Accident and Emergency department.

Introduction

Accident & Emergency Department is one of the busiest units of hospital. As the children`s hospital is the tertiary care centre, patients are being referred to us not only from all cities of Punjab but also from other provinces of the country. Most of the referred patients are in very critical condition. It is one of the departments that started with day one of inauguration of hospital.

Organization

    • Triage area. Triage is done by senior staff nurses.
    • Registration. Computerized data entry of each patient to maintain the record.
    • Assessment area – By: casuality medical officer
    • Critical care area – Room no 23 & 24
    • Resuscitation Room.
    • Patients who need nebulizations or transfusions are treated here. If a patient needs investigations before decision of admission, he is also kept here.
    • Patients who need nebulizations or transfusions are treated here. If a patient needs investigations before decision of admission, he is also kept here.
    • Oral Rehydration area Room 21
    • Diarrhea Section – Room 20. Those patients who need intravenous fluid therapy are treated in this room.
    • Surgical Emergency Room: All Patients with any Surgical Emergency initially treated by staff of medical Emergency. After resuscitation and stabilization of patient, they are referred to General surgeons or surgical sub specialties.
    • Neonatal Emergency

All newborns whether sick or healthy report in Neonatal emergency for check up and admissions. This section is also looked after by staff of medical emergency. After initial stabilization all relevant investigations are sent and after receiving the investigations patients are shifted to neonatal Department.

FUNCTIONING OF DEPARTMENT:

All patients reported in emergency department for check up are immediately screened by senior staff nurses to sort out the sick patients who need immediate treatment in critical area. All other patients are then examined by Casuality Medical Officer. He advises the patients accordingly.

FACULTY :

Dr. Muhammad Nasir Rana
FCPS

 

Assistant Professor, Pediatrics Emergency

Dr. Asif Manzoor Basra

FCPS

Senior Registrar

Dr. Khalida Amir

D C H

Pediatrician

Dr. Ali Abu Zar

D C H

Registrar

Facilities For The Patient

Radiology and Imaging

We use bedsides imaging & radiology by pediatrics trained radiologist, and further intervention is done in specific room designed for CT Scan and MRI

Laboratory Support:

24hrs services for hematological and biochemical investigation are available.

Blood Transfusion Section:

Working round the clock and immediate availability of all type of blood by products such as

packed cell, platelets, FFP etc after screening.

Pharmacy Services:

All sorts of medicine are provided to the patients. It includes, antibiotics, fluids, antidotes, anti- snake venoms, anti rabies vaccine and immunoglobulin and ATS.

Teaching Activities

  • Daily teaching rounds conducted by consultant and senior registrar to residents and house officers.
  • The trainees are trained in both critical and routine pediatric emergencies during their rotation in following diseases and procedures./li>
  • In critical care emergencies: shock, status asthmatics, status epilepticus, respiratory failure, diabetic ketoacidosis, hypertension and hypertensive crisis, addision crisis and hepatic encephalopathy and inborn error of metabolism.
  • In routine Emergencies such as – fluid and electrolyte management, Bleeding disorder, a plastic and other anemia’s Leukemia’s and lymphomas, thallasemia, Piosoning management and antidote therapy.
  • Training the following procedures such as
    • Blood sampling techniques.
    • Vascular access: Peripheral intravenous placement, central venous catheter, Intra osseous placement, Umbilical artery catheterization
    • Body fluid sampling: Lumber puncture, chest tube placement, thorancentesis, pericardiocentesis, urinary bladder catheterization, suprapubic bladder aspiration.
    • Peritoneal dialysis
    • Subdural tap
    • Basic laceration repair such as suturing
    • Basic splinting in orthopedic emergencies.
  • Lectures and bed side teaching and training by consultant and senior registrar of Allied health sciences students are also conducted according to their schedule.

Research Activities

Many research activities are carried out in our department. Following have been published, others are in process of publication.

  1. Profile of Patients with Pneumonia according to Acute Respiratory Infections (A.R.I) program of WHO from 2 to 60 months of age. Published in Pakistan Journal of Medical and Health sciences, Apr-Jun 2011.
  2. Seizures in Children with fever presenting in accident and emergency department of children’s Hospital, Lahore. Published in PPJ in 2010.
  3. Johanson-Blizzard Syndrome with Diamond-Blackfan anemia. Published in JCPSP IN 2010.

Future Plans

  1. Expansion of Emergency Department. Increase in bed capacity from 50 to 100, and, acquisition of more rooms to house the same.
  2. Acquisition
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    of more staff so that at least 30 doctors and 30 nurses are working at any given time for 100 patients so that justice is done to the sort of critical patients we receive.

  3. Creation of Poisoning Treatment Centre with availability of all possible antidotes and access of the staff to computer and internet for ready reference.
  4. Compilation of a pocket guideline booklet for residents on rotation in the Emergency Department.
  5. Incorporation of curriculum on the pattern of Advanced Pediatric Life Support in the training (both theoretical as well as practical) of residents on rotation in the Emergency Department to ensure they have been trained in a systematized manner.
  6. Development of Post Graduation in Pediatric Emergency and its recognition by the CPSP.
  7. Developing reciprocity with the referring units (hospitals, clinics, doctors) to improve referral conditions.
  8. Emphasis on public and patient education by provision of printed material and through media.

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