advent of endotracheal intubation
and positive-pressure lung expansion.
3. Adrenaline Injection :
 Treat life threatening allergic reactions caused by insect bite or stings.
 Epinephrine injection is used along with emergency medical treatment to
treat life-threatening allergic reactions caused by insect bites or stings,
foods, medications, latex, and other causes.
 Epinephrine is in a class of medications called alpha- and beta-adrenergic
agonists (sympathomimetic agents).
4. Atropin Injection :
 Atropine injection is given before anaesthesia to decrease mucus secretions
such as saliva.
 During anaesthesia and surgery, atropine is used to help keep the heart beat
normal.
 Atropine sulfate monohydrate is also used to block or reverse the adverse
effects caused by some medicines and certain type of pesticides.
5. Deriphylline Injection :
 Used to treat asthma and chromic obstructive pulmonary disorder (a lung
disorder in which the flow of air to the lungs is blocked).
 It helps in relaxing the muscles of the air passages and making it easier to
breathe.
 Deriphyllin Injection should be used with caution if you have hypertension
as it may further increase your blood pressure leading to a heart attack.
6. Aciloc Injection :
 Aciloc is used to reduce the amount of acid produced in the stomach.
 Aciloc Injection belongs to a group of medicines called H2-receptor
antagonists.
61

 It reduces the amount of acid your stomach makes and relieves the pain
associated with heartburn and acid reflux.
 You should take it exactly as it is prescribed for it to be effective.
 It is antacid medicine that is used in the treatment of stomach and intestinal
ulcers, heartburn, indigestion and gastroesophageal reflux disease.
7. Dicyclomin Injection :
 Dicyclomin used to treat bowel problem including irritable bowel
syndrome.
 Dicyclomine is in a class of medications called anticholinergics.
 It relieves muscle spasms in the gastrointestinal tract by blocking the
activity of a certain natural substance in the body.
 It is believed to be effective in reducing spasm of the bowel.
 This medicine may be used for other purposes; ask your health care
provider or pharmacist if you have questions.
8. Tramadol Injection :
 It help to relieve moderate to severe pain in condition that affect joints and
muscles.
 It is commonly used for the diagnosis or treatment of intense sudden pain,
long time pain .
 It has some side effects such as Abdominal cramps, Asthenia, Bloating,
Abnormal sensation.
 Tramadol oral tablet may cause drowsiness.
 You should not drive, use heavy machinery, or perform any dangerous
activities until you know how this drug affects you.
 Tramadol may also cause other side effects.
9. Laxis Injection :
 It help your body get rid of extra water by increasing the amount of urine
you make.
 It helps your body get rid of extra water by increasing the amount of urine
you make.
 Getting rid of extra water decreases the strain on your heart and blood
vessels, thereby lowering high blood pressure and reducing your risk of
strokes, heart attacks, and kidney problems.
62

10. Epsolin Injection :
 Commonly used for the diagnosis or treatment of seizure, migraine, cardiac
arrhythmias.
 It has some side effects such as Bruising or bleeding, Anemia, Depression,
Constipation.
 The salts Phenytoin are involved in the preparation of Epsolin injection.
 It works by decreasing the nerve impulses which cause the seizures, by
controlling the frequency of seizures, it will help you go about your daily
activities with more confidence.
11.Paracetamol Injection :
 It used to relieve mild to moderate pain and to treat fever.
 It belongs to the group of medicines called analgesic and antipyretic agents.
 Pain is a symptom triggered by the nervous system, which causes
uncomfortable sensations in the body,which prevents the formation of
chemical messengers called prostaglandins, which cause pain and swelling
at the injury sites.
 This process reduces the mild to moderate pain and inflammation at the
injured or damaged site.
63

19. DRESSING
1. A dressing is a sterile pad or compress applied to a wound to promote
healing and protect the wound from further harm.
2. A dressing is designed to be in direct contact with the wound as
distinguished from a bandage , where is most often used to hold a dressing
in place many modern dressings are self – adhesive .
3. Dressings serve a variety of purpose depending on the type , severity and
position of the wound .
Dressings are also important to help:
 Stop bleeding and start clotting so the wound can heal.
 Absorb any excess blood plasma and other fluids.
 Wound debridement.
 Begin the healing process.
Fig no. 22: Dressing
64

(I). Purpose of Dressing:
A dressing can have a number of purposes, depending on the type, severity and
position of the wound, although all purposes are focused towards promoting
recovery and preventing further harm from the wound.
Key purposes of are dressing are:
1. Stem bleeding: Helps to seal the wound to expedite the clotting process.
2. Absorb exudates: Soak up blood, plasma and other fluids exuded from the
wound, containing it in one place
3. Ease pain: Some dressings may have a pain relieving effect, and others
may have a placebo effect.
4. Debride the wound - The removal of slough and foreign objects from the
wound.
5. Protection from infection and mechanical damage, and
6. Promote healing – through granulation and epithelialisation.
(II). Types of Dressings :
1. Hydrocolloid: Hydrocolloid dressings are used on burns, light to
moderately draining wounds, necrotic wounds, under compression wraps,
pressure ulcers and venous ulcers.
2. Hydrogel: This type of dressing is for wounds with little to no excess
fluid, painful wounds, necrotic wounds, pressure ulcers, donor sites,
second degree or higher burns and infected wounds.
3. Alginate: Alginate dressings are used for moderate to high amounts of
wound drainage, venous ulcer, packing wounds and pressure ulcers in stage
3or 4th
.
4. Collagen: A dressing can be used for chronic or stalled wounds, ulcer, bed
sores, transplant sites, surgical wounds.
(III). Preparation of Dressing :
1. Introduce yourself to the patient and explain what you are doing and why.
If possible, provide privacy.
2. Position the patient comfortably and make sure the surrounding area is
clean and tidy before you start.
65

3. Check the patient's care notes to update yourself on any changes in the
patient's condition and to make sure the dressing is due to be changed.
4. Wash your hands and put on an apron.
5. Clean the trolley using soap and water, or disinfectant, and a cloth. Start at
the top of the trolley and work down to the bottom legs of the trolley using
single strokes with your damp cloth.
6. Place the sterile dressing/procedure pack on the top of the trolley.
7. Open the sterile dressing pack on top of the trolley.
8. Open the sterile field using the corners of the paper.
9. Open any other sterile items needed onto the sterile field without touching
them.
(IV) Removing an Old Dressing :
1. Wash your hands and put on non-sterile gloves (to protect yourself) before
removing an old dressing. Dispose of this dressing in a separate dirty
clinical waste bag.
2. Complete a wound assessment. This includes a visual check and comparing
and evaluating the smell, amount of blood or ooze (excretions) and their
colour, and the size of the wound.
3. If the site has not improved as expected, then the treating physician or
senior charge nurse must be informed so they too can evaluate it and
consider changing the care plan.
(V) After the procedure of Dressing :
1. Fold up the dressing/procedure pack and place all contaminated material
in a bag designated for clinical waste, making sure all sharps are removed
and disposed of in a sharps container.
2. Remove gloves and place in waste bag.
3. Wash your hands.
4. Clean the trolley with soap and water or disinfectant solution as before.
5. Record (document) on the patient's chart your wound assessment, the
dressing change and the care you have given.
6. Provide the patient with some dressing management education and answer
any questions before you go.
7. Report any changes to a senior nurse or doctor.
66

20. PATHOLOGY DEPARTMENT & BLOOD
BANK
1. Pathology is a branch of medical science primarily concerning the cause,
origin and nature of disease.
2. It involves the examination of tissues, organs, bodily fads and autopsies in
order to study and diagnose disease.
3. These labs perform tests to monitor the prevalence of certain diseases in
the community which are a public health concern, such as outbreaks of
foodborne or waterborne illnesses or detection of unique infectious agents.
4. The Department of Pathology is dedicated to understanding the
complexities of the general study of diseases of the human body systems,
blood diseases and forensic and to focus on the development of the key
skills and expert knowledge-base necessary to accelerate career
development and promote excellence in clinical care.
5. A blood bank is a center where blood gathered as a result of blood donation
is stored and preserved for later use in blood transfusion.
6. The term "blood bank" typically refers to a division of a hospital where the
storage of blood product occurs and where proper testing is performed.
Fig no. 23: Pathology Department
67

(I). Components of a pathology report :
In most cases, a pathology report contains the following information:
1. Your name and your individual identifiers.
2. These include date of birth, patient ID number, or Social Security number.
3. A case number. This is used to identify your specimen.
4. The date and type of procedure by which the specimen was obtained (for
instance, a blood sample, surgery, or biopsy)
5. Your medical history and current clinical diagnosis
6. A general description of the specimen received in the lab
7. A detailed description of what the pathologist sees during microscopic
exam of the specimen
8. The final diagnosis, which is the "bottom line" of the testing process. Your
medical provider relies on the final diagnosis to help choose the best
treatment choices
9. The name and signature of the pathologist, as well as the name and address
of the pathology lab
(II). Here are some common tests performed during the hospital
training in hospital.
1. Widal test :
 Salmonella typhi and Salmonella paratyphi, A, B and C cause enteric fever
(typhoid and paratyphoid) in humans.
 Laboratory diagnosis of enteric fever includes Blood culture, Stool,
Culture, and Serological test.
 Widal test is a common agglutination test employed in the serological
diagnosis of enteric fever.
 This test was developed by Georges Ferdinand Widal in 1896 and helps
the to detect the presence of salmonella antibody in a patient's serum.
2. Pregnancy test :
 A pregnancy test is a way to determine if you’re pregnant.
 If your pregnancy test is positive, it means you’re pregnant.
 If the test is negative, it means you aren’t pregnant.
 Pregnancy tests work by detecting human chorionic gonadotropin (HCG),
a hormone your body makes when you’re pregnant.
68

3. Glucose test :
 Both low blood sugar (hypoglycemia) and high blood sugar
(hyperglycemia) are of concern for patients who take insulin. It is
important, therefore, to carefully monitor blood glucose levels.
 In general, patients with type I diabetes need to take readings four or more
times a day.
Patients should aim for the following
a. Pre-meal glucose levels of 70 - 130 mg/dL.
b. Post-meal glucose levels of less than 180 mg/dL.
4. Urine test :
 A urinalysis or urine test is a non-invasive procedure to check for the
composition of urine, which is helpful in detecting some types of medical
conditions like diabetes, urinary tract infection, and kidney-related
diseases, to name a few.
5. Blood group test :
 A test to determine a person's Blood type is known as Blood typing.
 If you need a Blood transfusion or plan to donate Blood , a test is required.
 Because not all Blood types are compatible, knowing your Blood Group is
crucial.
 Receiving Blood that isn't compatible with your Blood type can result in a
hazardous immunological reaction.
Blood Type A B O AB
RH- Positive A+ B+ O+ AB+
RH- Negative A- B- O- AB-
Fig no. 24: Blood group table
69

20(I). SOME PATHOLOGY REPORTS
Fig no. 25: CBC report
Fig no. 26: Urine test report
70

21. OPHTHALMOSCOPY ROOM
1. It is used to detect and evaluate symptoms of retinal detachment or eye
diseases such as glaucoma.
2. Ophthalmoscopy may also be done if you have signs or symptoms of high
blood pressure, diabetes, or other diseases that affect the blood vessels.
3. The Department of Ophthalmology at CHC Hospital is aimed to provide a
comprehensive range of medical and surgical eye care to patients of every
age group.
4. The department specializes in treating conditions like Cataracts,
Glaucoma, Squint, Retinal Diseases, Congenital and Acquired
Deformities, Amblyopia, and Paediatric cataracts.
5. Integrated with sophisticated diagnostic and microsurgical equipment, the
department complies with the best standards of quality to deliver excellent
patient care.
6. The Ophthalmology Department takes great pride in its team of highly
experienced surgeons and paramedical experts.
7. The team ensures precision and accuracy of treatment with optimal care
and facilities to recover post-treatment.
Fig no. 27: Ophthalmoscopy Room
71

(II). Ophthalmologist or eye surgeon were use varios
ophthalmology instruments, some of the most common are as
follows:
1. Angle-supported intraocular lens : A special intraocular lens implanted
surgically into the eye’s anterior chamber.
2. Automated refraction system : Ophthalmic devices ( for determining a
person’s refractive error and aid in the prescription for contact lenses or
glasses.
3. Autorefractor : A computer-controlled device for measuring a person’s
refractive error).
4. Exophthalmometer : An instrument for measuring the eye’s forward
displacement degree in exophthalmos (out-of-the-orbit eye bulging).
5. Eye chart : A chart for measuring a patient’s visual acuity.
6. Focometer : Eye refractive errors measuring device.
7. Frenzel goggles : A diagnostic instrument for evaluating an involuntary
eye movement).
8. Fundus photography : A photograph of the eyes’ interior surface (retina,
macula, optic disc, and posterior pole included) to diagnose a disease or
monitor its progression.
9. Gonioscope : Used to diagnose or monitor various glaucoma-related eye
conditions.
10.Keratometer : A diagnostic instrument used to measure the curvature of
the cornea’s anterior surface.
11.Keratoscope : An ophthalmic instrument for assessing the shape of the
cornea’s anterior surface.
12.Lens clock : A mechanical dial indicator for measuring a lens’s dioptric
power.
13.Lensmeter : An ophthalmic instrument for verifying the correct
prescription of spectacles, properly orienting and marking uncut lenses,
and confirming the correct mounting of lenses in frames.
14.Ocular tonometer : A device for measuring the fluid pressure inside the
eye.
15.Ophthalmoscope : Used during eye examination for determining the
retina’s health.
16.Pascal photocoagulator : A half-automatic pattern scan laser system for
treating eye diseases by a predetermined pattern array or a single shot.
17.Phoropter : An instrument for measuring a person’s refractive error and
determining his or her prescription of spectacles.
72

18.Pupilometer : A device that can measure the distance between pupils, or
their response to visual stimuli.
19.Retinoscope : An instrument to shine light into an individual’s eye in order
to observe the reflection off his or her retina.
20.Schiotz tonometer : A device for measuring the intraocular pressure.
21.Vertometer : An ophthalmic instrument for determining dioptric power of
a lens.
22.Volk lens : An instrument for examining the tissues of the eye’s posterior
segment.
Fig no. 28: Inner view of Ophthalmoscopy Room
73

22. MATERNITY WARD
1. A maternity hospital specializes in caring for women during pregnancy and
childbirth.
2. It also provides care for new born infants, and may act as a centre for
clinical training in midwifery and obstetrics.
3. Traditional hospital births are still the most common option.
4. This means the mother-to-be moves from a labor room to a delivery room
and then, after the birth, to a semiprivate room.
5. A doctor and medical staff are still on hand. But the rooms create a
nurturing environment, with warm, soothing colors and features that try to
simulate a home-like atmosphere that can be very comforting for new
moms. Rooming in — when the baby stays with the mother most of the
time instead of in the infant nursery — also is more common.
6. It also provides care for new born infants, and may act as a centre for
clinical training in midwifery and obstetrics.
7. There should be higher standards of security to prevent infant abduction.
8. The inpatient area, nursery area, and birth unit should have restricted
access.
9. The maternity hospital should have an isolation room to prevent any risky
infection.
10.The maternity hospital should have a pharmacy within the hospital.
(I). In a hospital birth, these things required:
1. Pain medicines are available during labor and delivery, if a woman wants
them.
2. Labor can be induced, if necessary.
3. The baby is usually electronically monitored throughout the labor.
(II). Equipment required in maternity ward :
1. A maternity hospital is the one that handles mothers and their newborn
kids.
2. This includes those from preconceiving going till when the baby is born.
74

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