CHAPTER 3
EMERGENCY AND INJURY MEDICAL SERVICES MANAGEMENT
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Chapter Objective
By the end of this chapter the you will be able to apply the system of
emergency and injury care services management at hospital level
Enabling Objectives:
•Describe operational standards of emergency & injury care service practice
Design a system to implement emergency & injury care service
management.
Explore quality management activities across emergency & injury care
service
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Outline
Introduction
Operational standards
System design
Quality management activities
Summary
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Overview
Activity 22.1. Individual Reflection
Consider your healthcare setup and share your practical experience
Activities
Describe the difference b/n Emergency medical service
and Hospital Emergency service.
Describe emergency service levelling.
Time: - 5 min
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Overview
Emergency Medical Services (EMS) a network of services and
resources coordinated to provide aid and medical assistance from
primary response to definitive care.
The service given in a pre-hospital or hospital setting
Injury:- conditions most commonly result from traffic collisions,
drowning, poisoning, falls, burns and violence
Injuries comprises Majority of ER admission in our country’s
context, the emergency department shall give those services
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According to the 2020 Ethiopian Emergency service Leveling
health facilities are categorized into
1. Basic level - Health center and Primary hospitals
2. Intermediate level: General hospital
3. Advanced level: Tertiary hospital
4. Center of Excellence
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Operational standards
1. The department led by an emergency and critical care professional in accordance
with the hospital tier level
2. The department shall be easily accessible, labeled and clearly visible upon entry to
the facility with an ambulance parking area and it is in close proximity to the ICU
and OR
3. The emergency unit has separate areas for triage, resuscitation, examination,
procedure, short stay beds, isolation room and decontamination area.
4. The hospital has an Emergency department/unit equipped with necessary
equipment, drugs and supplies needed to provide emergency medical services as
per the hospital tier level.
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5. All emergency department clinical staff shall have emergency care
training.
6 The emergency department shall use a triage system of screening
and classifying patients to determine their priority needs and to
ration patient care efficiently.
7 The hospital provides emergency medical service 24 hours a day
and 365 days a year with a 24-hours’ access to diagnostic
laboratory, radiology, pharmacy services, blood products and
oxygen with priority for emergency clients.
8.
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8. The hospital shall have an emergency management team with a
documented emergency preparedness and response plan.
9. Emergency department or Unit has policies, protocols and
treatment guidelines for running ED/EU.
10. The emergency unit shall have a staff facility room for rest and
refreshment.
11. The hospital has guards, porters and cleaners dedicated for
emergency unit.
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System design for standard emergency service layout &
flow
Emergency & injury care service management structure
The case team should be overseen by a director of emergency
services
Services including patient triage, case management, laboratory,
pharmacy and diagnostic services of emergency unit
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Activity 3.2: Gallery walk
Instruction:-Be in group of 4 Consider your healthcare
setup and share your idea
On a piece of paper
Reflect
Debate on the recorded ideas
Post the summary report
Activities
Describe emergency service layout
Describe the site and activities at EM triage?
List the HR requirements of EM?
What are the equipment’s and supplies needed at EM
Time: - The time allocated to reflect on the activity is 28
min.
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Domains of Acute Care
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Emergency Services Layout
A. Ambulance parking space and
entrance I. Utility areas
P. Portable imaging facilities and
B. Patient assistant area at J. Isolation room
bay
Emergency gate K. Decontamination Room
Q. Nurses and physicians station
C. Triage area L. Medical records/Cashier/Social
R. Administration room
D. Resuscitation area worker
S. Staff room /Meeting room
E. Waiting area M. Pharmacy
T. Supportive service
F. Examination area [Link]/ sample collection
U. Emergency and mass causality
G. Procedure area and testing facilities
equipment store
H. The observation and treatment O. Emergency, OR and ICU
area
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Emergency patient flow/pathway
Emergency patient flow/pathway
Emergency Triage Activity:- be provided 24 hrs. a day, 365 days a year.
Emergency Patient Resuscitation:-life threatening conditions and with CVS arrest
should be admitted to this area for resuscitation.
Emergency Case Management :-who require temporary short-term observation
and management is admitted to this area
Ambulance service :-need for advanced life support to be deployed to assist the
pre-hospital providers
has to be equipped with equipment and supplies to render minimum Basic Life
Support/BLS/, Advance Life Support/ALS/ and trained ambulance drivers.
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Quality management activities
Hospital Emergency preparedness and response
Treating any acute event,
Natural or man-made,
Acutely or chronically ill or
Injured have medical needs,
which exceed available resources, resulting in patients receiving inadequate or
even no care. NEEDS > RESOURCES.
There shall be a trained emergency medical team (EMT) in the hospital which
will respond during time of disaster and mass casualties.
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summary
Emergency and injury care service is mainly about hospital based
emergency medical services
This chapter also emphasizes on injury and mass causality
management and its implementation mechanism.
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THANK YOU!
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