The document discusses guidelines for managing patients in the emergency department or casualty ward of a hospital. It provides information on prioritizing patients, procedures for medico-legal cases, appropriate patients to admit or observe, necessary investigations and paperwork, communicating with relatives, and facilitating effective functioning of the casualty department. It also includes multiple choice questions testing understanding of these guidelines.

1. SPMP Casualty Management Dr. S. Aswini Kumar. MD, Casuality is the Emergency department of the hospital, where the patients are received and first aid given and after prioritization decision on admission made. I. 1. The house surgeon coming for casualty duty must relieve the night duty HS not later than: 8.00am 8.10am 8.20am 8.35am 8.40am I. 2. In the medicine casuality patients can present with the following EXCEPT: Seriously ill state Bite by rat cat or human Brought dead Extensive burns Itching due to scratching I. 3. The duty doctor in the casualty can go for lunch by the following techniques EXCEPT: Entrusting the duty with the PG or HS in the unit Arranging the ward duty HS to sit in the casualty Going home without informing anybody & having lunch Bringing lunch packet & eating sitting in the side room Having a full day fast on the day of casualty duty I. 4. Sequential selection of seeing patients in the emergency department is best done by: Random selection Prioritization Queuing Introduction by other staff Ladies first I. 5. Casualty rush is better managed by house surgeon or Post graduate doctor: Always sitting Always standing Always walking Always disappearing Always quarrelling I. 6. While attending alcoholic gastritis a MI comes. You will proceed to do the following EXCEPT: Continue seeing the first patient Stop seeing the 1st and rush to see the 2nd Tell 1st that you will return after seeing the 2nd Give order to start IV and give placebo to 1st Remain with 2nd patient till he is shifted to ICCU I. 7. If a Medico Legal Case comes, you will enter in the Out Patient ticket: Exact time of arrival Name and address of person who brought him Alleged history with place and time of happening Identification marks All the above I. 8. Your strategy in admitting patients is that you will admit all patients EXCEPT those who are: Critically ill Having potentially fatal illness Referred by other doctors government or private Those patients insisting on admission Brought for drunkenness certification I. 9. Ideal group of patients to be kept in the observation room are the following EXCEPT: Bronchial asthma Infective diarrhea Labyrinthine vertigo Alcohol intoxication Minor illnesses from nearby places I. 10. Investigations to be done routinely in the casualty are the following EXCEPT: RUE RBE ECG CXR LFT I. 11. Admission procedure of a patient is said to be completed when: Written in the OP ticket Patient is told Investigations are done Treatment is started Patient is in the ward I. 12. Casualty is the place to: Receive patients Assess the progress Complete investigations Do all procedures Complete the treatment I. 13. The following will facilitate and improve functioning of casuality: Emergency tray Pre-filled syringes Quick shifting of patients Brief &complete records All the above I. 14. Effective communication with the relatives means the following EXCEPT: Explaining the organs which are affected Not explaining pathology and etiology too early Explaining about the investigations needed urgently Explaining the treatment plan and cost of therapy Not at all entertaining relatives I. 15. A patient suddenly collapses in the casualty. You will do the following EXCEPT: Start resuscitation stat Take a brief history Rush to MICU with assisted ventilation Postpone admission procedure if required Waste no time for explaining to relatives I. 16. In a suspected case of brought dead you will now proceed to do the following EXCEPT: Confirm death; if needed get second opinion Skip any resuscitation attempts Inform relatives’ early regarding death Enquire into the illnesses & circumstances Release the body with out delay I. 17.A cup of tea and snacks given to paramedical staff can facilitate the following EXCEPT: Shifting patients to the wards quickly by attenders Doing stomach wash etc by nursing assistants Resuscitating patients with help of nurses Maintaining discipline with help of security staff Managing mass casualty alone & making it a “mess”