Turning casualty wards into robust emergency medicine departments

This year, Karnataka has seen cases that highlight not only the consequences of medical negligence, but also the glaring gaps in its healthcare infrastructure.
doctors are demanding urgent upgrades at these facilities, particularly the transformation of ‘poorly-equipped casualty wards’ into fully-developed ‘emergency medicine departments’ (Representative image)
doctors are demanding urgent upgrades at these facilities, particularly the transformation of ‘poorly-equipped casualty wards’ into fully-developed ‘emergency medicine departments’ (Representative image)(Photo | EPS)
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BENGALURU: With government hospitals being the first, and often, the only point of care for many, doctors are demanding urgent upgrades at these facilities, particularly the transformation of ‘poorly-equipped casualty wards’ into fully-developed ‘emergency medicine departments’.

The calls come after repeated instances of medical negligence and delays in patient care, often due to insufficient resources and inadequate systems that result in unnecessary hospital transfers for patients and raise a question if general hospitals are even prepared for the common man.

This year, Karnataka has seen cases that highlight not only the consequences of medical negligence, but also the glaring gaps in its healthcare infrastructure. After a series of maternal deaths in Ballari district, a 27-year-old woman in Madikeri died following a surgical procedure at a Community Health Centre. Her condition worsened after anaesthesia was administered and the patient succumbed while she was being transferred to a district hospital.

While the victim’s family alleged medical negligence, doctors emphasise the importance of proper transfer protocols in such cases. “A transfer with trained staff and a doctor would have made a difference,” a senior doctor from Vani Vilas Hospital said, pointing to the significance of having proper medical support during emergencies. However, for years, most hospitals are only relying on casualty wards to manage emergencies, the doctor said.

“In nearly all government hospitals, casualty wards are managed by medical officers who are expected to juggle both administrative and clinical duties. This dual responsibility is making it difficult to manage the high influx of patients,” the doctor said.

Dr Ramesh GH, Head of Emergency and Critical Care at BMCRI, explained that when a patient arrives at a general hospital, they often have no clear understanding of what disease or condition is affecting them.

This raises the question – are general hospitals equipped with the necessary specialists to handle such cases effectively? Unfortunately, the answer often remains unclear. Many patients endure the frustration and trauma of being referred from one hospital to another due to a lack of resources or expertise at the first point of contact, he said.

The current system which lacks a fully equipped emergency department is not only overburdened, but also outdated, Dr Ramesh said, stressing that casualty wards need to be transformed into fully developed emergency medicine departments, staffed by doctors trained in modern protocols, treatment methods, and referral systems.

Emergency departments are the need of the hour in not only speciality hospitals, but also general hospitals. Speciality centres catering to maternal, child, cardiac, respiratory, neuro, and nephrology care often lack the necessary expertise to provide comprehensive emergency services. Even trauma centres are often inadequately staffed and poorly equipped to manage complex cases, Dr Ramesh said, adding that upgrading casualty wards into well-organised emergency departments can address these challenges.

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