Survey of the current state of emergency care in Chennai, India

doi:10.5847/wjem.j.1920-8642.2011.03.002

Abstract

Abstract:

BACKGROUND: On July 21, 2009, the Medical Council of India officially recognized the specialty of emergency medicine in India. The city of Chennai with over six and a half million people is the fourth largest on the subcontinent and has already been a prominent city of interest in the specialty's development. However, there is no standardization of the resources found in the city's emergency departments. This study was to survey the equipment, training, and certification of Chennai area emergency departments and their staff.
METHODS: We conducted a cross-sectional survey of emergency department staff from 38 Chennai area hospitals. The survey instrument contained 44 questions pertaining to hospital demographics, staff training and certification, and ED equipment and supplies. The items on the survey were specifically chosen to represent only the most basic and common resources necessary to practise emergency medicine.
RESULTS: The survey found a majority of hospitals are privately operated but there is a wide range in terms of size and volume of patients. A minority of both doctors and nurses are certified in BLS, ACLS, PALS, and ATLS. While almost all departments surveyed had the basic code medications, a number of basic equipment items were lacking from a large percentage of the EDs surveyed.
CONCLUSION: The newly established EP community in Chennai will have the responsibility to establish standards for both training and resources so that the specialty may grow and provide a higher standard of emergency care moving into the future.

Key words: Emergency medicine, India, Health resources

Jay Khadpe, Tausif Thangalvadi, Parivalavan Rajavelu, Richard Sinert. Survey of the current state of emergency care in Chennai, India[J]. World Journal of Emergency Medicine, 2011, 2(3): 169-174.

Figures/Tables 6

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References 15

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Parameters	Results
EDs studied	38
Public hospitals	8%(3/38)
Private hospitals	92%(35/38)
Teaching hospitals	40%(15/38)
Non-teaching hospitals	60%(23/38)
ED stretchers (mean)	8 (313/38)
Inpatient beds (mean)	251 (9288/37)
Annual ED volume (mean)	17 494 (647 273/37)

Parameters	Results
ED physicians (mean)	6 (242/38)
Completed post-graduate training	20%
ACLS certified	22%
PALS certified	10%
ATLS certified	11%
ED nurses (mean)	11 (398/37)
BLS certified	27%
ACLS certified	10%

Parameters	Results
Triage protocol	24 (9/38)
Oxygen saturation	76 (29/38)
Cardiac monitor	71 (27/38)
BP monitor	58 (22/38)
Defibrillator	71 (27/38)
EKG	97 (37/38)
Portable X-ray	62 (23/37)
Glucometer	95 (36/38)
Large bore IVs	79 (30/38)
Central venous catheters	32 (12/38)
Pressure bag	45 (17/38)
Infusion pump	37 (14/38)
Dressing material	100 (38/38)
Suturing material	100 (38/38)
Splinting /casting material	68 (26/38)
Cervical collar	61 (23/38)

Parameters	Results
Bedside suction	95 (36/38)
Supplemental oxygen	100 (38/38)
Nasal cannula /venturi mask	100 (38/38)
Non-rebreather mask	47 (18/38)
Bag valve mask (adult size)	89 (34/38)
Bag valve mask (pediatric size)	53 (20/38)
Intubation equipment (adult sizes)	87 (33/38)
Intubation equipment (pediatric sizes)	53 (20/38)

Parameters	Results
Epinephrine	92 (35/38)
Atropine	92 (35/38)
Vasopressin	38 (14/37)
Lidocaine	89 (34/38)
Amiodarone	42 (16/38)
Calcium (chloride or gluconate)	87 (33/38)
Bicarbonate	89 (34/38)
Dextrose (D25 or D50)	95 (36/38)