Latest update March 28th, 2024 12:59 AM
Oct 26, 2014 News
(With Dr Zulfikar Bux, Head of GPHC’s
A&E; Asst. Prof. of Emergency Medicine)
The emergency room of the Georgetown Public Hospital Corporation (GPHC) works without a break. It is there to
provide a service for those in need of urgent medical care, be it the late hours of the night or the early hours of the morning. The staff of this department is trained to provide effective emergent care while adapting to constant changes in their environment.
As previously discussed, there are three major sections of the department where patient care is delivered. Last week we focused on “triage”, this week we will discuss the other two sections; the “in room” and the “out room”.
IN ROOM PATIENT CARE
The “in room” section is the hub of the emergency department. It is where all the major decisions on patient care are made.
Diagnosing a patient’s condition, giving advanced cardiopulmonary resuscitation (CPR), re-aligning a broken bone, investigating a patient’s illness, giving pain relief, and admitting a patient for further care, are examples of features that occur in the “in room”.
It is in here that nurses, doctors, patient advocates, social workers, medical clerks, attendants, laboratory staff, emergency security, and janitors work in cohesion to provide a constant service for every patient that is in need of their care.
The final decision of discharging or admitting a patient is also done in this section. A discharged patient would have shown significant improvement in their presenting condition, and can be sent home with appropriate treatment or a follow-up plan.
Once a patient is admitted, it means that their condition did not improve significantly enough and they now require ward care. The emergency doctor will determine which specialty ward the patient would be admitted to, according to their medical condition.
An admitted patient may not go their designated ward instantly. They can spend prolonged periods in the emergency room, either for medial stabilization before transport or to await the availability of an appropriate bed, given their medical needs.
In general, patients that are sicker or seriously injured are kept in the “in room” section. The less sick or stable injured patients are usually placed in the “out room” section.
OUT ROOM PATIENT CARE
In this section, patients would have undergone “in room” treatment and are now stable enough to be placed here. Patients in this section are either awaiting return of their laboratory investigation or a period of observation to see the progression of their medical condition.
Only patients that are ambulating and have non-life threatening conditions are placed in this section. Patients and a relative are usually allowed in this section and this enhances patient safety and monitoring. These patients will be called back into the “in room” when their observation period has finished or their laboratory investigations have all returned. The doctor will then make a decision on discharge or admission for this patient.
Changes in social patterns and continued evolution in patient presentations will always pose a challenge to the emergency room staff. These are challenges that exist in any organization with emergency medical care. The creation of systems of hierarchy and accountability, along with appropriate and continued staff education, are important goals of the GPHC A&E.
Continued focus on these goals should help to manage the ever-evolving patient care challenges and ultimately contribute to the delivery of productive emergent medical care for all.
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