What is the need for an emergency room in medical institutions? You will learn the answer to this question from the materials in this article. In addition, we will tell you about what functions such a department performs, what are the duties of staff, etc.
General information
The emergency room is the most important medical and diagnostic department of the hospital. Almost all modern medical facilities have a centralized planning system. In other words, all diagnostic and treatment departments are concentrated in one building. In the same building, the receiving chamber is usually located.
If the hospital has a decentralized (i.e., pavilion) development system, then such a department can be located in one of the medical buildings or in a separate building.
Main functions
The reception department is necessary for:
- reception and registration of incoming patients;
- examination and initial examination of patients;
- emergency medical assistance;
- filling out all medical documentation ;
- transporting patients to other treatment departments.
Layout
Almost all hospital admissions departments consist of examination boxes with separate sanitary units, as well as a post of a nurse and a doctor’s office.
An X-ray room and a clinical, serological, biochemical, and bacteriological laboratory should be located next to the emergency room.
How can they deliver?
Patients can be delivered to an emergency room in one of the following ways:
- In the direction of the district doctor of the clinic (outpatient clinic). But this is only if treatment at home was ineffective.
- Ambulance In cases where the patient has an exacerbation of a chronic disease that requires highly qualified treatment in a hospital.
- Transfer from other medical institutions.
It should also be noted that the hospital’s emergency room is required to accept those patients who are on their own, without any referral to hospitalization.
Principle of operation
After the patient was taken to the hospital, or he himself arrived there, he should be examined by the doctor on duty at the admission department. This procedure is performed directly in the boxes. The nurse conducts thermometry, and also carries out the collection of materials (according to indications) for their further bacterioscopic or bacteriological examination, electrocardiography, etc.
It should also be noted that in the viewing boxes they provide emergency medical care. But often patients who are in critical condition enter the intensive care unit or intensive care unit immediately, without going to the doctor on duty.
After examining the patient with a doctor, the nurse of the admission department draws up all the documentation in the office or right at the post. Her responsibilities also include measuring the patient's body temperature and performing other manipulations prescribed by the doctor. Transportation of patients to other treatment and diagnostic departments is carried out according to the throughput principle immediately after the preparation of all documentation.
Basic medical documentation for the emergency room
The children's admission department is no different from the adult, except for the presence of highly specialized specialists. When a patient enters a medical institution, all his data is recorded at a nurse's post.
The following documents are filled in the reception department, which are maintained and executed exclusively by a senior hospital employee:
- Journal of refusals of hospitalization and patient admission. In such a journal, the employee records the name, patronymic and surname of the patient, his home address, year of birth, position and place of work, all details of the insurance policy and passport, telephones (office, home, close relatives), time and date of admission to the department, by whom and from where he was delivered, the diagnosis of the referring medical institution, the nature of hospitalization (emergency, planned, independent), the diagnosis of the emergency department, as well as where the patient was subsequently referred. If the patient refused hospitalization, then information about the reason for the refusal is entered in the journal.
- Medical record of an inpatient. Unofficially, this document is called a medical history. In the office or directly at the post, the nurse fills in his passport part, draws up the title page, as well as the left half, which has the heading “Statistical card of the patient who has left the hospital”. If pediculosis is detected in a patient, the pediculosis examination log is also filled. In this case, an additional note “P” is made in the medical history.
- If the patient has an infectious disease, pediculosis or food poisoning, the nurse must fill out an emergency notice to the epidemiological station.
- The log of telephone messages. In such a journal an employee of the emergency room records the text of the telephone message, the time of its transmission, the date, as well as who it was given and received.
- The magazine is alphabetic, fixing the patients who arrived. Such a document is necessary for the help desk.
Sanitary treatment of patients
After diagnosis, by decision of the doctor on call, the patient is sent for sanitary treatment. If the patient is in a serious condition, then he will be taken to the intensive care unit or intensive care unit without the above procedure.
Sanitary-hygienic treatment is usually carried out in a sanitary inspection room, where there is a viewing room, a cloakroom, a bath-shower room and a room where patients dress. It should be noted that often these rooms are combined.
In the first room the patient is undressed, examined and prepared for further hygiene treatment. If the patient’s underwear is clean, then he is put in a bag, and the outer clothing is handed over to the storage room. This compiles a list of things in duplicate. If the patient has money or any valuables, then they are handed over to a senior employee (nurse) against a receipt for storage in a safe.
If the patient has an infectious disease, then the linen is placed in a tank with bleach for two hours and sent to a special laundry.
So, we will consider what stages the sanitary-hygienic treatment of patients includes:
- examination of the hair and skin;
- nail and hair cutting, as well as shaving (if necessary);
- washing in the shower or taking a hygienic bath.
Distribution of patients in other departments
After making a diagnosis and collecting information about possible contacts with infected people, the arriving patient is sent to the necessary department.
If the medical institution has a diagnostic center, then individual patients with a dubious diagnosis are detained in the emergency room to clarify it. Patients with diphtheria, measles or chicken pox (or suspected disease) are placed in boxes specially equipped with autonomous ventilation.
Patients in the admission department are allocated so that newly arriving patients are not near convalescents or those who have complications.
Types of transporting patients to hospital treatment departments
Transportation is the transportation or transfer of patients to a place of medical care or treatment. What method to choose for this or that patient to take him out of the emergency room to the necessary department of the hospital is determined only by the doctor who conducts the examination.
Typically, vehicles such as stretchers and wheelchairs are provided with blankets and sheets. Moreover, bedding should change after each use.
Patients who can move on their own come from the emergency room to the ward with the help of a junior medical officer (for example, a junior nurse, a nurse or a nurse).
Patients with serious complications who are unable to walk themselves are transported to the department in a wheelchair or on a stretcher.
Staff Admission Rules
Each medical worker of the admission department is obliged to monitor his workwear, health condition, appearance, etc. Particular attention must be paid to the hands (lack of dermatitis, etc.).
Before starting a new job, a potential employee must undergo a medical examination and submit all certificates to the Central Bank or the Central District Hospital. The emergency room (especially infectious hospitals) is the strictest selection of nurses and doctors. So, only people who have reached the age of 18 are hired. If they have an open form of tuberculosis, sexually transmitted and other infectious diseases of the skin and mucous membranes, then their candidacy is immediately rejected.
During the functioning of the reception department, all its employees are periodically subjected to a medical examination (at least once a year). If carriage of pathogenic microorganisms is found in workers, then the question arises of their admission to the post.
The newly hired employees are instructed on the rules for fulfilling their duties, as well as labor protection. Junior medical personnel are specially trained. In such classes, employees are given a minimum of knowledge and work skills.
When instructing all the staff of the emergency room, the specific features of work in the department, the rules of the (internal) schedule for patients and employees, the anti-epidemic regime, and also personal hygiene are explained. In addition, workers should be instructed to prevent occupational exposure.
Admission to work in the emergency room without studying these standards is prohibited.
In the future, repeated safety training and personal prevention rules are conducted (at least 2 times a year). Typically, such training is provided by the head of the department or laboratory.