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Emergency Medicine Conference

Posted on by ask
Abdus Salam Khan, MD FACP
September, 2017
 

With great effort and continuous struggle, Pakistan is fortunate to have developed a small team of Emergency Physicians well geared towards improving emergency care in Pakistan. The efforts that started more then two decades ago are slowly bearing fruit. The background work was done through public awareness, research work and writing papers.

Since 2010 CPSP recognized Emergency Medicine as a discipline for the training. There are five centers recognized for the training and now the numbers will increase in future. The struggle of Emergency Medicine is entered into a new phase with the public sector Hospitals acquiring training status in Emergency Medicine fellowship through CPSP.

To highlight this further and let interested people come together and join forces and work to propagate Emergency Medicine the idea of having the Emergency Medicine Conference emerged. Through the efforts of President Royal College of Emergency Medicine and Emergency Physicians of Pakistan an International conference was arranged and successfully conducted. The people who delivered speeches came form all corners of the world including Australia, UK, Ireland, USA, Middle East and most importantly different part of Pakistan.

The theme of the conference was building EM in Pakistan. It was done as a joint effort of Shifa Tameer-e-Millat University, Society of Emergency Medicine and Royal College of Emergency Medicine. The audience was very motivated physicians in training, physicians in service and also plenty of medical students. It was exciting to see the representation from all of the area medical schools and hospitals.

The audience were kept engaged by equally impressive speakers. The notables were Surgeon General of Pakistan Dr. Asif Sukhara, Chairman HEC, President Royal College of Emergency Medicine , Councillors of CPSP, Vice Chancellors of local area university. The other honorable guests were CEO of Shifa International Hospital Dr. M. H. Qazi, Minister Health Azad Jammu Kashmir Dr. Najeeb Naqi, notable teachers and Professors of Public Hospitals including Professor Umar and Prof. Waseem ud din. The massage that was unanimously conveyed was that as a result of prolonged and hard efforts of people now emergency medicine has a powerful footing in Pakistan. Another thing was that public hospitals are also moving towards it as evidenced by the example of POF Wah and now the latest two institutions which are Lady Reading Hospital and Jinnah Post Graduate Medical Center.

The role of public hospital is important because the majority of citizen go to the public hospitals and because of having low resources and manpower, the untrained emergency doctors do their best yet unable to deliver safe care to the ailing citizens.

Speakers also gave message of hope to the physicians of Pakistan to keep up with the efforts of promoting emergency medicine by giving them examples of western world, where it took much longer to be recognized. They also conveyed important massages like converting our failures into success by learning from them and the value of teamwork and leadership.

There was poster presentation and abstract competitions. Research work originated from Pakistan and abroad was presented and local research started to show in Emergency Medicine from Pakistan and it is a great feeling.

This 2 day activity did much more then gathering people under one roof. It gave the physicians hope for the future of Emergency Medicine and plenty of motivation. It was felt that the heath care community has realized the value of Emergency Medicine and is willing to support this budding discipline. The foreign delegates mingled with the local stakeholders to encourage them and to help the emergency medicine. They were much amazed by the enthusiasm of the fresh graduates towards emergency medicine.

The organizers appreciated the participants and promised to continue their efforts and to conduct similar activities in future.

I can be reached at askhan65@yahoo.com

Ethical aspects of emergency medical care.

Posted on by ask
Abdus Salam Khan, MD FACP
August, 2017
 

While providing care for our patients as doctors, nurses, staff and technicians what is the expectations of our patients. Although everyone expects the problem that they are facing should go away but in real sense the problem sometimes does not hurt as much as our attitude hurt our patients.

The expectations of a patient from the healthcare system are always compassionate care. Mostly because when they are going through a very rough time with their sickness, the last thing they expect is an uninterested doctor or a nurse. Our sense of duty to our patients should be our ethical and moral responsibility. In order to fulfill our responsibility we need to understand the ethical principles governing healthcare all over the world. Among all ethical principles the following four are considered core of the medical ethics. These include:

  1. Autonomy
  2. Beneficence
  3. Non-maleficence.
  4. Justice

Let us talk about these principles so that we understand them in a bit deeper way.

Autonomy:

As the healthcare provider may have the responsibility to make sure that our patients make decisions which are informed and free of coercion. Every patient has the right to choose or refuse any treatment or part of the treatment. In our Pakistani situation it is hard for the patients as well as treating physicians to understand this phenomena. Usually it results in a conflict between the patient and the care provider when the patients autonomy is not respected.

Beneficence:

This ethical principle means that all actions of physicians nurses technicians and everyone getting for a patient has to be in the best interest of the patient. It means they all try to do good for the patient. This requires everyone caring for the patients to acquire and update knowledge so that they can provide the best care to the patients in the best possible way.

Non-maleficence:

This ethical principle assumes that everyone getting for the patients will make sure that their actions don’t harm any patient. It is the most difficult ethical principle, as we take plenty of decisions in order to care for the patient which turn out to have either a side effect or an untoward effect and can be seen as harming the patient. A careful balance requires knowledgeable and caring people working with their utmost attention and utilizing best skills.

Justice:

This ethical principle is also difficult to practice, because as the healthcare professionals we should provide treatment to all segments of the society in a fair way. In other words, we should always try to do most for the most. It is difficult because of the design of our society and so we favor the rich and the powerful and neglect the poor.

There are other ethical issues associated with providing medical care but these four are the core principles that are applied on day to day care of the patients. While working the emergency departments these ethical considerations become more important due to time limited and emergency nature of their problems.

For all my esteemed readers, it is my advice to promote the ethical dimension of the care, as we are the advocate of our patients and should be working with our patients to help them make informed decision, do good for them and avoid harm. At the same time do most for the most.

I can be reached at askhan65@yahoo.com

Role of technology in emergency department.

Posted on by ask
Abdus Salam Khan, MD FACP
July, 2017
 

Emergency department is a place can be chaotic and is prone to potential errors. This is due to high risk situations addressed in shorts span of time. Sometimes difficult situation arise due to crowding of patients and other times delay in decision-making due to factors not in control of the emergency department. Let us talk about instances arise due to these difficult situations and see how and what technology can do to overcome it.

 

Emergency department by design in Pakistan are not close area of patient care and sees unending arrival of patients 24 hours a day. Due to lack of pre-hospital care sometimes ED is the first point of contact for unstable patients even when they arrived by ambulances. So by the time the patient is seen by the emergency doctor enough time is gone since the conditions started developing and a good outcome becomes less likely because of time-lapse.

 

Once the patient arrives and the evaluation started, the different input/output points become very important. We need laboratory data quick, radiology data quick and at the same time access to previous records of the patient. For proper treatment of unstable patients these parameters and results should be available to physicians as soon as is feasible, otherwise the patient satisfaction go down and the quality of care is compromised.

 

Technology can provide enormous help in regards to all the above input points and can provide treating physician needed information. The technology has in enormous ways to streamline what, make clinical decisions, audit, forecast and document quality of care. From time management to bed management, from lab reporting to radiology films technology provides options that tailored to individual needs and circumstances.

 

For the treating physician it is most important to have old ECG or the medication record and allergy information available at the time when patients are seen in the emergency department. For the nurse incharge the bed situations and bottlenecks are the issues that can’t be effective resolved using technology. For the patients availability of their previous information and smoothly orchestrated process of treatment is all that they required when they visit the emergency department.

 

For the hospital financial issues and outcome studies matter a lot. Similarly safety issues for the patients and hospital can amicably be addressed using technology. From small-scale to nationwide, data input and analysis is now integral part of healthcare delivery. Electronic medical records is a must for patients for plenty of countries and healthcare systems for good reason. We need to create this understanding among our care providers as well as decision makers. All across healthcare dimensions technology can play a role to help specific concerns and make process and safe.

 

Small scale data when collaborated among different individual institutions can produce a nationwide data resource that can effectively improve our national healthcare system through audits and research based on outcome studies. Due to the nature of emergency work and the way our emergency care is delivered, it is utmost important to utilize technology in our patients favor and give them satisfaction regarding the system of care.

 

I can be reached at askhan65@yahoo.com.