An Introduction To Pre-Hospital Care in MalaysiaChew Keng Sheng
This document provides information on pre-hospital emergency care, including transport modes, ambulance equipment types, response times, patient assessment, trauma management principles, and mass casualty incident response. It discusses concepts like the golden hour and platinum 10 minutes for trauma patients, and outlines standards for scene size-up, patient packaging and sorting in multi-casualty events.
GIRN is a radio system used by the Ministry of Health in Malaysia for communication between emergency responders and hospitals. It allows for open communication channels coordinated by the National Security Council. The system requires users to identify themselves clearly, speak one at a time, keep messages brief, and say "over" to indicate they have finished transmitting. Key elements for effective communication over GIRN radios include accuracy, clarity, and using proper procedures like pressing the push-to-talk button to transmit and releasing it to receive transmissions. The system is used in various emergency communication scenarios.
This document provides information on the Malaysian Triage Category (MTC) system used in emergency departments in Malaysia. The MTC system classifies patients into three categories - Red (Critical), Yellow (Semi-Critical), and Green (Non-Critical) - based on the urgency of their condition. The Red category includes life-threatening conditions requiring treatment within 5 minutes. Yellow indicates conditions that could become life-threatening without treatment within 30 minutes. Green covers non-emergent conditions treatable within 90 minutes. Each category has further subcategories to aid in prioritizing patient flow and resource allocation in emergency departments.
Prehospital care in Malaysia - Issues and ChallengesChew Keng Sheng
The document discusses pre-hospital care in Malaysia and identifies several issues and challenges. It notes that Malaysia has a complex pre-hospital care system incorporating hospital-based, civil defense, private, volunteer-based, and other models. Key challenges include a lack of standardized training for pre-hospital providers, inconsistent communication between agencies, and limited access to care in remote areas. The document calls for addressing these challenges to improve pre-hospital care coordination and patient outcomes in Malaysia.
Disaster and field triaging ppw 2014 selvaSelvendra Shan
This document discusses disaster and field triage. It defines disasters as complex incidents resulting in loss of life, property damage, or disruption to daily life. Several types of disasters are described, including natural disasters, industrial accidents, and transportation accidents. The document outlines Malaysia's disaster management structure and the agencies involved in response. Two triage systems are explained - START and JumpSTART. START triages patients into immediate, delayed, minor, and deceased categories based on breathing, perfusion, and mental status. JumpSTART is modified for pediatric patients and includes a brief ventilation trial for non-breathing children with a pulse.
The document discusses pre-hospital care, which includes emergency care provided at the scene of an incident and during transport to a healthcare facility. It outlines the goals of pre-hospital care as providing systematic pre-hospital services, qualified staff and equipment, and handling cases at the scene to ultimately save victims. Key aspects of pre-hospital care systems that are discussed include triage, primary and secondary surveys, resuscitation, re-evaluation, definitive care, documentation, and transportation. Various life-threatening conditions seen in trauma patients such as airway obstructions, tension pneumothorax, and cardiac tamponade are also summarized.
An Introduction To Pre-Hospital Care in MalaysiaChew Keng Sheng
This document provides information on pre-hospital emergency care, including transport modes, ambulance equipment types, response times, patient assessment, trauma management principles, and mass casualty incident response. It discusses concepts like the golden hour and platinum 10 minutes for trauma patients, and outlines standards for scene size-up, patient packaging and sorting in multi-casualty events.
GIRN is a radio system used by the Ministry of Health in Malaysia for communication between emergency responders and hospitals. It allows for open communication channels coordinated by the National Security Council. The system requires users to identify themselves clearly, speak one at a time, keep messages brief, and say "over" to indicate they have finished transmitting. Key elements for effective communication over GIRN radios include accuracy, clarity, and using proper procedures like pressing the push-to-talk button to transmit and releasing it to receive transmissions. The system is used in various emergency communication scenarios.
This document provides information on the Malaysian Triage Category (MTC) system used in emergency departments in Malaysia. The MTC system classifies patients into three categories - Red (Critical), Yellow (Semi-Critical), and Green (Non-Critical) - based on the urgency of their condition. The Red category includes life-threatening conditions requiring treatment within 5 minutes. Yellow indicates conditions that could become life-threatening without treatment within 30 minutes. Green covers non-emergent conditions treatable within 90 minutes. Each category has further subcategories to aid in prioritizing patient flow and resource allocation in emergency departments.
Prehospital care in Malaysia - Issues and ChallengesChew Keng Sheng
The document discusses pre-hospital care in Malaysia and identifies several issues and challenges. It notes that Malaysia has a complex pre-hospital care system incorporating hospital-based, civil defense, private, volunteer-based, and other models. Key challenges include a lack of standardized training for pre-hospital providers, inconsistent communication between agencies, and limited access to care in remote areas. The document calls for addressing these challenges to improve pre-hospital care coordination and patient outcomes in Malaysia.
Disaster and field triaging ppw 2014 selvaSelvendra Shan
This document discusses disaster and field triage. It defines disasters as complex incidents resulting in loss of life, property damage, or disruption to daily life. Several types of disasters are described, including natural disasters, industrial accidents, and transportation accidents. The document outlines Malaysia's disaster management structure and the agencies involved in response. Two triage systems are explained - START and JumpSTART. START triages patients into immediate, delayed, minor, and deceased categories based on breathing, perfusion, and mental status. JumpSTART is modified for pediatric patients and includes a brief ventilation trial for non-breathing children with a pulse.
The document discusses pre-hospital care, which includes emergency care provided at the scene of an incident and during transport to a healthcare facility. It outlines the goals of pre-hospital care as providing systematic pre-hospital services, qualified staff and equipment, and handling cases at the scene to ultimately save victims. Key aspects of pre-hospital care systems that are discussed include triage, primary and secondary surveys, resuscitation, re-evaluation, definitive care, documentation, and transportation. Various life-threatening conditions seen in trauma patients such as airway obstructions, tension pneumothorax, and cardiac tamponade are also summarized.
Pre-hospital care aims to reduce morbidity and mortality for patients outside the hospital by providing immediate medical care at the scene and during transport. It involves various providers like paramedics, nurses, and doctors who are specially trained to treat patients in pre-hospital settings. The philosophy is to intervene appropriately and transport patients safely to definitive care in a timely manner. An effective pre-hospital care system requires coordination between various stakeholders including emergency responders, hospitals, and policymakers to ensure patients receive optimal care from the scene to the hospital.
Malaysian Triage Scale New Revised 2019-1.pdfMathanRaj581834
The document outlines the Malaysian Triage Scale process for emergency departments. It describes the primary and secondary triage process which involves a critical first look, rapid assessment of vital signs, complaints and initial tests to assign a triage level between 1 and 5. Level 1 is resuscitation, level 2 is emergency, level 3 is urgent, level 4 is early care and level 5 is routine. The primary triage officer ensures safety by identifying infectious diseases, hazardous exposures, aggressive or violent patients and resolving issues before they enter the emergency department.
Emergency medical services in Malaysia have improved in recent decades but still face challenges. The system includes government-run and non-government organization ambulances, with varying levels of staff training and equipment. Coordination between emergency response organizations was problematic until 2007 when Malaysia implemented a single emergency number and improved dispatch systems. Pre-hospital care is still developing, with most ambulances staffed by drivers and nurses providing basic care, though specialized emergency physician training programs are expanding.
Disaster and Mass Casualty Incidents (updated 7th July 2020)Chew Keng Sheng
This document discusses disasters, mass casualty incidents, and terrorism. It provides definitions for disasters, mass casualty incidents, and terrorism. Disasters are events that disrupt basic services and cause widespread losses exceeding local response capacity. Mass casualty incidents involve large numbers of casualties that overwhelm normal healthcare services. Terrorism involves man-made external disasters. The document outlines three levels of disasters according to Malaysia's Directive 20 from the National Security Council and describes the formation of the National Disaster Management Agency. It also discusses disaster response, including contingency planning, and provides an overview of various weapons that could potentially be used in terrorist attacks.
PHEM - Pre Hospital Emergency Medicine Guidelines for TrainersEmergency Live
This Guide describes the curriculum, training and assessment processes for Pre-hospital Emergency
Medicine (PHEM) sub-specialty training. It reflects the General Medical Council (GMC) standards and the
uK wide regulations for specialty training (the Gold Guide).1,2 Where there are differences between the four
uK national agencies, the parts of the Gold Guide applicable to these agencies should be regarded as the
definitive guidance.
Role and responsibility of First Responders In MOHdrnikahmad
Dokumen tersebut membahas tentang tugas, tanggung jawab, dan etika first responder dalam memberikan perawatan pertolongan pertama. Ia menjelaskan bahwa first responder adalah orang pertama yang tiba di tempat kejadian dan terlatih untuk memberikan perawatan awal. Dokumen tersebut juga membahas tentang nilai-nilai integritas seperti kejujuran, tanggung jawab, dan komitmen dalam pelaksanaan tugas first responder.
This document discusses methods for triage and assessment in mass casualty situations. It describes evaluating patients based on airway, breathing, circulation, disability and exposure (ATLS methodology). Patients are categorized into triage categories (immediate, delayed, minimal, expectant) based on their injuries and prognosis. Scoring systems like Injury Severity Score (ISS) and Revised Trauma Score (RTS) are used to evaluate patients and compare outcomes between treatment centers using TRISS methodology.
Dokumen tersebut memberikan informasi mengenai persiapan sebelum dan perawatan setelah pembedahan secara umum. Persiapan sebelum pembedahan meliputi persiapan psikologis, fisik, dan administratif. Perawatan setelah pembedahan meliputi perawatan awal, setelah sadar dari bius, hingga pemulihan total, serta komplikasi yang mungkin terjadi.
The document provides guidance on performing an initial patient assessment for EMTs. It describes evaluating the scene for safety, determining the mechanism of injury or nature of illness, and performing an initial assessment of the patient's airway, breathing, circulation, mental status and skin signs. The assessment may be followed by a more focused physical exam and history gathering for medical versus trauma patients. Key steps include maintaining spinal immobilization if needed, assessing vital signs, and identifying any life-threatening conditions requiring immediate treatment.
Trakeostomi adalah prosedur membuka saluran eksternal ke trakea. Hal ini dilakukan untuk mengatasi penyekatan saluran pernafasan akibat berbagai kondisi seperti cedera kepala, tumor, atau gagal intubasi. Penjagaan pasca-trakeostomi meliputi penilaian stoma, penyedutan sekret, dan pembersihan tiub serta area sekitarnya untuk mencegah komplikasi seperti infeksi.
Prehospital care in trauma is as important as in hospital care. The presentation addresses simple and basic approach to care a polytrauma victim in platinum 10 minutes based on BTLS.
Basic principle of medicolegal management in emergency departmentLee Oi Wah
This document provides guidelines for managing patients' property in healthcare facilities. It states that hospitals are responsible for safely storing any valuable items patients arrive with while unconscious, and must record any movements of patient property. Signs should also inform patients not to bring valuables, and that the hospital is not liable for lost, stolen or damaged personal items. When property is unclaimed, hospitals must handle it according to established guidelines. Proper documentation in property log books is required from all relevant departments.
Dokumen ini membincangkan penjagaan pra dan pos pembedahan. Ia menyenaraikan persediaan pra dan pos surgeri seperti penjagaan psikologikal, fizikal dan pengurusan pesakit. Dokumen ini juga membincangkan komplikasi yang mungkin berlaku selepas pembedahan dan penjagaan awal, pos anestesia serta pemulihan pesakit selepas pembedahan.
Pre-hospital care aims to reduce morbidity and mortality for patients outside the hospital by providing immediate medical care at the scene and during transport. It involves various providers like paramedics, nurses, and doctors who are specially trained to treat patients in pre-hospital settings. The philosophy is to intervene appropriately and transport patients safely to definitive care in a timely manner. An effective pre-hospital care system requires coordination between various stakeholders including emergency responders, hospitals, and policymakers to ensure patients receive optimal care from the scene to the hospital.
Malaysian Triage Scale New Revised 2019-1.pdfMathanRaj581834
The document outlines the Malaysian Triage Scale process for emergency departments. It describes the primary and secondary triage process which involves a critical first look, rapid assessment of vital signs, complaints and initial tests to assign a triage level between 1 and 5. Level 1 is resuscitation, level 2 is emergency, level 3 is urgent, level 4 is early care and level 5 is routine. The primary triage officer ensures safety by identifying infectious diseases, hazardous exposures, aggressive or violent patients and resolving issues before they enter the emergency department.
Emergency medical services in Malaysia have improved in recent decades but still face challenges. The system includes government-run and non-government organization ambulances, with varying levels of staff training and equipment. Coordination between emergency response organizations was problematic until 2007 when Malaysia implemented a single emergency number and improved dispatch systems. Pre-hospital care is still developing, with most ambulances staffed by drivers and nurses providing basic care, though specialized emergency physician training programs are expanding.
Disaster and Mass Casualty Incidents (updated 7th July 2020)Chew Keng Sheng
This document discusses disasters, mass casualty incidents, and terrorism. It provides definitions for disasters, mass casualty incidents, and terrorism. Disasters are events that disrupt basic services and cause widespread losses exceeding local response capacity. Mass casualty incidents involve large numbers of casualties that overwhelm normal healthcare services. Terrorism involves man-made external disasters. The document outlines three levels of disasters according to Malaysia's Directive 20 from the National Security Council and describes the formation of the National Disaster Management Agency. It also discusses disaster response, including contingency planning, and provides an overview of various weapons that could potentially be used in terrorist attacks.
PHEM - Pre Hospital Emergency Medicine Guidelines for TrainersEmergency Live
This Guide describes the curriculum, training and assessment processes for Pre-hospital Emergency
Medicine (PHEM) sub-specialty training. It reflects the General Medical Council (GMC) standards and the
uK wide regulations for specialty training (the Gold Guide).1,2 Where there are differences between the four
uK national agencies, the parts of the Gold Guide applicable to these agencies should be regarded as the
definitive guidance.
Role and responsibility of First Responders In MOHdrnikahmad
Dokumen tersebut membahas tentang tugas, tanggung jawab, dan etika first responder dalam memberikan perawatan pertolongan pertama. Ia menjelaskan bahwa first responder adalah orang pertama yang tiba di tempat kejadian dan terlatih untuk memberikan perawatan awal. Dokumen tersebut juga membahas tentang nilai-nilai integritas seperti kejujuran, tanggung jawab, dan komitmen dalam pelaksanaan tugas first responder.
This document discusses methods for triage and assessment in mass casualty situations. It describes evaluating patients based on airway, breathing, circulation, disability and exposure (ATLS methodology). Patients are categorized into triage categories (immediate, delayed, minimal, expectant) based on their injuries and prognosis. Scoring systems like Injury Severity Score (ISS) and Revised Trauma Score (RTS) are used to evaluate patients and compare outcomes between treatment centers using TRISS methodology.
Dokumen tersebut memberikan informasi mengenai persiapan sebelum dan perawatan setelah pembedahan secara umum. Persiapan sebelum pembedahan meliputi persiapan psikologis, fisik, dan administratif. Perawatan setelah pembedahan meliputi perawatan awal, setelah sadar dari bius, hingga pemulihan total, serta komplikasi yang mungkin terjadi.
The document provides guidance on performing an initial patient assessment for EMTs. It describes evaluating the scene for safety, determining the mechanism of injury or nature of illness, and performing an initial assessment of the patient's airway, breathing, circulation, mental status and skin signs. The assessment may be followed by a more focused physical exam and history gathering for medical versus trauma patients. Key steps include maintaining spinal immobilization if needed, assessing vital signs, and identifying any life-threatening conditions requiring immediate treatment.
Trakeostomi adalah prosedur membuka saluran eksternal ke trakea. Hal ini dilakukan untuk mengatasi penyekatan saluran pernafasan akibat berbagai kondisi seperti cedera kepala, tumor, atau gagal intubasi. Penjagaan pasca-trakeostomi meliputi penilaian stoma, penyedutan sekret, dan pembersihan tiub serta area sekitarnya untuk mencegah komplikasi seperti infeksi.
Prehospital care in trauma is as important as in hospital care. The presentation addresses simple and basic approach to care a polytrauma victim in platinum 10 minutes based on BTLS.
Basic principle of medicolegal management in emergency departmentLee Oi Wah
This document provides guidelines for managing patients' property in healthcare facilities. It states that hospitals are responsible for safely storing any valuable items patients arrive with while unconscious, and must record any movements of patient property. Signs should also inform patients not to bring valuables, and that the hospital is not liable for lost, stolen or damaged personal items. When property is unclaimed, hospitals must handle it according to established guidelines. Proper documentation in property log books is required from all relevant departments.
Dokumen ini membincangkan penjagaan pra dan pos pembedahan. Ia menyenaraikan persediaan pra dan pos surgeri seperti penjagaan psikologikal, fizikal dan pengurusan pesakit. Dokumen ini juga membincangkan komplikasi yang mungkin berlaku selepas pembedahan dan penjagaan awal, pos anestesia serta pemulihan pesakit selepas pembedahan.
1. EMS Communication and Documentation
John Britto Victor Arokiasamy
BSc.(Hons) Nursing Practice Development (Northumbria,UK),
Adv. Dip. AEMTC (MAL), Dip.MA (MAL), Certified EMD & ED-Q (IAED)
Assistant Medical Officer U29,
Emergency and Trauma Department,
Hospital Seberang Jaya
3. MEDICAL EMERGENCY COORDINATION
CENTRE (MECC)
Pusat Koordinasi Perubatan Kecemasan
Dilengkapi dengan sistem
- Computer Aided Dispatch (CAD)
- GIS (Geography Information System)
- Call Taking Protocol
Dikendalikan oleh Profesional Emergency
Dispatcher (PED)
1. Call Taker
2. Call Dispatcher
4. FUNGSI MECC DAN MERS 999
HOSPITAL SEBERANG JAYA
• MENERIMA PANGGILAN 999 DARI RC TM BAGI NEGERI PULAU
PINANG
• MENJAWAB PANGGILAN PEMANGGIL MENGGUNAKAN SISTEM MERS
999
• MENYARING PANGGILAN MENGGUNAKAN PERISIAN PRO QA BAGI
MENENTUKAN TAHAP PASUKAN RESPON.
• MENGKOORDINASIKAN SUMBER AMBULAN YANG TERDAPAT
DINEGERI PULAU PINANG
• MENGATUR DAN MENGURUSKAN AMBULAN UNTUK KES-KES
INTERFASILITI
• MENGURUSKAN PASUKAN PHC UNTUK RESPON KES
• MELAKUKAN RADIO CHECK (GIRN)
5. Apa itu MERS 999
MALAYSIA EMERGENCY RESPONSE SERVICE 999
• Sistem bersepadu yang mengabungkan 5 agensi
bantuan kecemasan bagi mengendalikan dan
menyalurkan panggilan serta maklumat kecemasan
melalui satu nombor iaitu nombor universal respons
kecemasan “999” bagi memudahkan rakyat jika
menghadapi kecemasan.
• Dilancarkan oleh kerajaan Malaysia pada tahun 2007 –
“Satu Malaysia, Satu Nombor ”
6. • The protection and safety of human life.
• The preservation and protection of property
and environment.
• The improvement of the quality in life and
social conditions for the public
15. TUGAS-TUGAS PED
Call Taker
Menjawab panggilan yang disalur oleh
Pusat Respon Telekom Malaysia.
Menggunakan Perisian ProQA bagi proses
saringan pesakit.
Mengesahkan buitr-butir Pemanggil.
Mengesahkan Lokasi Kejadian
Menerima butir kejadian
Memberi bantuan melalui talian (DLS)
16. Call Despatcher
Membuka data melalui sistem CAD
Melihat maklumat kejadian pada call card
Menentukan kawasan yang terlibat dan
menghantar responder yang sesuai.
Menerima laporan dari team kecemasan
dan situasi semasa.
Merekod laporan kedudukan semasa
ambulan.(Resos)
17. Kelayakan sebagai PED
Lulus dengan jayanya kursus dan
peperiksaan ADVANCED EMEREGENCY
MEDICAL DISPATCHER oleh
International Academy of Emergency
Medical Dispacth (USA)
18. PRO- QA
Perisian yang digunakan dalam system
MERS bagi membantu penyaringan
pesakit.
Perisian telah dibentuk menggunakan
panel skrip yang terbaik bagi membantu
melancarkan respon dan soalan kepada
pemanggil
Mempercepatkan masa proses despacth
kes.
20. EMD PROTOKOL
(MPDS)
Digunakan oleh PED semasa
panggilan 999 sebagai panduan
di dalam mengendalikan
panggilan kecemasan
Terdapat 33 c/c protokol yang
ditentukan oleh MPDS (no 1-33)
yang menggunakan format yang
telah disusun ( Key Question)
bagi menilai keadaan pesakit di
tempat kejadian dan penilaian
prority respon.
21. Chief Complaint Protocol
1. Sakit Perut
2. Allergi ( Alahan? Bisa sengatan, Patukan )
3. Serangan/Gigitan Haiwan/Binatang
4. Dipukul/Serangan Seksual
5. Sakit Belakang ( Bukan Trauma@Trauma Bukan baru )
6. Masalah Pernafasan
7. Terbakar ( melecur )/Letupan( Blast )
8. Karbon monoksida/Terhidu ( Inhalasi ) HAZIMAT/ CBRN
9. Tidak Sedar Dan Tidak Bernyawa
10. Sakit Dada ( Bukan Trauma )
11. Tercekik
12. Sawan
13. Masalah Kencing Manis ( Diabetis )
14. Lemas ( Hampir Lemas )/Terjun Junam/Kemalangan Scuba
15. Renjatan Elektrik/Dipanah Petir
16. Masalah/Kecederaan Mata
17. Jatuh
22. Chief Complaint Protocol (Samb…)
18. Sakit Kepala
19. Masalah Jantung / A.I.C.D
20. Terdedah Kepada Kepanasan/Kesejukan
21. Pendarahan/luka
22. Insiden Putus Hubungan/Terperangkap ( Bukan Kenderaan)
23. Overdos/Keracunan (ingesi)
24. Mengandung ( Hamil )/Bersalin/Keguguran
25. Psikiatrik/Tingkahlaku Tidak Normal/Cubaan Bunuh Diri
26. Orang sakit ( Diagnosis Spesifik)
27. Tikaman/Tembakan/Luka Tertusuk
28. Strok
29. Kemalangan Trafik/Pengangkutan
30.Trauma Kecederaan ( Specifik )
31.Tidak Sedar/Pengsan
32. Masalah Tidak Diketahui ( Man Down )
33. Rujukan Kes/Inter fasiliti/Rawatan Paliatif
23. Kandungan EMD Protokol
1. Case Entry Protocol
2. Key Questions
3. Post Despacth Instructions
4. Pre-Arrival Instruction
5. Case Exit Protocol
24. Case Entry Protokol
Protokol yangmemerlukan maklumat asas
yang diperlukan dalam proses panggilan
kecemasan seperti
Pengesahan alamat dan nombor telefon
pemanggil.
Chief Complaint.
Umur.
Status kesedaran.
Status Pernafasan.
25.
26. Post- Dispacth Instruction
Arahan yang perlu
diberikan kepada
pemanggil selepas
“Determinant
Code” dipilih dan
didispatch.
27. Pre-Arrival Instructions
PAI protokol diberikan oleh PED bagi membantu pemanggil dalam
proses membantu dan menjaga pesakit mengikut protokol PAI yang
disediakan sebelum ketibaan bantuan Ambulan.
- Protokol A : Airway/Arrest/Choking (Unconcious) –Infant < 1yrs
- Protokol B : Airway/Arrest/Choking (Unconcious) –Child 1-7yrs
- Protokol C : Airway/Arrest/Choking (Unconcious) –Adult > 8 yrs
- Protokol D : Choking (concious) Infant/Child/Adult
- Protokol F : Childbirth – Delivery
- Protokol Ya : Tracheostomy(stoma) Airway/Arrest/Choking
(Unconcious) –Infant < 1yrs
- Protokol Yb : Tracheostomy(stoma) Airway/Arrest/Choking
(Unconcious) – Child< 7yrs
- Protokol Yc : Tracheostomy(stoma) Airway/Arrest/Choking
(Unconcious) –Adult > 8 yrs
- Protokol Z : AED Support
28. Case Exit
Case Exit protocol memberi arahan atau
nasihat sesuai keadaan pesakit dalam
proses menamatkan panggilan samada
pesakit kekal di talian atau memutuskan
talian sebelum bantuan tiba.
Bergantung kepada chief complaint dan
Pemanggil.