Goals and Objectives:

GOALS & OBJECTIVES OF PRE HOSPITAL CARE

1. To learn common organizational structures of emergency medical services

2. To learn the principles of EMS operations, disaster management, prehospital triage and EMSresearch.

3To learn medico legal principles relating to EMS.

4. To be familiarize with the local EMS.

5. Where available, actively participate in EMS.

6. To demonstrate familiarity with research methodologies relating to EMS and disaster management.

7. To discuss the medico legal issues relating to EMS.

8. To discuss the development of EMS prehospital care protocols.

9. To discuss basic concepts of mass casualties and disaster management.

10. To describe common environmental, toxicological, and biological hazards

11. encountered in the prehospital care setting.

GOALS AND OBJECTIVES OF HOSPITAL CARE

  1. To assimilate general concepts of emergency medicine, focused history taking, and physical examination skills to develop a systemic evaluation for patients presenting to the emergency department.
  2. To demonstrate the ability, based on the history acquired, to do an immediate assessment and initial stabilization, followed by a complete directed examination.
  3. To combine the knowledge with the history and physical examination, to develop an appropriate differential diagnosis for all presentations.
  4. To demonstrate knowledge of the causes, presentation, and management of commonly presenting emergencies.
  5. To perform primary and secondary survey with management of polytrauma patients effectively.
  6. To demonstrate the ability to perform essential emergency procedures.
  7. To be able to differentiate and place patients on care pathways which lead to appropriate discharge with follow up when needed, admission to an ED based observation unit or admission into hospital.
  8. To work in the difficult and challenging environment of the Emergency Department and to be able to re-prioritize and respond to new and urgent situations.
  9. To be a part of a multi-disciplinary team where good communication and interpersonal skills are essential.
  10. To be able to work both within and lead a team to ensure the patient’s needs.
  11. To be able to work closely with a wide variety of in-patient teams and with primary care and pre-hospital clinicians.
  12. To be committed to the highest standards of care and of ethical and professional behavior within the specialty of Emergency Medicine and within the medical profession as a whole.
  13. The Emergency Physician should be caring, empathetic, conscientious and practices medicine without prejudice.
  14. To continually seek to improve care by utilizing up to date evidence, being committed to lifelong learning and being innovative.

 

Head of Department’s Message:

Emergency Medicine is a new specialty in India. B. J. Medical college, Ahmedabad, is honoured to have the first MCI recognized degree course in India. At present we have 2 PG seats for the same. It has a bright future with good opportunities for its students.

Facilities in the Department:

1. Infrastructure

a. Civil facilities and building

1. Building - Modified multipurpose building available

2. Reception area

3. Case registration desk

4. Helper desk

5. Triage area (EMO room) and Resuscitation area – Ground Floor

6. Surgical Resuscitation area – Trauma Bay 1 and 2

7. High Dependency Unit – 22 beds

8. Central Oxygen and Suction facility

9. Doctor’s Room

10. Nursing station

11. Plaster Room

12. X-ray room

13. Waiting area for relatives with patients

14. Refreshment Stall

b. Diagnostic Facilities

1. ECG

2. X-Ray

3. Ultrasonography (Portable)

4. CT-Scan, MRI ( nearby)

5. Various biochemical investigations as per Annexure 17

c. Supportive Facilities

1. Ambulance Service

2. Police Station

3. CCTV supervision

4. PRO

5. Phone call facility

6. Disaster Preparedness and control room

7. Fire Safety

8. Volunteer service

9. Generator facility

10. Cold storage and Postmortem room

d. Operative Facilities

1. Well Equipped operation theatre - 4

2. IITV

e. Critical Care Facility

1. Ventilators

2. Continuous vital sign monitoring

3. Beds in ICU - 32

4. Liaison with organ donation bank

f. Blood Bank

1. Blood and various blood components available

2. Plasmapheresis

 

2. Human Resource

a. Consultants

1. Physician

2. Anaesthetist

3. Surgeon

4. On call orthopedics, neurosurgeon, plastic surgeon, ENT surgeons

b. Resident Doctors

1. Senior residents

2. Postgraduate junior residents

3. Interns

c. Emergency Medical Officer

1. EMO as first responder at triage area

d. Paramedical staff

1. Nurses on shift duty/ EMT trained

2. Technicians (X-Ray, ECG, OT, Sample collection), Clerk, Computer Operator, Servant, Sweeper)

3. Physiotherapist

 

3. Work Style

a. Patient management

1. First Responder and their duties

i. Emergency cases are attended first by EMO on duty and triage is done

ii. Primary survey and resuscitation are performed as per standard guidelines and protocols by Emergency physician

iii. Airway management, resuscitation, C-Spine immobilization, wound debridement and suturing, bone immobilization, vascular access, foreign body removal are performed in medical / surgical emergencies by senior resident and consultant

iv. Diagnostic investigations carried out as per requirement

v. After stabilization patients are handed over to concern speciality for definitive care

 

2. Various emergency procedures are done in the department by faculty members and residents for better management of patients

3. Extended and specialized emergency medical care is provided during special festivities

4. Special Equipments are available and used for better emergency management of patients

5. Special emergency medical care provided for VVIP coverage whenever required.

 

b. Academic activities for

1. Emergency medicine resident during their 3 years of residency in the form of bedside teaching, grand rounds, regular case presentations, didactic lectures, discussions and simulated learning sessions on manikins. Record is maintained in log book

2. Second year residents of various clinical and non-clinical branches, Interns, UG students and paramedical staff are also trained regarding various medical and surgical emergencies.

3. Disaster preparedness training and Mock drills are conducted at regular interval.

4. CME and seminars are held regularly.

5. Foreign faculties are visiting our department for better development and academic support as per MOU’s

 

Subject curriculum:

List of Didactic lectures for PG students

  • Cardio-Pulmonary Resuscitation and assessment.
  • D/d of Cardiac symptoms.
  • Treatment of Acute LVF / CCF.
  • Treatment of Acute MI.
  • Interpretation of ECG.
  • Interpretation of X-ray chest.
  • Interpretation of echocardiography.
  • Central Venous pressure monitoring.
  • Pericardiocentesis.
  • Inotropic agents.
  • Treatment of Hypertention – Urgency and emergency.
  • Approach to Coma.
  • Treatment of status epilepticus.
  • Treatment of status asthmatics.
  • Diabetic emergencies.
  • Management of Shock.
  • Airway management.
  • Pharmacologic agents used in Anesthesia.
  • Standard monitoring techniques.
  • Pre-Operative Cardio-Pulmonary assessment.
  • Principles of pain management.
  • Pathophysiology of trauma.
  • Diagnostic and Therapeutic intervention in critically ill patients.
  • Rationality of Lab. test in critically ill patient.
  • Arrhythmias and treatment.
  • AHA recommendation in resuscitative procedures.
  • Cardiac arrest.
  • Pathophysiology of respiration.
  • Acute abdominal pain (Medical / Surgical).
  • Principles of care of the pre-operative patient.
  • Common surgical procedures.
  • Ageing process.
  • Principles to manage geriatic patient.
  • Detailed neurological examination.
  • CSF Physiology shunt and malfunction.
  • Management of emergent complications of pregnancy.
  • Management of labour complicated / uncomplicated.
  • Diagnosis of vaginal bleeding.
  • D/D visual loss.
  • Principles of ocular trauma management.
  • Evaluation of musculoskeletal trauma.
  • Acute and chronic pain management in musculoskeletal pain.
  • Management of facial trauma.
  • Evaluation of upper airway disorders.
  • Principles of management of violent patient.
  • Acute psychosis.
  • Acute poisoning – General management.
  • Approach to trauma patient.
  • Learning of systematic approach to trauma management including statewide trauma systems & categorization.
  • Management of renal calculi.
  • Management of renal and genito-urinary trauma.
  • Pathophysiology of wound healing.
  • Wound evaluation and management.
  • Closure techniques.
  • Complications of traumatic wounds.
  • Resuscitation issues in pregnancy.
  • Acid-base disorders.
  • Blood gases: Pathophysiology and interpretation.
  • Lacerations to the face and scalp.
  • Fingertips and Nail injuries.
  • Lacerations of the extremities and joints.
  • Soft tissue foreign bodies.
  • Puncture wounds and bites.
  • Syncope.
  • Valvular emergencies.
  • Acute myocarditis.
  • Aortic dissection and Aneurysms.
  • Tuberculosis.
  • Swallowed foreign bodies.
  • Appendicitis.
  • Peptic ulcer disease and gastritis.
  • Intestinal obstruction.
  • Acute Cholecystitis.
  • Complications of General surgical procedures.
  • Complications of gastro-intestinal devices.
  • H.I.V. infection.
  • Rabies.
  • Reportable communicable diseases.
  • Antibiotics in emergency department.
  • Blood Transfusions.
  • Blood component therapy.
  • Ataxia & gait disturbances.
  • Jaw emergencies & Nasal emergencies.
  • Oral and Dental emergencies.
  • Strangulation.
  • Approach to Dermatologic patient in EMD.
  • Head injury.
  • Penetrating and blunt neck trauma.
  • Abdominal injuries.
  • Genito-urinary trauma.
  • Wound Ballistics.
  • Early evaluation and management of orthopedic injuries.
  • Injuries to Hand and digits.
  • Injuries to Elbow and forearm.
  • Wrist injuries.
  • Injuries to Shoulder complex and Humerus.
  • Trauma to pelvis, Hip and femur.
  • Knee injuries.
  • Ankle injuries.
  • Compartment syndromes.
  • Emergencies in systematic Rheumatic diseases.
  • Death notification.
  • Principles of emergency department sonography.
  • MRI principles and Applications.
  • Pre-hospital equipment and Adjuncts.

Medicine Emergencies.

A. Poisoning & Bites.

  • O.P. poisoning
  • Diazepam poisoning.
  • Acid poisoning.
  • Snake bite.
  • Scorpion bite.

B. C.V.S. & Respiratory emergency.

  • Acute MI & Unstable Angina.
  • LVD with Pulmonary edema.
  • AF with fast VR.
  • Ventricular tachycardia.
  • Acute exacerbation of Asthma / COPD.
  • Pneumothorax.
  • Hypertensive encephalopathy.
  • Acute respiratory failure.

C. G.I.T./G.U.T.

  • Acute Gastroenteritis with severe dehydration.
  • Hemetemesis.
  • Hepatic encephalopathy, Acute fulminant Hepatitis.
  • Acute Renal failure
  • Ureteric encephalopathy.
  • Acute Mesenteric ischemia.
  • Acute pancreatitis

D. Hematological emergencies.

  • Severe Aneamia with C.C.F.
  • Thrombocytopenia.
  • P-falciparum Malaria with complication.
  • Thalassemia.
  • Haemophillia.
  • Disseminated intra vascular coagulation.
  • Acute hemolytic crisis.
  • Acute haemorrhagic fever.

E. Electrolytes and Metabolic emergencies.

  • Hyperkalemia.
  • Hypokalemia.
  • Hyper natremia
  • Metabolic acidosis.
  • Metabolic alkalosis.

F. Neurology.

  • AIDP with unstable vitals.
  • C.V. Stroke with unstable vitals.
  • GTCS & Status epilepticus.
  • Meningitis / Encephalitis.
  • Myesthenia crisis.
  • GBS
  • Intracranial Hypertension.

G. Endocrine:

  • Hypoglycemia.
  • Diabetic ketoacidosis.
  • Nonketotic hyperosmolar coma.
  • Myxedema coma
  • Acute adrenal insufficiency.
  • Thyrotoxicosis-Storm.

H. Miscellaneous.

  • Neuroleptic Malignant Syndrome.
  • Tetanus.
  • Lactic acidosis.
  • Shock.
  • Burns.
  • Electrical injuries.
  • Anaphylactic reaction.
  • Rhabdomyolysis.
  • Central venous cannulation.
  • Cardioversion.
  • Thoracostomy.
  • Spinal cord injury.
  • Multiple fractures.

Examination Pattern: As per Gujarat University rules

Teaching staff information:

 

Name

Qualification

Designation

Unit 1

Dr. Samira N. Parikh

Dr. Chirag J. Patel

Dr. Shruti V. Sangani

Dr. Amit Desai

M.D. Anesthesia

M.S. General Surgery

M.D. Anesthesia

M.D. Medicine

Professor & Head of Department

Associate Professor

Assistant Professor

Assistant Professor

Unit 2

Dr. Nilima K. Shah

Dr. Jigar B. Gosai

Dr. Hardik Bhatt

M.D. Medicine

M.D. Anesthesia

M.S. Surgery

Professor

Assistant Professor

Assistant Professor

 

Nonteaching staff information:

 

S.No.

Designation

Total

1

Nurses

152

2

Technicians

9

3

Biomedical engineer

2

4

Clerical Staff

2

5

D class employees

84

6

Security staff

22

 

OPD day and Emergency day : Our department works 24*7. Unit 1 and 2 shares emergencies on alternate days.