The document discusses the management and accountability of neonatal intensive care units (NICUs) under Indian law. It provides details on:
1) What a NICU is and the types of babies that require NICU care, including premature babies and those with medical conditions.
2) The necessary equipment, facilities, staffing, and structure a NICU should have, including nurses, doctors, and other medical professionals.
3) The various laws governing medical liability and negligence in India, including civil laws around contracts, torts, and consumer protection, as well as criminal laws and regulations set by the Medical Council of India.
The document discusses neonatal intensive care units (NICUs), providing a history of their development and describing common diseases, challenges, and infections treated in NICUs. It notes that prematurity, respiratory issues, and sepsis are leading problems and that nosocomial infections from organisms like Klebsiella, E. coli, coagulase-negative Staphylococcus, and Candida are a major challenge requiring prevention efforts like judicious antibiotic use, sterile equipment and procedures, and contact precautions.
The document discusses neonatal intensive care units (NICU), including their definition, objectives, equipment, staffing, and trends. A NICU is an intensive care unit that specializes in caring for ill or premature newborn infants. The objectives are to save lives, prevent damage, and monitor high-risk newborns. Advanced technology, highly trained professionals, and a family-centered care philosophy are trends in NICUs. Equipment includes ventilators, monitors, infusion pumps, and incubators. Staff include neonatologists, nurses, and therapists who work as a team.
This document discusses infection prevention and control practices in perinatology. It outlines various risk factors for newborn infection including low birth weight, immature immune system, and vertical transmission from mother to child. Routine practices like hand hygiene, environmental cleaning, and protective equipment are emphasized. Specific recommendations are provided for cleaning areas like labor rooms, well baby units, NICUs, and equipment. Guidance is also given for screening mothers and newborns being transferred or readmitted, as well as managing visitors.
Neonatal sepsis is a clinical syndrome of bacteremia and systemic infection in infants under 4 weeks of age. It is classified as early onset (less than 72 hours) or late onset (more than 72 hours). Early onset sepsis is usually acquired from the mother during birth and has a sudden and fulminant presentation, while late onset sepsis is often acquired in the NICU from healthcare exposures and other infants. Blood culture is the gold standard for diagnosis but has low sensitivity, while urine and CSF cultures may also be obtained depending on the clinical scenario. Proper collection and handling of specimens is important for optimizing diagnostic yield.
The document provides details on the setup and operations of a Neonatal Intensive Care Unit (NICU). Key points include:
- The NICU cares for critically ill newborns and aims to reduce neonatal mortality and morbidity.
- Admission criteria includes low birth weight, birth asphyxia, jaundice, and other conditions requiring intensive monitoring and care.
- The NICU requires specialized equipment, facilities to control temperature and infection, and a high nurse to patient ratio including 1:1 for critical patients.
- Staffing includes neonatologists, nurses, technicians and other specialists available 24/7 to provide intensive care for high-risk newborns.
_______________________________________
Emergency Procedure? YES NO
Was subclavian or IJ vein the site for insertion?
YES NO
Specify: ________________________
Is the indication for insertion appropriate? YES NO
Date of Patient Discharged:
Surveillance of Healthcare
Associated Infection
Central Line Associated
Bloodstream Infection
Insertion and Maintenance Bundles
Childhood Tuberculosis and Community Healthcare_Kechi Achebe_5.8.14CORE Group
- Childhood tuberculosis (TB) is a significant but underrecognized public health problem, with around 500,000 children developing TB annually and 64,000 dying from it. Actual cases are likely higher than reported.
- Children face barriers to accurate TB diagnosis including non-specific symptoms, difficulty obtaining sputum samples, and lack of screening guidelines. Contact tracing of children exposed to TB patients is also lacking.
- Integrating childhood TB screening and management into existing community health platforms could help improve case detection and ensure children complete treatment.
The document discusses neonatal intensive care units (NICUs), providing a history of their development and describing common diseases, challenges, and infections treated in NICUs. It notes that prematurity, respiratory issues, and sepsis are leading problems and that nosocomial infections from organisms like Klebsiella, E. coli, coagulase-negative Staphylococcus, and Candida are a major challenge requiring prevention efforts like judicious antibiotic use, sterile equipment and procedures, and contact precautions.
The document discusses neonatal intensive care units (NICU), including their definition, objectives, equipment, staffing, and trends. A NICU is an intensive care unit that specializes in caring for ill or premature newborn infants. The objectives are to save lives, prevent damage, and monitor high-risk newborns. Advanced technology, highly trained professionals, and a family-centered care philosophy are trends in NICUs. Equipment includes ventilators, monitors, infusion pumps, and incubators. Staff include neonatologists, nurses, and therapists who work as a team.
This document discusses infection prevention and control practices in perinatology. It outlines various risk factors for newborn infection including low birth weight, immature immune system, and vertical transmission from mother to child. Routine practices like hand hygiene, environmental cleaning, and protective equipment are emphasized. Specific recommendations are provided for cleaning areas like labor rooms, well baby units, NICUs, and equipment. Guidance is also given for screening mothers and newborns being transferred or readmitted, as well as managing visitors.
Neonatal sepsis is a clinical syndrome of bacteremia and systemic infection in infants under 4 weeks of age. It is classified as early onset (less than 72 hours) or late onset (more than 72 hours). Early onset sepsis is usually acquired from the mother during birth and has a sudden and fulminant presentation, while late onset sepsis is often acquired in the NICU from healthcare exposures and other infants. Blood culture is the gold standard for diagnosis but has low sensitivity, while urine and CSF cultures may also be obtained depending on the clinical scenario. Proper collection and handling of specimens is important for optimizing diagnostic yield.
The document provides details on the setup and operations of a Neonatal Intensive Care Unit (NICU). Key points include:
- The NICU cares for critically ill newborns and aims to reduce neonatal mortality and morbidity.
- Admission criteria includes low birth weight, birth asphyxia, jaundice, and other conditions requiring intensive monitoring and care.
- The NICU requires specialized equipment, facilities to control temperature and infection, and a high nurse to patient ratio including 1:1 for critical patients.
- Staffing includes neonatologists, nurses, technicians and other specialists available 24/7 to provide intensive care for high-risk newborns.
_______________________________________
Emergency Procedure? YES NO
Was subclavian or IJ vein the site for insertion?
YES NO
Specify: ________________________
Is the indication for insertion appropriate? YES NO
Date of Patient Discharged:
Surveillance of Healthcare
Associated Infection
Central Line Associated
Bloodstream Infection
Insertion and Maintenance Bundles
Childhood Tuberculosis and Community Healthcare_Kechi Achebe_5.8.14CORE Group
- Childhood tuberculosis (TB) is a significant but underrecognized public health problem, with around 500,000 children developing TB annually and 64,000 dying from it. Actual cases are likely higher than reported.
- Children face barriers to accurate TB diagnosis including non-specific symptoms, difficulty obtaining sputum samples, and lack of screening guidelines. Contact tracing of children exposed to TB patients is also lacking.
- Integrating childhood TB screening and management into existing community health platforms could help improve case detection and ensure children complete treatment.
Infec control measures in icu day in life of bacterium-mghwanted1361
The document discusses infection control measures in the ICU, noting that bacteria can easily spread between patients and healthcare workers through contact with skin and the environment, and that proper hand hygiene is the cornerstone of prevention. It also presents data showing that hand hygiene compliance rates are lowest among physicians, and that a multifaceted campaign including incentives significantly improved hand hygiene rates and reduced MRSA infections at Massachusetts General Hospital.
Organization of a special care neonatal unitDr Anand Singh
- The organization of a special care neonatal unit is essential to reduce neonatal mortality and improve quality of life. It should be located close to the labor room and have adequate space, ventilation, temperature control, and equipment for resuscitation and care of sick and preterm newborns. Proper staffing by trained nurses and doctors is required for quality care. Preventive maintenance and emergency repairs of equipment is important for smooth functioning of the unit.
This document provides information about the neonatal intensive care unit (NICU). It discusses that some babies need special care if they are premature or have health issues at birth. The NICU plays an important role in reducing infant mortality. The document outlines the background, need, equipment, core components, levels of care, and design considerations for an ICU. It describes the space requirements for different areas like the baby care area, support services, gowning room, and hand washing stations.
This document provides guidelines for quarantining healthcare workers (HCWs) exposed to COVID-19 patients in India. It defines quarantine versus isolation and recommends facilities for quarantine. HCWs are categorized as high or low risk based on their exposure level. High risk HCWs should quarantine for 14 days, while low risk can continue working with self-monitoring. Guidelines are provided for active quarantine during work and passive quarantine afterwards, which may take place in institutional housing or at home if criteria are met. Testing is recommended upon start and end of quarantine. The policies aim to reduce virus transmission while accounting for available resources.
The document discusses coronavirus (COVID-19) infection and pregnancy. It notes that COVID-19 is a new strain of coronavirus that likely originated in bats. For pregnant women, the virus can potentially be transmitted vertically during pregnancy or delivery, though evidence is limited. Precautions are recommended for infected pregnant women, including self-isolation, attending medical appointments privately, and giving birth in isolation rooms.
The document provides guidelines from the World Health Organization (WHO) on preventing surgical site infections (SSIs). It discusses 29 recommendations across pre-operative, intra-operative, and post-operative periods. Some key recommendations include using chlorhexidine for skin preparation, mupirocin ointment for nasal carriers of Staphylococcus aureus, appropriate timing of pre-operative antibiotics, and not prolonging antibiotics post-operatively. The guidelines are informed by evidence reviews on topics related to reducing SSI risk and aim to provide guidance based on strength and quality of evidence.
This document discusses vaccination during pregnancy. It begins by outlining the success of maternal immunization and different types of vaccines. It then covers immunization before, during, and after pregnancy. Vaccines recommended during pregnancy include tetanus, diphtheria, pertussis (Tdap), and inactivated influenza vaccines. Live attenuated vaccines are generally contraindicated due to theoretical risk to the fetus. Postpartum, women should receive any recommended vaccines not administered during pregnancy. Vaccines are an effective way to prevent infectious diseases posing risks to mothers and newborns.
Preterm immunisation 2018 - Dr Karthik Nageshkarthiknagesh
This document discusses vaccination in preterm infants. It notes that preterm infants are at higher risk of morbidity and mortality from vaccine-preventable diseases. However, vaccination of preterms is often delayed. The document summarizes evidence that preterm infants can mount protective immune responses when vaccinated according to their chronological age, regardless of gestational age or birth weight. It addresses specific concerns about the safety and efficacy of various vaccines in preterm populations such as BCG, polio, hepatitis B, pertussis and others. Overall, the document advocates for vaccinating medically stable preterm infants according to routine schedules in order to provide them protection from serious diseases.
This document discusses vaccinations that are recommended, not recommended, and sometimes recommended during pregnancy. It provides information on several common vaccines including measles, mumps, rubella, polio, yellow fever, influenza, rabies, and hepatitis B. For vaccines using live viruses, the risks of potentially infecting the fetus are weighed against the risks of the disease. Inactivated virus vaccines like influenza, rabies, and hepatitis B are generally considered safe during pregnancy.
Intensive care units experience high rates of infection due to patients having more comorbidities and invasive devices, with ventilator-associated pneumonia, central line-associated bloodstream infections, and catheter-associated urinary tract infections being common; infection control strategies like hand hygiene, isolation precautions, environmental cleaning, and surveillance are effective at reducing the transmission of multidrug-resistant pathogens in ICUs and improving patient outcomes. Surveillance of device-associated infection rates and antimicrobial resistance patterns is important for guiding infection control efforts and antimicrobial stewardship in the ICU.
This document provides a 3-sentence summary of the COVID-19 Preparedness Document from AIIMS, New Delhi:
The document outlines infection control and clinical management guidelines for COVID-19 at AIIMS, New Delhi. It includes definitions of suspected and confirmed cases, guidelines for sample collection and testing, recommendations for personal protective equipment and hand hygiene, as well as protocols for treatment and supportive care of patients. The document is intended for internal use at AIIMS and may be modified as more data on COVID-19 becomes available.
1) Determining if a clinically unstable infant truly has an infection remains challenging in neonatal sepsis evaluation and management.
2) Advances like heart rate characteristics monitoring and new sepsis biomarkers show promise for earlier infection detection, while molecular techniques may reduce pathogen identification time.
3) Antibiotic-resistant infections require less common drugs like linezolid, daptomycin, ciprofloxacin, and colistin, though safety data in neonates is limited; prevention focuses on hand hygiene and early catheter removal.
A nurse has many duties when working in a therapeutic department including maintaining patient psychological well-being, ensuring a safe and clean environment, communicating with patients, collaborating with physicians and staff, managing patient care, monitoring patients, assisting with diagnostic testing, and administering medication. Specifically, the nurse assesses patient needs, develops care plans, provides direct care, monitors patients, assists with testing, and administers medication in accordance with physician orders while documenting all care and maintaining organization.
This document discusses vaccinations that are considered safe and not recommended during pregnancy. It states that routine vaccines like diphtheria, tetanus, influenza, hepatitis B, and meningococcal are generally safe during pregnancy. Live virus vaccines for measles, mumps, rubella, varicella, yellow fever, oral polio, and BCG are not recommended due to the theoretical risk of fetal transmission. Inactivated polio and rabies vaccines are also generally considered safe in pregnancy. The risks and benefits of vaccination during each trimester are reviewed for several common diseases.
This document provides an overview of immunization and the Universal Immunization Program (UIP) in India. It discusses the history and components of UIP, including routine immunization, Mission Indradhanush, intensified pulse polio immunization, sub-national immunization programs, and surveillance for vaccine-preventable diseases. The objectives of UIP are to provide vaccination coverage to children and pregnant mothers against preventable diseases. The document outlines the national immunization schedule, vaccine types, storage and handling, as well as competencies related to immunization.
Management of newborn infant born to mother suffering frommandar haval
Indian J Med Res 140, July 2014, pp 32-39 reviews current recommendations for managing newborn infants born to mothers with tuberculosis. There is no uniform consensus across different countries. Congenital tuberculosis is diagnosed using Cantwell criteria and treated with a 3-4 drug regimen for 9-12 months. Prophylaxis with isoniazid for 3-6 months is recommended for infants born to infectious mothers. Breastfeeding is recommended and isolation is only needed if the mother has multidrug resistant TB or is non-adherent to treatment. The BCG vaccine is given at birth or after prophylaxis completion. Guidelines vary on prophylaxis duration and dose, and timing of diagnostic tests.
This document discusses COVID-19 and pregnancy. It outlines that COVID-19 infection does not seem to be worse for pregnant women or affect the fetus. Antenatal care is emphasized through telehealth to reduce risk of exposure. For suspected or confirmed COVID-19 in pregnancy, a multidisciplinary approach is recommended based on symptom severity and obstetric issues. Management includes isolation, testing, monitoring for maternal and fetal well-being, and individualizing care during labor and postpartum based on the mother's condition.
Guidelines for ultrasound establishment s during the covid 19 pandemicDr. Jyoti Malik
This document provides guidelines for ultrasound establishments during the COVID-19 pandemic. It outlines recommendations for patient scheduling and triaging, informed consent procedures, venue sanitation, equipment sanitation, accelerating report availability, procuring protective supplies, and educating staff. Key recommendations include postponing non-essential scans, advanced scheduling to reduce wait times, thorough screening of patients, using appropriate PPE based on patient risk, frequent sanitization of surfaces, disinfecting ultrasound equipment between patients, and training staff on safety protocols. The guidelines aim to minimize exposure risks for both patients and healthcare workers while still providing necessary care.
Management of Covid Positive PregnancyReetaSingh19
The document discusses COVID-19 in pregnancy and provides guidance for antenatal care during the pandemic. It notes that pregnant women are not more susceptible to COVID-19 infection but may be at higher risk of severe disease. It recommends reducing and spacing antenatal appointments, conducting scans based on clinical need, and monitoring home vitals. Guidance is provided for care during labor and postpartum while minimizing viral transmission. Vaccination during pregnancy is not currently recommended but is safe during lactation.
This document provides information about India's National Immunization Programme (UIP). It discusses the targeted vaccine preventable diseases (VPDs), the history and objectives of the Expanded Programme on Immunization (EPI) and Universal Immunization Programme (UIP). It outlines the national immunization schedule, components of UIP including vaccination of pregnant women and children, and strategies to achieve coverage goals. Coverage levels from surveys are presented. The document also discusses vaccine administration techniques for different vaccines.
under this system of practice an advocate can provide his service in conjunction with other professionals like doctor, accountants L. I. C. agents etc., which is till now prohibited in India.
There are many different types of businesses that Versant Funding's factoring facility can help. Several scenarios are outlined in the attached presentation.
Infec control measures in icu day in life of bacterium-mghwanted1361
The document discusses infection control measures in the ICU, noting that bacteria can easily spread between patients and healthcare workers through contact with skin and the environment, and that proper hand hygiene is the cornerstone of prevention. It also presents data showing that hand hygiene compliance rates are lowest among physicians, and that a multifaceted campaign including incentives significantly improved hand hygiene rates and reduced MRSA infections at Massachusetts General Hospital.
Organization of a special care neonatal unitDr Anand Singh
- The organization of a special care neonatal unit is essential to reduce neonatal mortality and improve quality of life. It should be located close to the labor room and have adequate space, ventilation, temperature control, and equipment for resuscitation and care of sick and preterm newborns. Proper staffing by trained nurses and doctors is required for quality care. Preventive maintenance and emergency repairs of equipment is important for smooth functioning of the unit.
This document provides information about the neonatal intensive care unit (NICU). It discusses that some babies need special care if they are premature or have health issues at birth. The NICU plays an important role in reducing infant mortality. The document outlines the background, need, equipment, core components, levels of care, and design considerations for an ICU. It describes the space requirements for different areas like the baby care area, support services, gowning room, and hand washing stations.
This document provides guidelines for quarantining healthcare workers (HCWs) exposed to COVID-19 patients in India. It defines quarantine versus isolation and recommends facilities for quarantine. HCWs are categorized as high or low risk based on their exposure level. High risk HCWs should quarantine for 14 days, while low risk can continue working with self-monitoring. Guidelines are provided for active quarantine during work and passive quarantine afterwards, which may take place in institutional housing or at home if criteria are met. Testing is recommended upon start and end of quarantine. The policies aim to reduce virus transmission while accounting for available resources.
The document discusses coronavirus (COVID-19) infection and pregnancy. It notes that COVID-19 is a new strain of coronavirus that likely originated in bats. For pregnant women, the virus can potentially be transmitted vertically during pregnancy or delivery, though evidence is limited. Precautions are recommended for infected pregnant women, including self-isolation, attending medical appointments privately, and giving birth in isolation rooms.
The document provides guidelines from the World Health Organization (WHO) on preventing surgical site infections (SSIs). It discusses 29 recommendations across pre-operative, intra-operative, and post-operative periods. Some key recommendations include using chlorhexidine for skin preparation, mupirocin ointment for nasal carriers of Staphylococcus aureus, appropriate timing of pre-operative antibiotics, and not prolonging antibiotics post-operatively. The guidelines are informed by evidence reviews on topics related to reducing SSI risk and aim to provide guidance based on strength and quality of evidence.
This document discusses vaccination during pregnancy. It begins by outlining the success of maternal immunization and different types of vaccines. It then covers immunization before, during, and after pregnancy. Vaccines recommended during pregnancy include tetanus, diphtheria, pertussis (Tdap), and inactivated influenza vaccines. Live attenuated vaccines are generally contraindicated due to theoretical risk to the fetus. Postpartum, women should receive any recommended vaccines not administered during pregnancy. Vaccines are an effective way to prevent infectious diseases posing risks to mothers and newborns.
Preterm immunisation 2018 - Dr Karthik Nageshkarthiknagesh
This document discusses vaccination in preterm infants. It notes that preterm infants are at higher risk of morbidity and mortality from vaccine-preventable diseases. However, vaccination of preterms is often delayed. The document summarizes evidence that preterm infants can mount protective immune responses when vaccinated according to their chronological age, regardless of gestational age or birth weight. It addresses specific concerns about the safety and efficacy of various vaccines in preterm populations such as BCG, polio, hepatitis B, pertussis and others. Overall, the document advocates for vaccinating medically stable preterm infants according to routine schedules in order to provide them protection from serious diseases.
This document discusses vaccinations that are recommended, not recommended, and sometimes recommended during pregnancy. It provides information on several common vaccines including measles, mumps, rubella, polio, yellow fever, influenza, rabies, and hepatitis B. For vaccines using live viruses, the risks of potentially infecting the fetus are weighed against the risks of the disease. Inactivated virus vaccines like influenza, rabies, and hepatitis B are generally considered safe during pregnancy.
Intensive care units experience high rates of infection due to patients having more comorbidities and invasive devices, with ventilator-associated pneumonia, central line-associated bloodstream infections, and catheter-associated urinary tract infections being common; infection control strategies like hand hygiene, isolation precautions, environmental cleaning, and surveillance are effective at reducing the transmission of multidrug-resistant pathogens in ICUs and improving patient outcomes. Surveillance of device-associated infection rates and antimicrobial resistance patterns is important for guiding infection control efforts and antimicrobial stewardship in the ICU.
This document provides a 3-sentence summary of the COVID-19 Preparedness Document from AIIMS, New Delhi:
The document outlines infection control and clinical management guidelines for COVID-19 at AIIMS, New Delhi. It includes definitions of suspected and confirmed cases, guidelines for sample collection and testing, recommendations for personal protective equipment and hand hygiene, as well as protocols for treatment and supportive care of patients. The document is intended for internal use at AIIMS and may be modified as more data on COVID-19 becomes available.
1) Determining if a clinically unstable infant truly has an infection remains challenging in neonatal sepsis evaluation and management.
2) Advances like heart rate characteristics monitoring and new sepsis biomarkers show promise for earlier infection detection, while molecular techniques may reduce pathogen identification time.
3) Antibiotic-resistant infections require less common drugs like linezolid, daptomycin, ciprofloxacin, and colistin, though safety data in neonates is limited; prevention focuses on hand hygiene and early catheter removal.
A nurse has many duties when working in a therapeutic department including maintaining patient psychological well-being, ensuring a safe and clean environment, communicating with patients, collaborating with physicians and staff, managing patient care, monitoring patients, assisting with diagnostic testing, and administering medication. Specifically, the nurse assesses patient needs, develops care plans, provides direct care, monitors patients, assists with testing, and administers medication in accordance with physician orders while documenting all care and maintaining organization.
This document discusses vaccinations that are considered safe and not recommended during pregnancy. It states that routine vaccines like diphtheria, tetanus, influenza, hepatitis B, and meningococcal are generally safe during pregnancy. Live virus vaccines for measles, mumps, rubella, varicella, yellow fever, oral polio, and BCG are not recommended due to the theoretical risk of fetal transmission. Inactivated polio and rabies vaccines are also generally considered safe in pregnancy. The risks and benefits of vaccination during each trimester are reviewed for several common diseases.
This document provides an overview of immunization and the Universal Immunization Program (UIP) in India. It discusses the history and components of UIP, including routine immunization, Mission Indradhanush, intensified pulse polio immunization, sub-national immunization programs, and surveillance for vaccine-preventable diseases. The objectives of UIP are to provide vaccination coverage to children and pregnant mothers against preventable diseases. The document outlines the national immunization schedule, vaccine types, storage and handling, as well as competencies related to immunization.
Management of newborn infant born to mother suffering frommandar haval
Indian J Med Res 140, July 2014, pp 32-39 reviews current recommendations for managing newborn infants born to mothers with tuberculosis. There is no uniform consensus across different countries. Congenital tuberculosis is diagnosed using Cantwell criteria and treated with a 3-4 drug regimen for 9-12 months. Prophylaxis with isoniazid for 3-6 months is recommended for infants born to infectious mothers. Breastfeeding is recommended and isolation is only needed if the mother has multidrug resistant TB or is non-adherent to treatment. The BCG vaccine is given at birth or after prophylaxis completion. Guidelines vary on prophylaxis duration and dose, and timing of diagnostic tests.
This document discusses COVID-19 and pregnancy. It outlines that COVID-19 infection does not seem to be worse for pregnant women or affect the fetus. Antenatal care is emphasized through telehealth to reduce risk of exposure. For suspected or confirmed COVID-19 in pregnancy, a multidisciplinary approach is recommended based on symptom severity and obstetric issues. Management includes isolation, testing, monitoring for maternal and fetal well-being, and individualizing care during labor and postpartum based on the mother's condition.
Guidelines for ultrasound establishment s during the covid 19 pandemicDr. Jyoti Malik
This document provides guidelines for ultrasound establishments during the COVID-19 pandemic. It outlines recommendations for patient scheduling and triaging, informed consent procedures, venue sanitation, equipment sanitation, accelerating report availability, procuring protective supplies, and educating staff. Key recommendations include postponing non-essential scans, advanced scheduling to reduce wait times, thorough screening of patients, using appropriate PPE based on patient risk, frequent sanitization of surfaces, disinfecting ultrasound equipment between patients, and training staff on safety protocols. The guidelines aim to minimize exposure risks for both patients and healthcare workers while still providing necessary care.
Management of Covid Positive PregnancyReetaSingh19
The document discusses COVID-19 in pregnancy and provides guidance for antenatal care during the pandemic. It notes that pregnant women are not more susceptible to COVID-19 infection but may be at higher risk of severe disease. It recommends reducing and spacing antenatal appointments, conducting scans based on clinical need, and monitoring home vitals. Guidance is provided for care during labor and postpartum while minimizing viral transmission. Vaccination during pregnancy is not currently recommended but is safe during lactation.
This document provides information about India's National Immunization Programme (UIP). It discusses the targeted vaccine preventable diseases (VPDs), the history and objectives of the Expanded Programme on Immunization (EPI) and Universal Immunization Programme (UIP). It outlines the national immunization schedule, components of UIP including vaccination of pregnant women and children, and strategies to achieve coverage goals. Coverage levels from surveys are presented. The document also discusses vaccine administration techniques for different vaccines.
under this system of practice an advocate can provide his service in conjunction with other professionals like doctor, accountants L. I. C. agents etc., which is till now prohibited in India.
There are many different types of businesses that Versant Funding's factoring facility can help. Several scenarios are outlined in the attached presentation.
This document provides an overview of leadership approaches and strategies for addressing youth violence. It discusses that youth violence prevention requires a flexible approach that addresses behavioral, environmental, and social factors. Public sector leaders must function as change agents in developing and implementing collaborative strategies. The document reviews theories of charismatic, transformational, and servant leadership and their focus on empowering followers, envisioning change, and prioritizing followers' needs and interests to motivate them. Trust and open communication between leaders and stakeholders are essential for effective collaboration on complex issues like youth violence.
JavaScript is a programming language used to make web pages interactive. It allows calculations, form validation, games and other effects to be added to web pages. JavaScript code runs in the user's browser and works on any platform with a JavaScript-capable browser. Events like clicks or page loads can trigger JavaScript functions. JavaScript can be embedded directly in HTML pages or linked from external files and is commonly used to enhance user experience on websites.
மனத்தை ஒருமுகப்படுத்து, சிந்தனையை ஒழுங்குபடுத்து, செயலின் வெற்றியை உறுதிப்படுத்து.
இயலாமை எனும் இருட்டை குறை கூறி என்ன இலாபம்?.
அறிவு என்னும் விளக்கை ஏற்றி இயலாமை என்னும் இருட்டை அகற்றினால் நாம் அனைத்திலும் இலாபம் என்னும் வெற்றியை அடையலாம்.
KOWSHIKAA CONSULTANCY - R.RAJARAM - 9865118262
Dokumen tersebut memberikan informasi mengenai persiapan menghadapi ujian semester di Pondok Pesantren Daar El-Qolam. Terdapat himbauan untuk belajar, berdoa, menjauhi maksiat, tidak malas, membaca buku, serta gedung tempat ujian yang akan menjadi saksi bagi keberhasilan atau kegagalan siswa. Ada juga komentar dari beberapa siswa mengenai kesiapan dan persiapan mereka menghadapi ujian.
„Nás se bát nemusíte! Proč to děláme a jak to děláme? Zamýšlíte se ve své škole a školní jídelně nad problematikou hygienických povinností? Nejste si jisti, zda Vaše zařízení vyhoví nekompromisnímu zraku hygieniků? Obáváte se možných sankcí a dopadu při vzniku alimentárního onemocnění z pokrmů Vašeho zařízení?“
12 under 12 spotlight from texas aggie mag 2014-01Andy Ellwood
This document discusses 12 young Texas A&M University alumni who have been recognized for their achievements and representation of the university's core values. It profiles several of the alumni in 1-2 paragraphs each, describing their careers and how their experiences at Texas A&M helped prepare them for success. For example, it discusses how Jeff Schiefelbein founded the nonprofit CARPOOL organization to provide safe rides to students and how his leadership of that organization helped in his current business career.
R. Ann Moody is seeking a management or executive assistant position. She has 32 years of experience in the military, including supervising teams, managing resources, and conducting administrative duties. She has extensive experience in areas such as project management, human resources, training, and computer systems administration.
Alessandro Del Piero is a retired Italian professional footballer who played as a deep-lying forward. He spent most of his career at Juventus, where he is regarded as one of the best players in the club's history. With Juventus, Del Piero won the UEFA Champions League in 1996 and several domestic titles, and he is currently the club's all-time leading goalscorer. At the international level, he played in over 100 matches for the Italian national team, participating in seven major tournaments and winning the 2006 FIFA World Cup. After leaving Juventus in 2012, Del Piero spent time in Australia with Sydney FC and India with Delhi Dynamos before retiring in 2017.
This document outlines tourism options around Vietnam, including destinations near Hanoi such as Ninh Binh, Mai Chau, Halong Bay, Sapa, and Ha Giang. It also lists attractions around Hue like Phong Nha cave, Da Nang and Hoi An, coastal cities like Nha Trang, Da Lat, and Mui Ne. In southern Vietnam it covers Saigon, the Mekong Delta, Vung Tau, Cu Chi Tunnels and destinations like Phu Quoc and Con Dao islands. Transportation options and sample accommodation choices are also provided.
மனத்தை ஒருமுகப்படுத்து, சிந்தனையை ஒழுங்குபடுத்து, செயலின் வெற்றியை உறுதிப்படுத்து.
இயலாமை எனும் இருட்டை குறை கூறி என்ன இலாபம்?.
அறிவு என்னும் விளக்கை ஏற்றி இயலாமை என்னும் இருட்டை அகற்றினால் நாம் அனைத்திலும் இலாபம் என்னும் வெற்றியை அடையலாம்.
KOWSHIKAA CONSULTANCY - R.RAJARAM - 9865118262
Cryptologypastpresentandfuture 130131082256-phpapp02KARNAN L S
Cryptology is the study of secret writings and involves encoding information using computer science and mathematics to ensure data security. It involves encryption to encode plaintext into ciphertext using an encryption key, and decryption to decode the ciphertext back into plaintext using a decryption key. Cryptography is the art and science of creating secret codes, while cryptanalysis is the art and science of breaking those codes. Cryptology methods like substitution ciphers are used to securely transmit data over insecure networks like the internet as well as in applications like ATMs and during World War II. However, cryptology also has limitations in that both creating and breaking codes can be long processes.
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Failure to Observe Corporate Formalities: Corporations and LLCs are required to observe certain formalities, such as holding regular meetings, maintaining separate financial records, and avoiding commingling of personal and corporate assets. If these formalities are not observed and the corporate structure is used as a mere façade, courts may disregard the corporate entity.
Alter Ego: If there is such a unity of interest and ownership between the corporation and its shareholders or members that the separate personalities of the corporation and the individuals no longer exist, courts may treat the corporation as the alter ego of its owners and hold them personally liable.
Group Enterprises: In some cases, where multiple corporations are closely related or form part of a single economic unit, courts may pierce the corporate veil to achieve equity, particularly if one corporation's actions harm creditors or other stakeholders and the corporate structure is being used to shield culpable parties from liability.
सुप्रीम कोर्ट ने यह भी माना था कि मजिस्ट्रेट का यह कर्तव्य है कि वह सुनिश्चित करे कि अधिकारी पीएमएलए के तहत निर्धारित प्रक्रिया के साथ-साथ संवैधानिक सुरक्षा उपायों का भी उचित रूप से पालन करें।
1. MANAGEMENT OF NEONATAL
INTENSIVE CARE UNIT (NICU)
&
ACCOUNTABILITY UNDER THE
L A W
Dr. Rajneesh Kumar Patel
Associate Professor
Faculty
of Law, B.H.U.
2. WHAT IS THE
NEONATAL INTENSIVE CARE UNIT (N.I.C.U.)
?
The NICU is life saving unit of the Hospital, any newly
born babies who needs a very special type of care or
intensive medical attention and admitted into a special area
of the hospital called the Neonatal Intensive Care Unit
(NICU). In this unit one can find advanced technology and
trained healthcare professionals to provide specialized care
to the babies.
3. WHICH BABIES NEED N.I.C.U. ?
generally, premature babies requirs
NICU or low birth weight babies or
any other medical condition which
requires special care and attentions by
medical professionals.
4. Reasons for NICU
◦ If mother is younger than 16 or older than 40 years, or
◦ Alcohol user, or
◦ Diabetic patient, or
◦ Hypertension, or
◦ any Bleeding, or
◦ Suffering from sexually transmitted diseases.
◦ In case of multiple pregnancy, or
◦ Inadequate amniotic fluid.
5. ◦ In case of changes in organ systems due to lack of
oxygen.
◦ Breech delivery presentation or other abnormal
presentation.
◦ The Baby's First Stool Passed during pregnancy into the
Amniotic Fluid, known as Meconium.
◦ Cord around the Baby's Neck.
6. ◦ Birth at Gestational Age less than 37 Weeks or More than
42 Weeks
◦ Birth weight less than 2,500 Grams (5 Pounds, 8 Ounces)
or Over 4,000 Grams (8 Pounds, 13 Ounces)
◦ Small for Gestational Age.
◦ Medication or Resuscitation in the Delivery Room
◦ Birth Defects.
◦ Respiratory Distress including Rapid Breathing, Grunting,
or Stopping Breathing.
◦ Infection .
◦ Hypoglycemia (Low Blood Sugar)
7. WHO WILL CARE FOR BABY IN THE NICU
It is a team work and this groups includes, Neonatologist ,
Neonatal nurses and other staffs.
Member of this group should be a man of special training,
skill, and knowledge in the care of newborn babies.
In advance system the members of the NICU team are also
working together with parents to develop a plan of care for
high-risk newborns.
8. STRUCTURE OF N.I.C.U.
This unit should be well organized and advance unit in
comparison with other wings of the hospital. It should
contain all necessary equipments and proper facilities.
It includes adequate number of following equipments:
Resuscitation set.
Open care system.
Incubators.
Infusion pumps.
Positive pressure ventilators.
Oxygen hoods, oxygen analyzers.
Heart rate – apnea monitors with scope.
Phototherapy unit.
9. Cont………
Electronic Weighting Scale.
Pulse Oxymeters.
End tidal CO2 monitor .
Transcutaneous PO2 & PCO2.
Noninvasive B.P. monitors.
Invasive B.P. monitors.
ECG monitor with defibrillator.
Intra cranial pressure monitor.
Portable radiographic machine.
Portable ultrasound machine.
Blood gas analyzer.
11. ESTABLISHMENT AND CONDITION OF
N.I.C.U.
The N.I.C.U. should be established closer to the labour
rooms and operation theatre.
There should be proper sunlight and ventilation of fresh air.
There should be proper space for concerning of patient,
keeping the essential equipment and for movement of
doctors, nurses, other staff.
12. Cont………………
There should be proper arrangement of uniform and
shadow-free lighting .
The temperature should be adequate inside the unit.
The unit should also have an intercom & a direct outside
telephone line .
There should be round-the-clock power back up including
provision of UPS system.
13. NURSES
Nurse : patient ratio of 1:1 must be maintained 24
hours.
In addition to basic nursing, staff nurse need to be
trained in handling equipment, use of ventilators and
initiation of life-support like use of bag and mask
resuscitation, endotracheal intubations, arterial
sampling and so-on.
The staff must have a minimum of 3 years work
experience in special care neonatal unit.
14. STAFF
A full time neonatologist. (One neonatal physician is
required for every 6-10 patients)
At least two resident doctors should be present in the unit
round-the-clock.
Pediatric Surgeon, Pediatric Pathologist and Respiratory
Therapist, Laboratory Technician, Public Health Nurse or
Social Worker, Biomedical Engineer are very much
essential persons in establishment of a admirable quality of
NICU.
15. Right to considerate and respectful care.
Right to information on diagnosis, treatment and medicines.
Right to obtain all the relevant information about the
professionals involved in the patient care.
Right to expect that all the communications and records
pertaining to his/her case be treated as confidential
Right to every consideration of his/her privacy concerning
his/her medical care programme.
Right to expect prompt treatment in an emergency
Right to refuse to participate in human experimentation,
research, project affecting his/her care or treatment.
16. GENERAL DUTIES OF MEDICO PERSONALS
Every doctor has some basic things to do :
1. He must listen to the patient and take proper history.
2. Examine him carefully. He must attend him or her
personally and give diligent care.
3. He must explain the relevant facts related to the illness.
4.He must advice proper medicines.
5.He must have average, recent knowledge and equipments in
possession, as per their specialty.
6.He must be able to foresee the complications and refer the
patient at proper time.
7.He must also maintain a proper record of their patients.
17. RESULT OF FAILURE
There are three types of law which may be applicable to the
medical staff :
1.Statutory law, which are creation of legislators.
2.Regulatory law or administrative law which are created by
administrative bodies and it consists of rules and regulations.
3.Judicial law , which are the decisions of mainly High Courts
or Apex Court of India.
18. STATUTORY LAWS
1. INDIAN CONTRACT ACT, 1872.
2. INDIAN PENAL CODE, 1860.
3. CONSUMER PROTECTION ACT,1986.
4. INDIAN MEDICAL COUNCIL ACT,1956.
5. PRE- NATAL DIAGNOSTIC ACT, 1994.
19. REGULATORY LAWS
•Indian Medical Council (Professional Conduct, Etiquette and
Ethics) Regulations, 2002
•Hippocratic Oath.
•Declaration of Geneva.
•Declaration of Helsinki.
•International Code of Medical Ethics.
•Govt. of India Guidelines for Sterilization.
20. JUDICIAL LAW
Decision of High Courts and Supreme Court.
21. REMEDIES AVAILABLE UNDER THE INDIAN
LAW IN CASE OF MEDICAL NEGLIGENCE
(1) CIVIL SUIT BEFORE CIVIL COURT.
(2) CIVIL SUIT BEFORE CONSUMER
COURT.
(3) COMPLAINT BEFORE MEDICAL
COUNCIL.
(4) CASE BEFORE CRIMINAL COURT.
22. WHEN DOES ACCOUNTABILITY
ARISE?
It is well known that a doctor owes a duty of care to his
patient. This duty can either be a contractual duty or a duty
arising out of tort or civil law. This may be a criminal
breach of duty for which penal action may be taken. In
some cases, however, though a doctor-patient relationship
is not established, the courts have imposed a duty upon the
doctor. In the words of the Supreme Court “every doctor, at
the governmental hospital or elsewhere, has a professional
obligation to extend his services with due expertise for
protecting life” (Parmanand Katra vs. Union of India).
23. LIABILITY UNDER CIVIL LAWS
1. Under Contract Act :
According to Sec. 70 of Indian Contract Act, when a patient
goes to a doctor for medical treatment, he enters into an
implied contract with the doctor that he will use reasonable
professional skill and care in treating the patient. If the doctor
doesn’t give complete or proper treatment or fail to fulfill this
contractual obligation the patient can claim damage under Sec.
73 of the Act. Similarly, if the patient doesn’t pay the fees,
doctors can file a civil suit. Doctors can take advances or
deposits before starting treatment, but they can’t keep the
patient in confinement on the ground of nonpayment of fees.
24. LIABILITY UNDER CIVIL LAWS
2 . Under Tort Law :
If a doctor does not take reasonable degree of
care, which he is required to take under law
and thereby causes injury to his patient, he
can be sued under the law of Tort.
25. LIABILITY UNDER CIVIL LAWS
3. Under C. P. Act:
After 1995, the medical profession comes within the ambit
of a 'service' as defined in the Consumer Protection Act,
1986.This defined the relationship between patients and
medical professionals as contractual. Patients who had
sustained injuries in the course of treatment could now sue
doctors in 'procedure-free' consumer protection courts for
compensation, even though services rendered by medical
practitioners are of a personal nature they cannot be treated
as contracts of personal service They are contracts for
service, under which a doctor too can be sued….. Indian
Medical Association v VP Shantha.
26. LIABILITY UNDER CRIMINAL LAW
If negligence is so blatant then it invites criminal proceedingsand
on proof of negligence penal action may be taken against
doctors. A doctor can be punished under Section 304A of the
Indian Penal Code for causing death by a rash or negligent act,
for example : where death of a patient is caused during operation
by a doctor not qualified to operate. Some of the common
sections of Indian Penal Code which are applicable to doctors
include: Sec. 312-316 related to causing abortions or miscarriage
without proper consent; Sec. 319-322 deals with causing
grievous hurt, or disfigurement endangering the life; Sec. 340-
342 related to wrongful confinement of patient; and Sec. 499 is
related to defamation.
27. LIABILITY UNDER MEDICAL COUNCIL
ACT
This Act provide for the constitution of a
Medical Council of India. Under section 33 this
council can set norms to regulate the conduct
and behaviour for the medical practitioners.
The norms set by the council are mandatory
and also followed by the State Medical
Council.
28. WHAT IS THE DUTY OWED?
The duty owed by a doctor towards his patient, in the words
of the Supreme Court is to “bring to his task a reasonable
degree of skill and knowledge” and to exercise “a
reasonable degree of care” (Laxman vs. Trimback).
The doctor, in other words, does not have to adhere to the
highest or sink to the lowest degree of care and competence
in the light of the circumstance. A doctor, therefore, does
not have to ensure that every patient who comes to him is
cured. He has to only ensure that he confers a reasonable
degree of care and competence.
29. MEDICAL NEGLIGENCE
Under Indian law; medical negligence may be
two types, civil wrong or criminal offence. For
civil wrong compensation may be awarded
and for criminal offence a doctor can be
imprisoned.
30. NEGLIGENCE
In its general sense negligence means lack of
proper care and attention or it is a carless
behaviour.
It contain three things:
1. A legal duty.
2. Breach of this duty.
3. Damage caused by breach.
31. WHAT IS MEDICAL NEGLIGENCE
There are three essential of medical negligence:
The existence of a duty to take care, which is
owed by the doctor to the complainant.
The failure to attain that standard of care,
prescribed by the law or administrative bodies or
by judiciary.
Damage, which is both causally connected with
such breach and recognized by the law, has been
suffered by the complainant.
32. The court’s view:
BOLAM VS. FRIERN HOSPITAL MANAGEMENT
COMMITTEE the Queen’s Bench Division of the British
Court held that:
A doctor is not guilty of negligence if he has acted in
accordance with a practice accepted as proper by a
responsible body of medical men skilled in that particular
art.
33. Cont………
Jacob Mathew vs. State of Punjab :
The standard of care, when assessing the practice as adopted is judged
in the light of the knowledge available at the time (of the incident),
and not at the date of trial. When the charge of negligence arises out
of a failure to use some particular equipment, the charge would fail if
the equipment was not generally available at that point of time on
which it is suggested as should have been used. So long as a doctor
follows a practice acceptable to the medical profession of that day, he
cannot be held liable for negligence merely because a better
alternative course or method of treatment was also available or simply
because a more skilled doctor would not have chosen to follow or
resort to that practice or procedure which the accused followed.
34. Cont…….
Therefore, a professional may be held liable for
negligence when
a) He was not possessed of the essential skill
which he professed to have possessed; [and/ or]
b) He did not exercise, with reasonable
competence in the given case, the skill, which he
did possess.
35. Dr. Suresh Gupta vs. Govt. of Delhi
a medical practitioner cannot be held punishable for
every mishap or death during medical treatment. No
criminal liability should be attached where a
patient’s death results from error of judgment or an
accident. Mere inadvertence or some degree of want
of adequate care and caution might create civil
liability but would not suffice to hold him criminally
liable. The degree of medical negligence must be
such that it shows complete apathy for the life and
safety of the patient as to amount to a crime against
the state.
36. Dr. Anand R. Nerkar vs. Smt Rahimbi
Shaikh Madar
In this case the Supreme Court laid down following guidelines for prosecuting
doctors:
1. A private criminal complaint should not be entertained unless the
complainant has produced prima facie evidence in the court in the form of a
credible opinion given by another competent doctor to support the charge of
rashness or negligence.
2. The investigating officer, before proceeding against a doctor, should obtain
an independent medical opinion preferably from a doctor in government
service qualified in that branch of medical practice.
3. The accused doctor should not be arrested in a routine manner unless his
arrest is necessary for furthering investigation or for collecting evidence or
unless the investigating officer feels satisfied that the doctor will escape.
However ……………………………..
37. CONCLUSION
In ancient days, medical profession was considered to be a
noble field. The patient’s faith and trust in doctors was so
much that a doctor was equated to lord Vishnu. Gradually, this
relationship is turning into a love and hate phenomenon. In
this era, the focus of medical profession is progressing from a
noble one to a commercial one. The cost of medical education,
equipments, construction of clinics and hospitals are to some
extent responsible for the commercial approach on part of
doctors. Patients now are also more interested in facilities and
good looking hospital rather then quality of care and
competency of doctors. In this scenario, litigations related to
medical practice are on the rise.
38. HOW TO AVOID COURTS?
If you wish to avoid such situation, attend all patients
personally and carefully. Behave humanely, avoid rough,
rude or inhuman behavior with the patients or their
relatives. Communicate with the patient and take proper
consent after explaining the condition. Documents related
to a particular case should be maintained properly.
Be efficient and have proper expert opinion especially in
serious illnesses. Keep your knowledge updated and keep
latest instruments , if possible.
39. MESSAGE TO MEDICO-PERSON
PLEASE DOCTORS, think twice litigations against
medical practitioners are rising as the relationship between
doctor and patient is deteriorating.
Don’t forget your duties with your rights as a medical
practitioner.
Take a valid consent and maintain perfect records of your
patients.
Don't get upset if there is case against you in consumer
forum.
Have a respect for law, God and of course for human
beings.