SOPs framed for emergency care at Civil Hospital, Ludhiana

Days after the case of an elderly man found lying dead on the same bed with another patient at the civil hospital in Ludhiana came to the fore, the health department has framed standard operation procedures (SOPs) to ensure that such negligence is not repeated. However, doctors believe the SOPs were a mere eyewash due to the hospital’s resource crunch.

The SOPs call for marking the beds in the emergency ward in red, yellow, green and black. Three beds for patients requiring immediate care, two for those who could be attended later, one for those with minor injuries and could be discharged after dressing, and one for the deceased with screens.

It also prescribes a sorting scheme with tags for prioritising patients. The patients whose injuries are critical but need minimal time and equipment are to be tagged red, those with serious injuries but do not need immediate help are to be tagged yellow, those with minimal chances of survival are to be tagged green, and the deceased are to be tagged black.

Setting up a triage ward has also been recommended to sort the patients.

The responsibility has been fixed with the senior medical officers and the emergency medical officers (EMOS) to ensure these SOPs.

Welcoming the SOPs, Punjab Civil Medical Service Association (PCMSA) president Dr Akhil Sareen said, “These can’t work properly unless the issue of severe staff crunch is addressed.”

“There was a similar case in August last year and the health minister had also visited the hospital. We had told him that unless the resources at the hospital were upgraded to take on the load it at present faces, no measures would work,” he said.

The hospital, now an over 300-bedded facility, works with the same old-sanctioned strength, and even of those many positions lay vacant. There is a sanctioned strength of 47 nurses, and at present there are only 37 working. According to Indian Public Health Standards, the number must be between 135 and 140. There are at present 42 doctors at the hospital against the sanctioned strength of 50 and three of them are on deputation.

The sanctioned strength of the EMOs is 15, but there are only three, besides three roped in every month on a rotational basis. To make up for the lack of EMOs, four specialists have also been made to work as EMOs.

The emergency ward, which on average sees over 100 patients a day has only seven beds.

On Sunday morning, an elderly man was found lying dead on the same bed with another patient. After the case hogged headlines, the health officials and deputy commissioner Sakshi Sawhney swung into action to probe the matter. Ludhiana civil surgeon Dr. Jasbir Singh Aulkah, after the preliminary probe, recommended the health secretary to take action against senior medical officer Dr Mandeep Kaur and EMO Manju Nahar for negligence. The DC asked the health department to frame SOPs to deal with such cases in the future.

The civil surgeon acknowledged the problems faced due to staff shortage. He said, “I have written to the DC to return seven doctors working in the jails in the district and have asked the health secretary to operationalise the 17 emergency wards lying closed at urban and rural community health centres to relieve the pressure at the civil hospital.” Hindustan Times