Accident and Emergency Center is an important unit that must provide the best care for patients because every split second is an opportunity for life. The work of the Accident and Emergency Center of Thammasat University Hospital, everyone is ready to work against time in exchange for the safety of patients in every emergency case.
In the previous episode, we went to see the work of pharmacists or pharmacists that we often meet after receiving treatment from a doctor, right? There must be many things from the previous episode that made us understand pharmacists more. The work that seems like you can see what they are doing right away, but it turns out that there are many parts of the work that cannot be seen from sitting and waiting to receive medicine.
Now, the admin will take everyone to get to know the urgent work. If you look at it, I can say that you will see only chaos and chaos every day. And in almost every hospital, this team has to work all the time, almost to the point of not breathing. They are the Accident and Emergency Center. Today, the team that will take us to get to know this center is P. Witthaya Pho Luang, Head of the Emergency Medical Service Center and Transfer Operations, Ms. Phutthida Nuchnat, General Administration Officer, Stretcher and Vehicle Service, Mr. Kittipong Mokngam and Mr. Thanawat Kham Bai Yai, Stretcher Service Assistants, Stretcher and Vehicle Service, P. Siriporn Kiwsathaporn and P. Phanthippha Areemit, Professional Nurses, Accident and Emergency.
“The emergency center will be the first to enter the battlefield.”
The work at the Accident and Emergency Center is going to the area to pick up patients. That is, when a call comes in to 1679, the team personnel will ask for basic information about the level of risk. It is just a short screening over the phone. After that, a car will be sent to pick up with the emergency team. Another part of the work is transferring patients. This is transferring patients between hospitals, both normal cases and COVID-19 cases.
“The risk arises as soon as the work begins.”
When personnel go to pick up patients at home, they do not always wear PPE to work because sometimes it is inconvenient to do various tasks. Some things cannot be done when wearing PPE. In some cases, after initial inquiries, it is assessed that there is no risk, but when going to the area and finding that the patient is at risk, they must wear PPE before going to work. Therefore, screening by phone is an important thing that patients should cooperate with personnel as much as possible for the safety of personnel and the patient themselves.
Stretcher service
It is a service in the form of patient transport for both inpatients and outpatients. The service will cover both patient transport in the case of patient transfers and emergency patient admissions to receive treatment in the hospital according to the hospital’s transportation standards.
“Every job here has risks.”
First of all, all personnel must wear protective equipment because all patients who come to receive services are at risk. Therefore, protective clothing and equipment must be worn to provide services to patients safely, both patients and service providers. All staff and teams will be trained in wearing clothing and following COVID-19 prevention measures so that personnel and patients do not have to come into unnecessary contact.
“If we don’t do it, we may be at risk and others will be at risk too.”
Mostly, they will ask about symptoms and basic history, such as what happened, how did it happen, whether they have been to a risk area, or if they have any symptoms that are considered a risk group. If they have symptoms that are considered a risk group, they will be sent to a nurse for further screening. They have to do this because if they are admitted right away, there is a high risk of infection spreading in the hospital, which would become a very big issue. Therefore, the stretcher staff must do their best to screen patients before they reach the nurse or the hospital.
Patient Assessment
We need to know what is wrong with the patient, where the injuries are, how we can move the patient. If it is an accident, we need to see if it can be lifted to move, is it an emergency or not? Then we will assess the symptoms and the level of emergency of the patient to separate them into wheelchairs and beds. After the assessment is complete, the patient will be sent for screening from the hospital and then treated inside. The admitted patients will be divided into 3 levels: green, yellow, red, and if it is an accident, orange.
“At first, it was very difficult. I wanted to treat every patient but I couldn’t.”
The initial COVID-19 outbreak was a very difficult time for the emergency center because there were not enough emergency rooms. While patients were coming in without limits, the hospital did not even have enough space to separate confirmed COVID-19 patients. At that time, patients, staff, and the personnel themselves were all at risk of infection. No matter how much they wanted to admit patients, they could not because there were not enough rooms.
“The word emergency doesn’t mean that we only treat emergency patients.”
Even though it is an accident and emergency center, the patients that the center accepts are more than just “emergencies.” They also include critical patients, such as patients with cerebrovascular disease, heart disease, cardiac arrest, severe shortness of breath, and respiratory arrest. This group of patients must receive immediate treatment within 4 minutes. In addition to critical patients, the next most common group are emergency patients, which are further divided into urgent, normal urgent, ordinary urgent, and general patients. Emergency patients must receive treatment within 15 minutes, urgent within half an hour, and general urgent 1-2 hours.
Negative pressure room
Negative pressure rooms will have specific patients. If the negative pressure is 5, it will be for patients who are still suspected of being infected or not, and are waiting for results. Negative pressure rooms of 10 will be for patients who are already infected. There is also a positive pressure room for staff who come to observe the work. The center will provide care via CCTV cameras and communicate with patients via the war. If the communication is successful and the patient is aware, they may just nod or raise their hand. However, if there is additional physical examination, and there is close contact, they must wear a PPE suit.
“Because if we don’t do it, no one will.”
This job is stressful and pressured, and we receive pressure from both the patients themselves and their relatives. The important thing is that we need the best information from the patients so that we can choose the right treatment for them. All personnel are ready to provide services to all patients to keep them safe. When the patients recover and are able to return home normally, they feel proud and happy.
Conclusion
Emergency and Accident Center work is a job that normally requires living with risks. Working here has become the front line that must be encountered first, received first, and moreover, going to the field to receive patients each time is considered a challenging job with risks and must be very careful. Because if they get infected, it does not only affect them, but also the entire hospital. These things are therefore difficult, stressful, and challenging that they have to face every day at work. Everything they do is so that patients and everyone who comes to receive services can go home safely and healthy. Just this makes them proud.
“Going outside the hospital is the job we are best at.”
Time is life by Emergency and Accident Center | Thammasat University Hospital
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