seema.pdf

A REPORT
on
HOSPITAL TRAINING-I
at
Community Health Centre, Hazipur, Fatehpur
Submitted to ASHOK SINGH PHARMACY COLLEGE,MAHAROOPUR,
JAUNPUR for partial fulfillment of the requirements for the award of
thedegree of
BACHELOR OF PHARMACY
Affiliated to
Dr. A. P. J. Abdul Kalam Technical University
(Formally Uttar Pradesh Technical University)
LUCKNOW
Under the Supervision of
Mr. ADITYA GUPTA
(Head of department)
By
SEEMA SINGH LAXMI
B.Pharm.5th
Sem.
Roll no. 2011430500051
Department of Pharmacy
ASHOK SINGH PHARMACY COLLEGE,JAUNPUR
DECEMBER 2022

(1143)ASHOK SINGH PHARMACY COLLEGE
MAHROOPUR,JAUNPUR 222138 (U.P.) INDIA
Call us: +91 9935899383
WhatsApp : +91 9935899383
E-mail:aspc.jaunpur@gmail.com
Website: www.aspcjaunpur.com
Approved by PCI and Govt. of India & Govt. of U.P. and Affiliated to
Dr. A. P. J.Abdul KalamTechnical University, Lucknow
Ref. No.ASPC/Admin Date……………………….
Declaration by student
This is to be certified that SEEMA SINGH LAXMI (2011430500051), has carried out “A
report on Hospital Training – I” for the award of Bachelor of Pharmacy during his B.Pharm 5th
semester in ASHOK SINGH PHARMACY COLLEGE,MAHAROOPUR,JAUNPUR under
the guidance of Mr. ADITYA GUPTA, which is submitted to Dr.A.P.J. Abdul Kalam Technical
University, Lucknow, in partial fulfillment for the award of degree of Bachelor of Pharmacy.
SEEMA SINGH LAXMI
B.Pharm 5th
sem.
Roll.No. 2011430500051

Call us: +91 9935899383
WhatsApp : +91 9935899383
Declaration by Guide
This is to be certified that SEEMA SINGH LAXMI (2011430500051), has carried out“A
report on Hospital Training -I ”for the award of Bachelor of Pharmacy during his B.Pharm
5th
semester in Ashok Singh Pharmacy College, Maharoopur, Jaunpur under my
guidance which is submitted to Dr.A.P.J. Abdul Kalam Technical University, Lucknow, in
partial fulfillment for the awardof degree of Bachelor of Pharmacy.
Mr. ADITYA GUPTA
Department of Pharmacy,
ASHOK SINGH PHARMACY
COLLEGE,MAHAROOPUR,
JAUNPUR (UP)

Call us: +91 9935899383
WhatsApp : +91 9935899383
Declaration by Principal
This is to be certified that SEEMA SINGH LAXMI (2011430500051), has carried out “A
report on Hospital Training –I ” for the award of Bachelor of Pharmacy during his B. Pharm
5th
semester in Ashok Singh Pharmacy College, Maharoopur, Jaunpur under the guidance of Mr.
ADITYA GUPTA, which is submitted to Dr. A.P.J. Abdul Kalam Technical University, Lucknow,
in partial fulfillment for the award of degree of Bachelor of Pharmacy.
Dr.JAYANT KUMAR MAURYA
(Principal)
ASHOK SINGH PHARMACY COLLEGE
MAHAROOPUR,JAUNPUR

INDEX
Chapter No. Title Page No.
Chapter - 1 Introduction 1-2
1.1 Community Health Center Fatehpur
1.2 Hospital Layout
Chapter - 2 Hospital Facilities 3-18
2.1 OPD Facilities
2.2 Word Facilities
2.3 Operation Theatre Facilities
2.4 T.B Ward
2.5 Eye Ward
2.6 Pediatric Ward
2.7 Burn Ward
2.8 Pharmacy Facilities
2.9 Emergency Department
2.10 Pathology Facilities 19-24
Chapter- 3 Prescription
3.1 Procedure in writing a prescription
3.2 Parts of Prescription
3.3 Flow Chart of handling Prescription
3.4 Maintaining and handeling of different
Register
3.5 Responsbiliies of Hospital Pharmacist
3.6 Dispensing
3.7 Coding
3.8 Various advantage of coding
3.9 List of Medicine
Chapter - 4 First Aid 25-33
4.1 First Aid World Wide
4.2 Professional Leaves
4.3 Issue in Providing Care
4.4 Fist Aid
4.5 Emergency First Aid
4.6 AIMS of First Aid
Chapter -5 Routes of Administration 34-36
5.1 Subcutaneous Under the Skin
5.2 Intramuscular in a muscle
5.3 Intravenous in a Vein
5.4 Intraheacal Aruond the Spinal Cord
Chapter - 6 Artificial Respiration and CPR 37-38
Chapter - 7 Patient Observation Chart 39
7.1 Diagnostic Report
Chapter- 8 Ambulance Service 40
Chapter - 9 Conclusion 41
Chapter -10 Reference 42

List of Figures
Figure No. Name of Figure Page No.
1.1 Front of CHC 1-2
1.2 Hospital Layout
2.1 OPD Service
2.2 Indoor Facility 3-18
2.3 Operation Theatre
2.4 Pharmacy
2.6 Pathology
3.1 Prescription
4.1 First Aid
5.1 Under The Skin
5.2 Intramuscular
5.3 Intravenous
5.4 Intrathecal
6.1 Artificial respiration and CPR 19-24
7.1 Observation Chart
8.1 UP Ambulance Service

ACKNOWLEDGMENT
In the name of “God most beneficial and merciful” I offer mine gratitude to almightily “God”
who created us as a human being and give us potential for solving every problem. Inspiration is the only
source of light in the darker side of life. We wish to dedicate this report to our parents.
Firstly, and foremost, I would acknowledge to Dr. JAYANT KUMAR MAURYA(Principal)
of ASHOK SINGH PHARMACY COLLEGE,MAHAROOPUR JAUNPUR (U.P.) for providing
facilities to carry out this report.
I am especially thankful to Mr. ADITYA GUPTA (Assistant Professor) who gave me
permission and accompanied to complete my work.
I take privilege to acknowledge to all those who have helped us in completion of the work. I
express my deep sense of gratitude indebtedness to my guide Mr. ADITYA GUPTA , for their kind
recommendation to complete my hospital training report.
I would like to acknowledge with much appreciation the crucial role of all teachers specially
Mr. ADITYA GUPTA (H.O.D ), Mr. Gyanbahadur Pal, Mr. Lavkush Rajabhar, Mr. Govind
Kumar Kannaujiya, Mr. Sachin Kumar Yadav, Mr.Sajan Maurya, Dr.Ankit Sharma,
Mr.Abhishek Singh, Mrs. Supriya Gupta, Miss. Sukanya Yadav, Mrs. Shashikala Vishwakarma,
Mrs. Jyoti Singh, Mrs.Manju Verma, Mrs. Anita Maurya. They always encouraged and support me
to complete my report.
I am grateful to ASHOK SINGH PHARMACY COLLEGE,MAHAROOPUR,JAUNPUR
for providing infrastructure, computer lab, Library and other facilities. I am also thankful to my parents
and classmates for their kind co- operation and the author whose book I had consulted while making the
report and to myteachers and my dear friends.
Thinking You

A report on Hospital training- I 2022
Ashok Singh Pharmacy College Mahroopur, Jaunpur, U.P. Page 1
CHAPTER: 1
INTRODUCTION
1.1 Hospital
The word hospital derived from the Latin word “hospitium” which means a place where
guests are received. Hospital is a complex organization may be defined as “An institution of
providing health to individuals with the help of complex and special scientific modern
medical science.
1.2 History
In 1996, Community Health Centre (CHC) was established by a group of not for – profit and
community – operated health care system dedicated to the sustainability of community
based hospitals. Driven by the passion they shared, this group of organisations formed CHC
to sustain community hospital well into the future.
Since its inception, CHC remain a not for profit company whose sole mission is to help
hospital remain community – operated and governed . CHC owns manages and consult with
hospitals across the United States.
Based in Plano, Texas, our organization provides community hospital with the resources and
experience they need to improve the quality of treatment outcomes, patient satisfaction
and financial performance.
Community Health Centre Government Hospital Fatehpuris basically established to centre
the need of local residents of Fatehpur. The hospital was established in the year 2012 as a 4
bedded hospital which was extended up to 50 beds in 2018 . Casually started in 2014 for day
time only and with effect from April, 2015 it become functional round the clock in 2016
emergency block was commission which increase the bed strength to 20 emergency services
shift to this new block with expanded emergency room and words the hospital is providing
specialized services to people of Fatehpur and importing training to under graduate medical
students and para/medical CHC refers to essential health centre that is based on
scientifically and socially acceptable method and technology this makes universal healthcare
assible to all individual and family in a community CHC initiative allowed for the full
participation of community members Implantation and decision making.

Fig.1.1 C.H.C Swastya Kendra Hazipur, Fatehpur
1.3 Classification of Hospital
Hospitals are classified on the basis of clinical, non clinical and medical system size
and cost.

1.4.1. Clinical hospital: This is also classified on the basis of diagnosis and Treatments.
a) Medicine: Communicable disease Samudayik Swasthya Kendra Fatehpur
hospital.
b) Surgery: Surgery performed such as cardiac surgery, kidney surgery, eye
surgery, orthopedic surgery, gynecological surgery (In case of women)
c) Maternity: This type of hospital deals with the delivery cases
d) Pediatric: This type of hospital treating the disease of children’s including new
born Childs.
e) 1.4.2. Non- Clinical hospital: This is also classified on the basis of
ownership of hospital, which may be of two types
f) Central Government Hospital: This type of hospital runs by state government
authorities. E.g. Railway Hospital, Defence Hospital, command Hospital Lucknow,
AIIMS New Delhi etc.
g) Public ownership: Public hospital may govern by following authority:
h) State Government Hospital: These type hospitals are run by state government
authorities. E.g. Civil Hospital Lucknow and other civil hospital, J.J. hospital
Mumbai etc.
 Local self- Government hospital: These types of hospital are run by
municipalities or corporation e.g. BMC Hospital, Bhagwati Hospital in Mumbai
etc.
 Private ownership hospital: These hospital are run by the following
organization:
a) Trusts hospital: This type of hospital runs by trustees of the trust.
b) Religious bodies: These type of hospital govern by the group of people belonging
to particular religion e.g. Jain hospital and medical College, Christians Medical
College and hospital.
c) Limited companies: These type hospitals are governed by public limited
companies, e.g. Bactra Hospital , Escort Heart Research Institute etc.
1.4.4 Size based hospitals:
These type of hospital are classified on the basis of sizes
occupying capacity of the beds.
a) Medium hospital: ( Beds up to 300). E.g. District hospital
b) Small hospital: (Beds between 100-200)
c) Very small hospital: (Beds less than 100)
1.4.5 On the basis of cost:
1. Elite hospitals: There are the symbols of high technology and advance in
medical sciences. They have deluxe room equipped with TV, telephone and
refrigerator, room rate may vary from 1000 to 10,000.
2. Budget Hospitals: These are meant for moderate budget and low budget users,
e.g. civil hospitals, corporation hospitals etc.

1.1.1 Functions of Hospital
a) Its provides patients care with nursing,dietarydiagnostic,therapy,pharmacy and
laboratory services.
b) It provides teaching and training for doctor, nurses & pharmacist and health
personnel’s.
c) It improves the quality of care and general standard of medical services.
d) It stimulates the growth of medical science, Doctors and nurses receive their training in
large teaching hospitals.
e) It provides medical cares such as prevention, diagnosis, therapy, rehabilitation,
treatment, education and research.
f) It lowers the incident of disease through early detection and treatment.
g) It provides job opportunities for doctor, nurses & pharmacist and health personnel’s.
h) It provides research work.
i) Large hospital co-operates with smaller hospitals, specialized hospitals co-operate
withgeneral hospitals, private hospital co-operates with public hospitals.
j) It provide control of communicable disease and provides family welfare services.
1.1.3 Aims and Objective of Hospital
a) Provide healthcare services to ensure the wellness of people living in the state.
b) Prevent diseases from spreading in the rural areas by using safety measures.
c) Offering dental, mental and medical check-ups to those who cannot afford or do not have
access to such services in their area.
d) Protect the human rights of clients.
e) Provide cure,care,preventive services.
f) Participate or conduct research.
g) Provide in-service/continuing education in all discipline professional technical personnel.
h) Provides public health education and promotion done through a variety of
programs,including smoking cessation programs,weight loss programs etc.

1.1.3 Advantage
 can help put an end to infant mortality and maternal deaths.
 More awareness regarding healthcare can be spread among people.
 People living in rural areas can easily benefit from regular medical It
check-ups.
 This place is not only treating sickness but it also helps improving
the health of community.
 Low-income people can easily get access to healthcare facilitie.
 Many hospitals are creating programs that offer financial assistance
to patients who can not afford to pay for hospital care.
Disadvantage
 In public hospitals low quality care,corruption,overcrowding of clinics,barrier of
access etc can occur.

CHAPTER:2
HOSPITAL LAYOUT AND DESIGN
 At the entrance of C.H.CFatehpurhave main entrance in south side face . After the
main entrance there is present a reception where the prescription slip was
prepared . A pharmacy room is present in right sides of reception room . At the right
side of the pharmacy room a pathology and dental departments are present . In
front of dental room ,an two beded emergency department is present for primary
treatment of minor accidental cases .At the right side of emergency room , a general
physician room is situated for opd .A gynecologist room is also situated in front of
pharmacy department.Atleftside of reception room an administrative room present
and a chief pharmacist room also attached with administrative room at right side. In
front of chief pharmacist room a x-ray department is present and delivery
department is situated in a separate area in C.H.C. FATEHPUR

Fig.2.1.Layout ofC.H.C.Government Hospital Fatehpur,Jaunpur
Type of department in hospital
 Ophthalmic department
 Outpatient department (OPD)
 Surgical department
 Inpatient service (IP)
 Nursing department
 Peadriatic block
1. Pharmacy department
2. Operation theater complex (OT)
3. Radiology department (X-ray)
4. Dental department
2.2.Ophthalmic Department:
Definition :
Ophthalmology is the area of medicine and surgery concerned with the eye and
its relationship with the brain.

An ophthalmologist is a physician who specializes in the diagnosis and treatment
of diseases of the eye. Ophthalmologists may prescribe and fit eyeglasses and
contact lenses and also treat eye diseases with drugs and surgery.
Deployed doctor - Dr. Ankit Srivastava (MBBS)
 Out-Door facilities
a) Proper diagnostic instruments are available.
b) Proper medication facilities are available.
c) The no. of doctors available is that clinic.
d) Facilities of regular checkups of patients are provided.
 Some other facilities
a) Provision and instrument are available for surgery.
b) Bedding facilities are also provided to the patients who undergo surgery.
c) Proper facilities for spectacles are also available there.
Fig.2.2 Eye block
2.3.Dental department:
Dentists are the frontline of good oral health. They work with communities
to prevent and treat dental/oral disease, correct dental irregularities and treat
dental/facial injuries.

Deployed doctor - Dr. Diksha Singh (MD)
Fig. 2.3 Dental Department
 In-Door facilities
a) Proper beds with require metallic instruments.
b) Proper medication available.
c) Proper dressing and feeling of medicament in pit of tooth.
d) Provision and instrument for surgery are also available.
e) Proper instrumental facilities are available to support to their decay tooth or there
part.
a) Proper regular checkup.
b) Removal of damage tooth.
c) Availability of proper medication facilities.
d) Proper counselling of patient is done.
 Some other facilities
a) TNursing facilities available are 2.
b) No. of doctors available are 1.
c) Proper dietary supplement are available
2.4.Peadriatic Department:
Pediatrics is the branch of medicine dealing with the health and medical care of
infants, children, and adolescents from birth up to the age of 18. The word

“paediatrics” means “healer of children”; they are derived from two Greek words:
(pais = child) and (iatros = doctor or healer).
Deployed doctor - Dr. Alok Singh (MBBS)
 In-Door facilities
a) Special intensive care is being provided in this block.
b) Proper beddingfacilities are available.
c) Routinecheckup is done.
d) Proper diagnostic instruments and other devices are available.
e) An importance is given to cleanliness and hygiene in this block.
f) Proper dietary supplement are available for In-Door patients such as eggs, milks,
rice, wheat, pulse and vegetables etc.
a) Proper diagnostic instruments are available.
b) Proper medication facilities are available.
c) Proper counselling is provided to guardians and parents.

Fig. 2.4 Peadriatic ward
2.5.Diagnostic:
Diagnostic tests play a crucial role at every step of disease management – Diagnosis,
Monitoring, Screening and Prognosis. Diagnosis helps find out if a patient is suffering from
a specific condition. A diagnostic test detects a possible condition or confirms the lack of
one.
Deployed docter – Ashok Yadav
. Facilities available in this block
a) Proper time to time diagnosis is being done by doctor

Fig. 2.5 Radiology Department (X_RAY)
Sr. No Staffs and there post No. of workers
1. physician 1
2. Child Care Specialist 1
3. E.N.T Physician 1
4. Chief Pharmacist 2
5. Pharmacist 2
6. X- Ray Technician 1
7. Lab Technician
Physician
2
Table 2.6Data of Hospital Staffs and Other Facilities available

CHAPTER:3
ROUTE OF DRUG ADMINISTRATION
Techniques involved in each route of medication administration are different, and
some of the important points are summarized as follows:
Drugs are introduced into the body by several routes. They may be
1. Taken by mouth (orally)
2. Given by injection into a vein (intravenously, IV), into a muscle
(intramuscularly, IM), into the space around the spinal cord (intrathecally), or
beneath the skin (subcutaneously, sc)
3. Placed under the tongue (sublingually) or between the gums and cheek
(buccally)
4. Inserted in the rectum (rectally) or vagina (vaginally)
5. Placed in the eye (by the ocular route) or the ear (by the otic route)
6. Sprayed into the nose and absorbed through the nasal membranes (nasally)
7. Breathed into the lungs, usually through the mouth (by inhalation) or mouth
and nose (by nebulization)
8. Applied to the skin (cutaneously) for a local (topical) or bodywide (systemic)
effect
9. Delivered through the skin by a patch (transdermally) for a systemic effect
Each route has specific purposes, advantages, and disadvantages.
Oral route
When a drug is taken orally, food and other drugs in the digestive tract may affect
how much of and how fast the drug is absorbed. Thus, some drugs should be taken
on an empty stomach, others should be taken with food, others should not be

taken with certain other drugs, and still others cannot be taken orally at all.
Fig.3.1 Different route of drug administration
Administration by injection (parenteral administration) includes the following
routes:
1. Subcutaneous (under the skin)
2. Intramuscular (in a muscle)
3. Intravenous (in a vein)

4. Intrathecal (around the spinal cord)
 Sublingual and buccal routes
A few drugs are placed under the tongue (taken sublingually) or between the gums
and teeth (buccally) so that they can dissolve and be absorbed directly into the
small blood vessels that lie beneath the tongue. These drugs are not swallowed.
The sublingual route is especially good for nitroglycerin, which is used to relieve
angina, because absorption is rapid and the drug immediately enters the
bloodstream without first passing through the intestinal wall and liver. However,
most drugs cannot be taken this way because they may be absorbed
incompleteerratically.
 Rectal route
Many drugs that are administered orally can also be administered rectally as a
suppository. In this form, a drug is mixed with a waxy substance that dissolves or
liquefies after it is inserted into the rectum. Because the rectum’s wall is thin and
its blood supply rich, the drug is readily absorbed. A suppository is prescribed for
people who cannot take a drug orally because they have nausea, cannot swallow,
or have restrictions on eating, as is required before and after many surgical
operations. Drugs that can be administered rectally include acetaminophen (for
fever), diazepam (for seizures), and laxatives (for constipation). Drugs that are
irritating in suppository form may have to be given by injection.
 Vaginal route
Some drugs may be administered vaginally to women as a solution, tablet, cream,
gel, suppository, or ring. The drug is slowly absorbed through the vaginal wall. This
route is often used to give estrogen to women during menopause to relieve vaginal
symptoms such as dryness, soreness, and redness.

 Ocular route
Drugs used to treat eye disorders (such as glaucoma, conjunctivitis, and injuries)
can be mixed with inactive substances to make a liquid, gel, or ointment so that
they can be applied to the eye. Liquid eye drops are relatively easy to use but may
run off the eye too quickly to be absorbed well. Gel and ointment formulations
keep the drug in contact with the eye surface longer, but they may blur vision.
Solid inserts, which release the drug continuously and slowly, are also available,
but they may be hard to put in and keep in place.
 Nasal route
Nasal administration, popularly known as snorting, is a route of administration in
which drugs are insufflated through the nose. It can be a form of either topical
administration or systemic administration, as the drugs thus locally delivered can go
on to have either purely local or systemic effects.
 Nebulization route
Similar to the inhalation route, drugs given by nebulization must be aerosolized into
small particles to reach the lungs. Nebulization requires the use of special
devicesterMs the bloodstream. Drugs administered by this route generally work
quickly
.
 Otic route
The lungs. How deeply into the lungs they go depends on the size of the droplets.
Smaller droplets go deeper, which increases the amount of drug absorbed. Inside the
lungs, they are absorbed into the bloodstream.
 Transdermal route
Some drugs are delivered bodywide through a patch on the skin. These drugs are
sometimes mixed with a chemical (such as alcohol) that enhances penetration
through the skin into the bloodstream without any injection. Through a patch, the
drug can be delivered slowly and continuously for many hours or days or even
longer
 FIRST AID
First aid is the assistance given to any person suffering a sudden illness or injury, with
care provided to preserve life, prevent the condition fromworsening, and/or promote
recovery. It includes initial intervention in a serious condition prior to professional
medical helpbeing available, such as performing CPR while awaiting an ambulance,
as well as the complete treatment of minor conditions, such as applying a plaster to a
cut. First aid is generally performed by the layperson, with many people trained in
providing basic levels 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 cover
mental health.
Fig.3.2 First for different cuts
 First aid box
It is the first emergency box available for providing medical treatment and relief the
patients at the moment. It consist of various necessary medication which are frequently
used it. First aid box contain:
a) Sterilized gauze pads of different size.
b) Adhesive tape
c) Adhesive bandages
d) Elastic bandages
e) Splint
f) Antiseptic wipes
g) Antibiotic ointment
h) Antiseptic solution
i) Hydrocortisone cream
j) Sharp scissor

k) Safety pins
l) Calamine lotion
m) Thermometer
n) Ipecac syrup
 Aims
The key aims of first aid can be summarized in three key points,
sometimes known as 'the three P's':
a) Preserve life: the overriding aim of all medical care, including first aid, is to save
lives and minimize the threat of death.
b) Prevent further harm: also sometimes called prevent the condition from
worsening, or danger of further injury, this covers 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
becoming dangerous.
c) Promote recovery: 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.
Fig. 3.3First aid box
 Wound
A wound is a type of injury which happens relatively quickly in which skin is torn,
cut, or punctured (an open wound), or where blunt force trauma causes a contusion (a

closed wound). In pathology, it specifically refers to a sharp injury which damages the
dermis of the skin.
a) Classification
1. Acute Wound:Acute wound is the result of tissue damaged by trauma. This may be
deliberate, as in surgical wounds of procedures, or be due to accidents caused by blunt
force, projectiles, heat, electricity, chemicals or friction. An acute wound is by
definition expected to progress through the phases of normal healing, resulting in the
closure of the wound.
2. Chronic Wound: Chronic wound fails to progress or respond to treatment over the
normal expected healing time frame (4 weeks) and becomes "stuck" in the
inflammatory phase. Wound chronicity is attributed to the presence of intrinsic and
extrinsic factors including medications, poor nutrition, co-morbidities or inappropriate
dressing selection.
3.3.Dressings
In the case of clean surgical wounds, there is no evidence that the use of topical
antibiotics reduces infection rates in comparison with non-antibiotic ointment or no
ointment at all. Antibiotic ointments can irritate the skin, slow healing, and greatly
increase the risk of developing contact dermatitis and antibiotic resistance. Because of
this, they should only be used when a person shows signs of infection and not as a
preventative.

Fig.3.4 Dressing of parts of body
3.4. Artificial respiration
Artificial respiration is the act of assisting or stimulating respiration, a metabolic
process referring to the overall exchange of gases in the body by pulmonary
ventilation, external respiration, and internal respiration. Assistance takes many
forms, but generally entails providing air for a person who is not breathing or is not
making sufficient respiratory effort on his/her own (although it must be used on a
patient with a beating heart or as part of cardiopulmonary resuscitation to achieve the
internal respiration). The first method of CPRwas developed in 1893.Pulmonary anton
ventilation (and hence external parts of respiration) is achieved through manual
insufflation of the lungs either by the rescuer blowing into the patient's lungs, or by
using a mechanical device to do so. This method of insufflation has been proved more
effective than methods which involve mechanical manipulation of the patient's chest
or arms, such as the Silvester method. It is also known as Expired Air Resuscitation
(EAR), Expired Air Ventilation (EAV), mouth-to-mouth resuscitation, rescue
breathing or colloquially the kiss of life. Artificial respiration is a part of most
protocols for performing cardiopulmonary resuscitation (CPR) making it an essential
skill for first aid.

 Insufflations
Insufflation also known as 'rescue breaths' or ‘ventilations’ is the act of mechanically
forcing air into a patient's respiratory system. This can be achieved via a number of
methods, which will depend on the situation and equipment available. All methods
require good airway management to perform, which ensures that the method is
effective. These methods include:
a) Mouth to mouth - This involves the rescuer making a seal between his or her mouth
and the patient's mouth and 'blowing', to pass air into the patient's body
b) Mouth to nose - In some instances, the rescuer may need or wish to form a seal with
the patient's nose. Typical reasons for this include maxillofacial injuries, performing
the procedure in water or the remains of vomit in the mouth
c) Mouth to mouth and nose - Used on infants (usually up to around 1 year old), as this
forms the most effective seal
d) Mouth to mask – Most organizations recommend the use of some sort of barrier
between rescuer and patient to reduce cross infection risk. One popular type is the
'pocket mask'. This may be able to provide higher tidal volumes than a Bag Valve
Mask.
e) Bag valve mask (BVM) - This is a simple device manually operated by the rescuer,
which involves squeezing a bag to expel air into the patient.
f) Mechanical resuscitator - An electric unit designed to breathe for the patient.[7]
Fig 3.5 Artificial respiration

Antidots
An antidote is a substance which can counteract a form of poisoning. The term
ultimately derives from the Greek antididonai, means"given against".
The antidotes for some particular toxins are manufactured by injecting the toxin into
an animal in small doses and extracting the resulting antibodies from the host
animals' blood. This results in an antivenom that can be used to counteract poison
produced by certain species of snakes, spiders, and other venomous animals. A
number of venoms lack viableantivenom, and a bite or sting from an animal
producing such a toxin often results in death. Some animal venoms, especially those
produced by arthropods (e.g. certain spiders, scorpions, bees, etc.) are only
potentially lethal when they provoke allergic reactions and induce anaphylactic shock;
as such, there is no "antidote" for these venoms because it is not a form of poisoning
and anaphylactic shock can be treated (e.g., by the use of epinephrine).Some other
toxins have no known antidote. For example, the poison aconitine – a highly
poisonous alkaloid derived from various aconite species – has no antidote, and as a
result is often fatal if it enters the human body in sufficient quantitie.

yu
Hospital Bed
A hospital bed or hospital cot is a bed specially designed for hospitalized patients other in
need some form of health care. These beds have special features both for comfort and well-
being of the patient and for the convenience of health care workers. Common features
include adjustable height for the entire bed, and the feet, adjustable side rails and electronic
buttons to operate both the bed and other nearby electronic device
Community Health Center Government HospitalFatehpurJaunpur is basically established to
center the need of local resident of Fatehpur. The hospital was established in year 2006 as a
5 beded which was extended up to 30 beds in 2018.
Size based hospital: these type of hospital are classified on the basis of size or occupying
of the bed.
a)medium hospital: (Beds between 500_1000)
b) small hospital: (Beds between 100_500)

c) very small hospital: bed less than 100
Fig. 3.6 Hospital Beds
Nurses Station
A nursesstation is an area of a health care facility such (hospital or nursing home), which
nurse and other health care staff sit behind when not working directly with patients and
where they can perform some of their duties. Stored behind the table are material for which
access is limited to health care staffs, such as patients file, medicines, and certain type of
equipment. The key functions performed are.
A) Secretarial work
B) Chart processing and Management
C) Medication Preparation

Fig. 3.7 Nurse station

 Vaccine
A vaccine is a biological preparation that provides active acquired immunity to a
particular disease. A vaccine typically contains an agent that resembles a disease-
causing micro-organism and is often made from weakened or killed forms of the
microbe, its toxins or one of its surface proteins. The agent stimulates the body's
immune system to recognize the agent as a threat, destroy it, and keep a record of it,
so that the immune system can more easily recognize and destroy any of these micro-
organisms that it later encounters. Vaccines can be prophylactic (example: to prevent
or ameliorate the effects of a future infection by any natural or "wild"pathogen), or
therapeutic (e.g., vaccines against cancer are also being investigated).
The administration of vaccines is called vaccination. The effectiveness of vaccination
has been widely studied and verified; for example, the influenza vaccine,theHPV
vaccine, and the chicken pox vaccine. Vaccination is the most effective method of
preventing infectious diseases; widespread immunity due to vaccination is largely
responsible for the worldwide eradication of smallpox and the restriction of diseases
such as polio, measles, and tetanus from much of the world. The World Health
Organization (WHO) reports that licensed vaccines are currently available to prevent
or contribute to the prevention and control of twenty-five infections.
The terms vaccine and vaccination are derived from Variolaevaccinae (smallpox of the
cow), the term devised by Edward Jenner to denote cowpox. He used it in 1798 in the
long title of his Inquiry into theVariolaevaccinae known asthe Cow Pox, in which he
described the protective effect of cowpox against smallpox.In 1881, to honor Jenner,
Louis Pasteur proposed that the terms should be extended to cover the new protective
inoculations then being developed.
VACCINE

CHAPTER:4
IN-PATIENT
An inpatient (or in-patient), on the other hand, is "admitted" to the hospital and stays
overnight or for an indeterminate time, usually several days or weeks, though in some
extreme cases, such as with coma or persistent vegetative state patients, stay in hospitals
for years, sometimes until death. Treatment provided in this fashion is called inpatient
care. The admission to the hospital involves the production of an admission note. The
leaving of the hospital is officially termed discharge, and involves a corresponding
discharge note.[9]
4.1Patient counselling
Counselling is the professional advice and guidance given to a person (client) by a
trained person (usually counselor), in order to assist the client to explore, discover and
clarify ways of living more positively, satisfactorily and resourcefully in society.You the
health worker is the trained person (counselor), the malaria patient or a member of the
community you serve are your “client”.Health Promotion is the process of passing
information and practical skills with the primary goal of improving people’s health by
promoting better health practices.Health promotion/education usually aims at changing
positively the knowledge, attitudes and practices of its rescipient.Before you proceed, do
Activity 1 it should take you5 minutes to complete. We hope your list included the
following important information about malaria, which should be part of your message to
the client or community:
1. Malaria is caused by a parasite that infects a person’s blood when he or she is bitten by a
mosquito carrying the parasite;
2. Malaria can also be transmitted through blood transfusion if the blood contains malaria
parasites;
3. The other method of transmission is to the unborn baby through the placenta. This is also
known as congenital malaria;
4. Malaria is not a sexually transmitted infection;
5. Malaria is commonly transmitted by a mosquito bite. Transmission by blood transfusion
or during pregnancy is very rare;
6. The unborn baby does not cause malaria to the mother;
7. If a pregnant mother gets malaria, the parasites live in blood and in the placenta. The
parasites in the placenta interfere with the nutrition and oxygen supply of the unborn
baby. When this happens, the following may occur:
1. Abortion,
2. The baby may die before birth. This is called still birth,
3. the baby may be born weak, small and sickly;
o Malaria is more dangerous for women when they are pregnant. It weakens them
and often causes anemia;

o Mosquitoes that transmit malaria breed in stagnant water. Draining the stagnant
water and building houses at least 2 Km away from water sources, such as rivers
and lakes reduces mosquitoes and their contact with people respectively.
o Malaria is best prevented by sleeping under LLINs every night to avoid mosquito
bites.
o Malaria is also prevented by spraying of internal walls of houses with residual
insecticides particularly in epidemic prone areas.
o Malaria is treatable and curable by effective anti-malarial.
 as. Counselling is important for a number of reasons:
o It is a psychological therapy. It enables patients/clients to release their stress and
anxieties on malaria;
o Patients/clients are empowered and able to understand and solve their own
problems relating to the treatment and prevention of malaria;
o It enables patients/clients to use available resources and experience to develop
positive ways of coping with situations/problems;
o It acts as a preventive measure since it encourages adoption of healthy behavior in
combating malaria;
o It ensures that patients/clients are adequately informed about their medication.
 The Counselling Process
When counseling patients/clients, we progress through a series of interconnected
and overlapping stages to help patients/clients make informed decisions. Both you
and the patients/clients actively participate. You exchange information and discuss
the patients’/client’s feelings and attitudes about the disease and drugs. Through this
interaction the patient/client makes a decision, acts and evaluates his/her actions.
Before you continue reading, do Activity 5. It should take you 10 minutes to
complete. Confirm your answer as you read the following discussion.
There are six elements to the counseling process. They are easy to remember with
the memory aid GATHER. Each letter in the word GATHER stands for an action or
step that a counselor is expected to take when counseling a patient/client. What does
each letter stand for?
a) G..... Greet the patient/client.
b) A....Ask patient/client about herself/himself.
c) T..... Tell patient/client about proper use of drugs.
d) H..... Help patient/client to understand the instructions
e) E..... Explain how to use the drugs.
f) R..... Return for follow-up.
 In order to have a successful counseling session you must do the following:
a) Give the patient/client the right to make his or her own decisions;
b) Keep patient’s/client’s problems confidential;

c) Be truthful to the patient/client;
d) Give correct information;
e) Recognize your own limitations in counseling in regard to specific problems.
Remember, self-introduction when you meet the patient/client and the initial questions
which address the purpose of the visit or nature of the problem, are useful activities to
encourage the patient/client to talk.
This brings us to the end of our discussion on the counseling process. Let us now discuss
barriers to effective counseling
 OUT-PATIENTS
An outpatient (or out-patient) is a patient who is hospitalized for less than 24 hours.
Treatment provided in this fashion is called ambulatory care. Sometimes surgery is
performed without the need for a formal hospital admission or an overnight stay. This is
called outpatient surgery. Outpatient surgery has many benefits, including reducing the
amount of medication prescribed and using the physician's or surgeon's time more
efficiently. More procedures are now being performed in a surgeon's office, termed
office-based surgery, rather than in a hospital-basedoperating room. Outpatient surgery is
suited best for healthy patients undergoing minor or intermediate procedures (limited
urologic, ophthalmologic, or ear, nose, and throat procedures and procedures involving
the extremities).

Fig.4.1Out-Patients waiting & seating area

4.2.Surgery
Deployed doctors - Dr.Satyamitra (MBBS)
Surgery is a technology consisting of a physical intervention on tissues, and muscle.As a
general rule, a procedure is considered surgical when it involves cutting of a patient's
tissues or closure of a previously sustained wound. Other procedures that do not
necessarily fall under this rubric, such as angioplasty or endoscopy, may be considered
surgery if they involve "common" surgical procedure or settings, such as use of a sterile
environment, anesthesia, antiseptic conditions, typical surgical instruments, and suturing
or stapling.
All forms of surgery are considered invasive procedures; so-called "noninvasive surgery"
usually refers to an excision that does not penetrate the structure being excised (e.g. laser
ablation of the cornea) or to a radiosurgical procedure (e.g. irradiation of a tumor).
 Types of surgery
Surgical procedures are commonly categorized by urgency, type of procedure, body
system involved, degree of invasiveness, and special instrumentation.Based on timing:
Elective surgery is done to correct a non-life-threatening condition, and is carried out at
the patient's request, subject to the surgeon's and the surgical facilities availability.
4.3Patient Care
Patientcare is the care of patients whose condition requires admission to a hospital.
Progress in modern medicine and the advent of comprehensive out-patient clinics ensure
that patients are only admitted to a hospital when they are extremely ill or have severe
physical trauma.

Fig.4.2 Patient Care
Fig.4.3Room for performing Surgery

a) Emergency surgery is surgery which must be done promptly to save life, limb, or
functional capacity. A semi-elective surgery is one that must be done to avoid
permanent disability or death, but can be postponed for a short time.
b) Based on purpose: Exploratory surgery is performed to aid or confirm a diagnosis.
Therapeutic surgery treats a previously diagnosed condition. Cosmetic surgery is done
to improve the appearance of an otherwise normal structure.
c) By type of procedure: Amputation involves cutting off a body part, usually a limb or
digit; castration is also an example. Resection is the removal of all or part of an
internal organ or part of the body. Replantation involves reattaching a severed body
part. Reconstructive surgery involves reconstruction of an injured, mutilated, or
deformed part of the body. Excision is the cutting out or removal of an organ, tissue,
or other body part from the patient. Transplant surgery is the replacement of an organ
or body part by insertion of another from different human (or animal) into the patient.
Removing an organ or body part from a live human or animal for use in transplant is
also a type of surgery.
d) By body part: When surgery is performed on one organ system or structure, it may be
classed by the organ, organ system or tissue involved. Examples include cardiac
surgery (performed on the heart), gastrointestinal surgery (performed within the
digestive tract and its accessory organs), and orthopedic surgery (performed on bones
and/or muscles).
e) By degree of invasiveness of surgical procedures: Minimally-invasive surgery
involves smaller outer incision(s) to insert miniaturized instruments within a body
cavity or structure, as in laparoscopic surgery or angioplasty. By contrast, an open
surgical procedure such as a laparotomy requires a large incision to access the area of
interest.
f) By equipment used: Laser surgery involves use of a laser for cutting tissue instead of
a scalpel or similar surgical instruments. Microsurgery involves the use of an
operating microscope for the surgeon to see small structures. Robotic surgery makes
use of a surgical robot, such as the Da Vinci or the Zeus surgical systems, to control
the instrumentation under the direction of the surgeon.
At divisional district hospital Lucknow, facilities for all surgeries are available
acceptneurosurgeon

PRESCRIPTION & DISPENSING
 Prescription
A prescription is a written, printed or electronic order from a registered medical
practitioner (RMP) or other properly licensed practitioner, such as dentist
veterinarian, physician etc to a pharmacist to compound and dispense a drug or
medication for a patient to use.
 Parts of prescription
The prescription contains following information:
i. Patient’s information block: Patient’s complete name, sex, and address should
be written to avoid medication error and to take follow up. Sex is needed for
pregnant women and address is required for any accidental mistake, pharmacist
can go there and rectify that problem.
ii. Date of Prescription: This is necessary for the prevention of misuse of
prescription especially for narcotics and controlled drug users.
iii. Superscription: It is denoted by the symbol Rx which means “take thou” or you
take.
iv. Medication Block or Incription: It contains:
 Name of ingredients
 Dosages form
 Strength and quantities of the medicament.
v. Subscription: It is instruction for the pharmacist.
vi. Signatura: Instruction for the patient.
vii. Prescriber’s block: It include:
 Name,
 Address,
 Contact number,
 Registration number and signature of RMP

Fig. 4.4 Prescription
 Dispensing
Dispensing is an integral service provided by pharmacists as part of the Medication
Management Cycle. The separation of prescribing and dispensing of medicines provides
a safety mechanism as it ensures independent review of a prescription occurs prior to the
commencement of treatment. The medicine dispensing processes include the following:
a) Accept and check
b) Review and process
c) Select/prepare and check
d) Label and assemble
e) Supply and counse

Fig. 4.5 Dispensing block

 Coding
Coding is a process of assigning a code, no. or code symbol to a particular material for
easy identification.
Various advantages of coding:
a) Easy identification of item.

b) Grouping the similar items together.
c) Avoid duplication of items.
d) Inspection of material.
e) Physical counting.
f) Computerization of store, records, and accounting.
g) Avoid confusion
.List of medicines
Agent Indication
100% Oxygen or Hyperbaric oxygen therapy Carbon monoxide or Cyanide poisoning
Activated charcoal with sorbitol Used for many oral toxin
Atropine Organophosphate and carbamate insecticides
Beta blocker Theophyline
Calcium chloride Calcium channel blocker
Calcium glucanate Hydrofluoric acid
Chelators such as EDTA, BAL Heavy metal poisoning
Cyanide antidote Cyanide poisoning
Cyproheptadine Serotonin syndrome
Deferoxaminemesylate Iron poisoning
Digoxin Immune Fab Antidote Digoxin poisoning
Benzotropinemesylate&Diphenhydramine
hydrochloride
Extrapyramidal reaction associated with antipsychotic
Ethanol or Fomepizole Ethylene glycol poisoning and methanol poisoning
Flumazenil Benzodiazepine Poisoning
Glucagon Beta blockers poisoning, Calcium channel blocker
Leucovorin Methotrexate and trimethoprim
Methylene blue Methemoglobinemia
N-acetylcystine Paracetamol
Naloxone hydrochloride Opioid overdose
Octreoide Oral hypoglycemic agents
Table 4.6. List of Medicines

 Medication for Out-Door patients
a) Generally the medicines provided to the Out-Door patients are for 3 days only.
b) The various medicines provided to Out-Door patients includes
 Ointment
 Suppositories
 Capsules
 Tablets
 Paranterals
c) Frequently used medication include
 Diclofenac Sodium
 Rantidine
 Deriphylline
 Paracetamal
4.1.0 Ambulance facilitie :
An ambulance is a medically equipped vehicle which transports patients to treatment
facilities,such as hospitals. Typically, out-of-hospital medical care is provided to the patient.
Ambulances are used to respond to medical emergencies by emergency medical services. For
this purpose, they are generally equipped with flashing warning lights and sirens. They can
rapidly transport paramedics and other first responders to the scene, carry equipment for
administering emergency care and transport patients to hospital or other definitive care. Most
ambulances use a design based on vans or pickup trucks.
An ambulance is a vehicle for transporting sick or injured people, to, from or between places
of treatment for an illness or injury. These are usually fitted with flashing warning lights and
sirens to facilitate their movement through traffic. The term ambulance comes from the Latin
word ambulare, meaning to walk or move about which is a reference to early medical care
where patients were moved by lifting or wheeling.
There are mainly two types of ambulance:
1. ALS (Advanced life support ventilator )
2. BLS ( Basic life support ventilator )
Daily average number calls for BLS service- 4 to 5 calls Daily average number calls for ALS
service - 2 to 4 calls Daily routine calls for Discharge and others - 1 to 2 calls Dead body
carrying ambulance (non-MLC cases only) - 2 to 4 cases per month. ALS ambulance has all
the features, equipment and properties of an ICU and can be considered as a mini ICU.

Fig. 4.7 Ambulance

SUMMARY:
Hospital training (2022_23) was done from C.H.C. Government Hospital Fatehpur, jaunpur
under the supervision of apprentice master Mr.Gyanchandra.Pal training was commenced
from 13/08/2022 up to date 29/09/2022 that is for period of 45 days
In that period I did various things which was in our course curriculum and which is of
immense important as per pharmacy point of view. Mine training include wound dressing
artificial respiration and other first aid measures different route of injection (Intra muscular,
Intravenous, Intradermal, Subcutaneous etc.) study of patient observation chart, prescription
handling and dispensing, simple diagnostic report, patient counseling.
Of all the things prescription handling and dispensing was of prime concern and I spent a
major period of time in dispensing department.
RESULT AND CONCLUSION
In today’s lifestyle and society, there seems to be great importance of hospital training
knowledge Day by day people are getting dependent on machine and technology and also the
people are getting more prone and susceptible to various disease and for the diagnosis
treatment, cure of those disease, there are health and care professional such as doctor,
pharmacist and nurse etc.
In hospital Training I learnt about first aid include various things such as wound dressing,
artificial respiration, blood pressure maintenance, etc. the first aid treatment varies according
to the type of injury like burn, shock, bone fracture, wound, etc. there I got training of
administration of injections via various routes of precautions that must be taken while
administration of injection.
Prescription handling and dispensing is the main role of pharmacist in health society. Our
major field in Hospital Training was this only and for that purpose I spent 2 weeks under the
supervision of Mr. Gyanchandra Pal.

REFERENCES
1. Nand P, Khar RK, (2005), “A Text book of Hospital and Clinical Pharmacy”, 15th
edition, Volume I, Published by Birla Publication (P) Ltd., Page- 11-19, 24-34.
2. Paradker AR, Chunawala SA, (2007), “A Text book of Hospital and Clinical
Pharmacy”, 19th
edition, Volume I, Published by NiraliPrakashan, Page- 121, 34-36,
118.
3. https://health.gov.mt/en/spbh/pages/hospital.axpx
4. Tripathi, K.D. ‘Essential of Medical pharmacology’ 6th
edition 2003, jaypee brother’s
medical publishers (p) ltd, page no. 03-10.
5. http://rkmsvrind.org/hospital.html#13
6. https://www.google.co.in/#q=route+of+injection&gws_rd=cr
7. http://www.sja.org.uk/sja/first-aid-advice/what-to-do-as-a-first-aider/the-role-of-a-
first-aider.aspx
8. http://www.merckmanuals.com/home/drugs/administration-and-kinetics-of-
drugs/drug-administration
9. http://pgimer.edu.in/PGIMER_PORTAL/PGIMERPORTAL/GlobalPages/JSP/Page_
Data.jsp?dep_id=388
10. http://www.slideshare.net/rajusanghvi1/drug-distribution-in-hospital-pharmacy
11. https://www.hl7.org/fhir/diagnosticreport.html
12. http://www.sja.org.uk/sja/first-aid-ambulance/what-to-do-as-a-first-aider/the-role-of-
a-first-aider.aspx

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