Abdus Salam Khan, MD FACPOctober, 2015
This months blog is about emergency management and its organization. For the several years now we have talked about emergency department and emergency care because the concept was new to the public of Pakistan. In many segments of society the realization is still incomplete about the role of emergency care providers and sometimes the expectations are too high and other times dependence is flawed that the real fruit of emergency care could not materialize. We are continuing our efforts to propagate the emergency care further and to continue educating masses. The crop or the fruit of our efforts is yet to come, so we know that the work is still needed in this arena.
Now I feel that it is time to start expanding the canvas and talk about combined efforts from a smaller to a bigger scale. Emergency care is a team effort, it starts with the team and finishes with the team. So if the team is not properly made or not in sync then the results produced may be less than expected. We all know that the emergency care starts from where the emergency has begun. So a good prehospital system paves the way for a quality emergency care. Immediate care starts at that place in real time and appropriate teams are activated so by the time the patient reaches the place for the definitive care, without delay the teams start working to alleviate the problem of the patient. At times the hospitals may be busy and the patient needs to be diverted to another facility or hospital so that the problem will be resolved amicably, without wasting time. This creates a point of appropriate communication between different institutions and different services.
We can call it a team work of emergency care personnel or define it as a circle of Emergency Management, either way, it requires a very good collaboration between the prehospital care, the hospital emergency care and the service specialities that are involved in the definitive care like surgery, vascular surgery, orthopedics and intensive care. Since it involves multiple specialities as well as multiple institutions and facilities, there should be a common thread to join them all together. Preferably this has to be either a government-sponsored entity or the city top management. This sytem when in sync with each other will result in a better arrangement and thus a better quality of care to the patients presenting to us with any emergency situation.
I am proposing a solution for the people of Islamabad to the top management of the capital City of Pakistan in which the Capital Development Authority and its medical Director should be the joining force to bring all the emergency personnel of the city as well as the hospital management of all private and public hospitals of appropriate sizes to come together joining hands to provide better care for the citizens of Islamabad. Prehospital care have to be joined with the institutions and their capabilities have to be defined properly so that whenever any problem arises with any of the citizens and if they call the prehospital care which is 1122 or 15, they should know the team has been activated and their care is going to be coordinated well by the system automatically. The ambulance people would know the capabilities of the hospitals in the city and also where the patients can be appropriately managed. Any stress on any institution would be appropriately shared by other institutions so that the safety of the patient would never get compromised. Defining the cost issue and other issues relating to the care is also important and has to be sorted out appropriately in appropriate time. This team should meet on a regular basis and discuss about how they can provide a better quality of care to the citizens.
Although world has demonstrated this capability and concept for long time, still it is not too late to get out and provide with the best care to our people. It is especially important for the patient population that faces emergencies as it is highly time dependent and skillful. It is my hope that people at appropriate places and access to resources look into this and help create this circle of emergency management.
You can reach me at erdoc@shifa.com.pk.