May 27 is World Emergency Medicine Day
TMH Jamshedpur Leads in Emergency Care and Training with State-of-the-Art ED Services
Dr Binita Panigrahi
Emergency Medicine is a specialised field of medical practice that deals with the urgent evaluation and management of patients who present with acute illnesses or injuries. Today it is a specialty in medical postgraduate curriculum.
Historically, French military surgeon Dominique Jean Larry, during the French Revolution, introduced the concept of ambulance to rapidly carry the wounded to a central place where medical care would be possible. This idea became the forerunner of modern MASH (Mobile Army Surgical Hospital) units, where focused care is possible during the “Golden Hour”- the first hour following injury. MASH units brought down death significantly following injury. Therefore, Golden-hour resuscitation became the primary function of Emergency Department (ED). Dominique Jean Larry was named the Father of Emergency Medicine for the concepts he implemented during the French wars.
Idea of Emergency Medicine Day was initiated by the European Society for Emergency Medicine (EUSEM) and was first observed on May 27, 2019. The goal of establishing this day was to raise awareness about the crucial role of emergency medicine and to advocate for better support, resources, and training for emergency medical professionals.
Emergency Medicine made its beginning in India in 1995 when it was introduced as a specialised discipline, that imparts training on trauma care, critical care, toxicology, resuscitation, and emergency procedures. The establishment of the National Health Mission (NHM) in 2013, which includes a dedicated program for emergency medical services, has helped to improve the availability and quality of emergency service. The National Medical Commission (NMC) has issued guidelines for establishment of Emergency Medicine departments in medical colleges in India pertaining to minimum infrastructure and faculty requirement, curriculum, clinical training requirement and quality assurance.
The ED is the first point of contact of patient with a hospital. It is usually a crowded place dealing with all kinds of patients. The seriously ill are identified and fast-tracked to receive immediate care through a process of triage (sorting) done by the Triage Doctor. The less sick and stable patients wait for their turn which could vary between 15 minutes to an hour, depending on the rush. The place is often witnessed to emotionally charged scenes, by relatives of serious patients, for which adequate security cover is mandatory.
The ED of Tata Main Hospital (TMH) handles all kinds of serious patients through a dedicated and competent team comprising of 23 medical officers, Emergency Medicine physician along with general physician, general surgeon, and 24×7 cover by every other specialty of the hospital. It handles a patient load of over 200 every day with seasonal surges. Depending on seriousness there are three zones in ED- Red (very serious), Yellow (less serious patients needing observation and treatment) and Green (stable patients not needing observation). Every shift is managed by a team of 5-6 trained doctors. The department is always in a state of disaster preparedness through regular training and mock drills. The critically ill patients receive initial stabilization in ED and ICU care starts here; while the less serious are given treatment and observed for admission or discharge, as per case. Patients of road traffic accidents, acute myocardial infarction (heart attacks) and acute stroke are given immediate care. There is a strict quality assurance programme to monitor the performance of the department which is audited by the higher management of the hospital. The department has enhanced its capability over the years and has served the population of Jamshedpur well, and adjoining areas, during COVID waves, dengue wave and the heat wave of last year. Today it is recognized for postgraduate (PG) training in Emergency Medicine by the National Board of Examinations in Medical Sciences (NBEMS) and intake of the first batch of PG students has happened this year. Emergency Department of TMH is headed by Dr Binita Panigrahi with Chief of Medical Support Services of TMH, Dr Mamta Rath Datta, as overall in-charge.
(Author is HOD, Emergency Medicine, Tata Main Hospital, Jamshedpur. Views are personal.)
