EMERGENCY MEDICINE CLINIC Güncelleme Tarihi: 25 Şubat 2020

EMERGENCY MEDICINE CLINIC


 PATIENTS PROFILE

Emergency Surgery, internal patients and Child trauma cases.

WORKING AREA :

 

Our clinic has 3 polyclinics,  one resuscitation room, 2 Intensive Care rooms and 3 observation rooms. There are 10 beds in total, 5 in each of the Intensive care rooms. Each of the observation rooms has an average of 10 stretchers.

 

CLINICAL WORK FLOW TIME:

 

Polyclinics are available 24 hours a day. The referral, examination, examination, treatment and discharge procedures of the patients applying to the outpatient clinic from the moment they arrive at the Emergency Department are carried out by the following units.

 

Triage Unit:

 

Patients who need help despite coming with a private vehicle or who apply to the Emergency Department with 112 emergency ambulances are welcomed by the patient referral staff.

Registration and acceptance procedures of patients; This is done by the patient himself, his relatives, referral staff or 112 emergency ambulance officers to the patient registration unit.

In the triage department patient registration staff Works. It is enough to  make the first registration of patients with T.R identification number regardless of social security. Patients are also evaluated by the triage officer. Triage attendant performs triage according to patients' complaints and clinical status. Patients are given green, yellow, red and black codes. This coding process is done by the triage officer. Color codes given to patients according to the triage system can also be seen simultaneously on the computer screen of the Emergency Room polyclinic. Triage attendant and referral staff inform patients and relatives about the  triage procces . After the registration and triage application, the ambulance team and the patient referral staff are taken to the emergency clinic doctor.

Patients who are given the green and yellow code are examined by the emergency outpatient doctor. Patients who are given red and black codes are taken to the resuscitation room without wasting time with guidance staff.

When a patient is asked to be sent from other centers, it is accepted by obtaining the approval of the relevant department and determining the service where the patient will sleep. The relevant doctor is informed about the patient whose referral is accepted. The acceptance document of these patients is signed by the relevant doctor who accepts the transfer of the patient or with his knowledge. Patients brought without admission are followed up in the emergency room until they are transferred to a suitable place.

For the patient referred to the emergency examination rooms, the emergency examination card is filled in completely by the doctor who sees the patient first. All examinations are requested from the information processing system. The patient is taken to the relevant units for examination, treatment and observation by the referral staff in accordance with the instructions of the doctor

In the emergency observation units, after the patients are accepted, the responsible nurse of the unit attaches  wristbands to the patient which contains threir. Patients who are referred to the observation unit are re-evaluated by the doctor in the observation unit, and the treatment proposed in the patient card is applyed  by the nurse after it is approved by the observation doctor. Patients whose treatment is completed in the observation unit are discharged with the approval and stamp of the emergency duty specialist. If required, additional radiological examinations from patients in the observation unit are sent to the relevant units accompanied by patient orientation staff. Blood samples taken in the observation unit are delivered to the laboratory by the referral staff.

In the Observation Units every weekday at 08:00 , With the Emergency Medicine Specialist, weekends, morning and all evening visas are held at 17:00 with the Emergency Service Specialist doctor. During the transfer, the transfer form including the name, diagnosis and transferred doctor information of all patients is written regularly.

Observation Rooms:

Consultations to be requested for the patient evaluated by the emergency physicians by the observation unit are requested by using the information-processing system, with the approval of the senior assistant doctor and the emergency staff on duty.

It is mandatory to use the electronic call system for the consultation request from the related branch. The doctor who comes for the consultation first ends the call system. The emergency doctor responsible for the follow-up of the patient gives the necessary information about the patient to the consultation physician. The treatment, follow-up duration, hospitalization or discharge suggestion to the patient in the consultation response are clearly stated in the consultation form. Patients whose prolonged follow-up or hospitalization must be deposited by the relevant branch within 4 hours. If the patient cannot be taken to the service because of the lack of bed, in the hospitalizations overnight in the emergency room; The emergency medicine specialist has to put hospitalization block on automation for elective patient hospitalization in the hospital where the patient will be hospitalized. Patients who are decided to undergo surgery after consultation are followed up in the department service, which makes the decision to operate until they are taken to the operating room. The operated patient cannot be followed up in the emergency room in the post-operative period.

After the first intervention is completed, patients with multiple trauma are followed by hospitalization in any of the relevant clinics, and if there is no place in the relevant clinic, they are tried to be transferred to another health center by the relevant department physicians. Regarding the patient who needs to be transferred to another health center, information is given to the chief of duty on duty outside the working hours, the assistant chief physician or the chief physician during working hours. The patient, who cannot be referred, can be monitored in the emergency room under the responsibility of the following departments. Necessary information about the patients who have problems in hospitalization and follow-up is notified to the chief chief physician or chief physician by the emergency duty specialist, and to the chief of the duty outside the working hours.

 

Resuscitation and Trauma Unit

Patients who are given red or black code are taken to the resuscitation unit quickly accompanied by the guidance staff. The patient is registered later. The resuscitation doctor quickly evaluates the patient, and the senior assistant doctor or emergency room specialist is notified when the intervention is performed. The patient's radiological examinations are completed in intubated patients, connected to a portable breathing apparatus. The intensive care place of the patients who are intervened and whose necessary consultations are completed is arranged by the doctor of the department. If there is no suitable bed in the hospital, negotiations with other hospitals are made by the relevant department for referral. The on-call emergency specialist and the on-call chief also provide coordination and are responsible for the outcome of the situation. If there is a need for a ventilator, the on-call chief or on-call observer nurse is informed and the need for the ventilator is met. In the absence of a ventilator, interviews are made with other hospitals for referral. In case of problems in meeting the need for intensive care or ventilators, the chief doctor assistant responsible for the emergency service during the working hours and the chiefs on duty outside the working hours are notified. Procedures to be performed on major trauma patients (incision suturing, etc.) are performed in the trauma room by the Emergency Medical Doctors or relevant Branch doctors.

Emergency Intensive Care Service:

The patient who needs inpatient treatment is temporarily transferred to the emergency intensive care unit if there is no place in the relevant branch clinics. Patients hospitalized in this unit are transported if there is room in other intensive care units.

Discharge Procedures:

The file of the patient who will be discharged is completed by the doctor of the patient and will ibe marked the discharge section. The file attachments (ECG, x-ray etc.) are specified and the file is stapled to the relevant staff in the discharge bank during working hours and delivered to the patient registration officer outside the working hours. The patient is then allowed to exit.

 

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