Emergency Care Given to Patients from Casualty

• Rapid Assessment: A quick physical examination is conducted to assess the patient’s immediate needs. Based on the triage findings, the patient is directed to the appropriate treatment area for emergency interventions.

Immediate Life-Saving Interventions:

• Airway, Breathing and Circulation (ABC): The emergency care team first ensures that the patient’s airway is open, they are breathing adequately and their circulation is stable. If necessary, airway management (intubation), oxygen therapy, or fluid resuscitation is provided.
• Resuscitation and Stabilization: For critically ill or injured patients, immediate resuscitation is performed. This can include cardiopulmonary resuscitation (CPR) for cardiac arrest, defibrillation for abnormal heart rhythms and blood transfusions for major blood loss.

Trauma Care:

• Fractures and Dislocations: The emergency team stabilizes fractures and dislocations using splints or traction to prevent further injury. Pain management is provided to ensure patient comfort while awaiting further treatment.
• Wound Care: Wounds and lacerations are cleaned, disinfected and dressed to prevent infection. In cases of severe injuries, emergency surgery may be required to repair damaged tissues.
• Burn Management: In burn cases, the affected area is cooled and covered with sterile dressings. Immediate fluid resuscitation is initiated to prevent shock and pain management is provided.
• Trauma Imaging: X-rays, CT scans and ultrasounds are used to assess the extent of internal injuries, fractures, or other trauma-related conditions, aiding in accurate diagnosis and treatment.

Cardiac Emergencies:

• Heart Attack (Myocardial Infarction): For patients experiencing chest pain or symptoms of a heart attack, an electrocardiogram (ECG) is immediately performed to assess heart function. Medications such as aspirin, nitroglycerin, or thrombolytics may be administered to dissolve blood clots and restore blood flow to the heart
• Cardiac Arrest: In cases of cardiac arrest, CPR and advanced cardiac life support (ACLS) measures are applied, including defibrillation to restart the heart and stabilize the patient.
• Angioplasty and Cath Lab Referral: If necessary, the patient is quickly transferred to the Cath Lab for angioplasty to restore blood flow to blocked coronary arteries.

Stroke Management:

• Rapid Assessment: Patients presenting with symptoms of stroke (e.g., weakness, facial drooping, speech difficulties) are immediately assessed using the FAST protocol (Face, Arms, Speech, Time). Time is critical and rapid interventions are required to minimize brain damage.
• Imaging and Diagnosis: A CT scan or MRI is performed to determine if the stroke is ischemic (caused by a blood clot) or hemorrhagic (caused by bleeding in the brain).
• Thrombolytic Therapy: For ischemic strokes, thrombolytic (clot-busting) medications may be administered within the first few hours of symptom onset to dissolve the clot and restore blood flow to the brain.

Respiratory Emergencies:

• Asthma and COPD Exacerbations: Patients experiencing severe breathing difficulties due to asthma or COPD are provided with bronchodilators, steroids and oxygen therapy to ease breathing. Nebulization treatments are also given to open up the airways.
• Intubation and Ventilation: In cases of respiratory failure or severe trauma, the casualty team may perform endotracheal intubation and provide mechanical ventilation to support breathing until the patient is stabilized.

Poisoning and Overdose Management:

• Gastric Decontamination: In cases of poisoning or drug overdose, emergency care involves gastric decontamination (e.g., administering activated charcoal) to limit absorption of the toxic substance.
• Antidote Administration: If available, specific antidotes are administered for cases such as opioid overdose (naloxone) or snake bites (antivenom).
• Observation and Monitoring: The patient’s vital signs, consciousness and neurological status are continuously monitored in the emergency setting to prevent further deterioration.

Seizure and Neurological Emergencies:

• Seizure Control: In cases of seizures, medications such as diazepam or lorazepam are given to stop the seizure activity. Oxygen may be administered and the patient’s airway is protected to prevent injury.
• Post-Seizure Care: After the seizure, the patient is monitored for neurological deficits or recurrence of seizure activity. Imaging tests may be performed to identify any underlying causes, such as brain injury or infection

Infection and Sepsis Management:

• Sepsis Protocol: For patients with suspected sepsis (a severe infection causing systemic inflammation), early and aggressive treatment is key. Intravenous fluids, broad-spectrum antibiotics and medications to maintain blood pressure are initiated immediately.
• Infection Source Control: Identifying and controlling the source of infection (such as an abscess or infected wound) is critical. Surgical intervention or drainage may be required in certain cases.

Pediatric Emergency Care:

• Specialized Pediatric Assessment: Children require specialized care and smaller doses of medications. Pediatric patients in casualty are quickly assessed for conditions like high fever, respiratory distress, dehydration, or trauma.
• Resuscitation in Children: The emergency team is trained to perform pediatric resuscitation techniques, including pediatric CPR, fluid management and medication administration based on weight and age.

Pain Management:

• Relief of Acute Pain: Pain relief is an essential part of emergency care. Depending on the condition, patients are provided with analgesics (e.g., morphine, paracetamol) to control pain. For trauma, fractures, burns, or post-surgical care, appropriate doses are given to ensure patient comfort during treatment.

Wound Care and Suturing:

• Laceration Repair: Wounds are cleaned, disinfected and stitched (sutured) in the casualty department. For deep or complex wounds, surgical referral may be necessary.
• Tetanus Prophylaxis: Patients with open wounds are assessed for tetanus risk and tetanus vaccines or immune globulin may be administered as a precaution.

Why Casualty/Emergency Care is Critical:

• Timely Intervention: The first few minutes and hours after an injury or medical emergency are crucial in determining the outcome. The casualty team is trained to deliver rapid, life-saving interventions to stabilize the patient and prevent deterioration.
• Comprehensive Services: Casualty departments provide multidisciplinary care by involving surgeons, neurologists, cardiologists, trauma teams and critical care specialists as needed. This integrated approach ensures that the patient receives all necessary treatments without delay.
• Continuous Monitoring: Patients in casualty are continuously monitored for changes in their condition. Vital signs are regularly checked and interventions are adjusted accordingly to optimize care.
• Coordination of Care: The emergency team ensures the seamless transition of patients to other departments, such as surgery, intensive care, or cardiology, for definitive treatment. They coordinate follow-up care, ensuring that patients receive long-term management after stabilization.

The Casualty Department provides critical and immediate care for a wide range of emergencies. From trauma and heart attacks to infections and poisonings, the emergency team is equipped to rapidly assess, stabilize and treat patients, improving survival rates and outcomes. The focus is on life-saving interventions, pain management and coordinated care, ensuring that patients are stabilized and receive appropriate long-term treatment for their injuries or conditions.