Hospital Training report

Hospital Training Project
MAHAVEER COLLEGE OF PHARMACY Page 1
At S.V.B.P. Hospital, Medical College, Meerut
Under the guidance of Mr. Pankaj kumar (Asst. Prof.)
Submitted by-
Suraj Mandal
Roll Number-1482150045
B.Pharma 4rt year
(7th sem)
Department of Pharmacy
Sardhana Road, Pohalli, Meerut
2017-2018

CERTIFICATE
This is to certify that this project report entitled “……….Hospital
Training Project……………..” submitted to “Mahaveer College of
Pharmacy,Meerut,” is a bonafide record of work done by “…..Pankaj
Kumar………” under my supervision from “21/06/2017” to
“14/08/2017”
SUPERVISOR Principal of Department
Mr.Pankaj Kumar Dr. Chattar Singh.
Assistant Professor Professor
Mahaveer College of Pharmacy Mahaveer College of Pharmacy
…………………………….
EXTERNAL EXAMINER
Place- Meerut
Date- 14/08/2017

ACKNOWLEDGEMENT
It has my proud privileges to be attached to
S.V.B.P.Hospital,Medical college, Meerut.A highly
professionalized hospital with modern outlook.I have learned a lot
during my training duration of 45 days and contain has been
fortunate in getting and opportunity of working in this hospital.
I would like to thanks Mr. Pankaj Kumar providing necessary
training facilities and guidance during entire period of my
training.
I would to thanks Mr. Pankaj Kumar,Who helped me very much and
all trainees & staffs without whom support and guidance it was
impossible for me to complete the project successfully
Suraj Mandal
Roll no. 1482150045

ENDORSEMENT BY THE PRINCIPAL OF INSTITUTION
This is certify that the report work entitled “ A Report of
Hospital Training(2nd
)” is a genuine work done by Suraj
Mandal under the guidance of Pankaj Kumar (Asst.
Prof.), Mahaveer college of pharmacy Meerut.
Dr. Chhater singh
(Professor)

Contents-
1) Object
2) Introduction
3) Emergency Wards
4) General Wards
5) Surgical Wards
6) Injection Room
7) Pathology Reports
8) Diagnostic Reports
9) Dispensing Sections
10) Conclusion
11) References

Objective of Training
 Hospital training is an observational oriented procedure in which a person
is able to learn practically from their theoretically knowledge.”
 Hospital training provides practical knowledge to thestudent.
 Hospital training helps to study closely the ground level problem regarding
their job profile.
 Hospital training promotes an environment in which student are induced to
adapt themselves quickly to changed circumstances.
 Training provides practical knowledge to thestudents.
 Training puts the students in real life situation.
 Training removes the hesitation of the student regarding their working skill
and personality development.
 Training is mandatory as per A.I.C.T.E. and affiliating universities and
pharmacy council of India.

INTRODUCTION
S.V.B.P. Hospital, Medical college, Meerut, which is popularly
Hospital is about 5000 miters under Lala Lajpat Rai Memorial Medical College.
Lala Lajpat Rai Memorial Medical College or LLRMC is a state-run Medical
College located in Meerut, Uttar Pradesh, India. It is named after the Arya
Samaj leader, Lala Lajpat Rai. It is an ancient city with settlements dating
back to the Indus Valley civilisation having been found in and around the area.
The city lies 70 km (43 mi) northeast of the national capital New Delhi, and
453 km (281 mi) northwest of the state capital Lucknow.
Meerut is the second largest city in the National Capital region, and as of 2011
the 33rd most populous urban agglomeration and the 26th most populous city in
India.
The hospital has 1090 beds (including the Emergency and Private Wards).
It is one of the oldest Gov. hospitals of the city more than 20 years, with
advancement of technology and with increasing demand of health sector this
hospital is keeping pace and fulfilling the demand of needy people. It is
equipped with modern Lab facilities, ECG, 2D,ECHO, XRAY,
ULTRASOUND 3D COLOR DOPLAR, 24 hours running blood bank with
blood.
S.V.B.P. Hospital, Medical college, Meerut has General Medicine,
Surgery (General as well as Laparoscopic), Gynecology, Pediatrics,
Nephrology, Cardiology, Orthopedics, ENT, Dermatology, Neurology,
Ophthalmology as OP departments. Other facilities include 24 hrs causality
service with an attached OT, Trauma care, Dialysis center, computerized lab,
ICU, PICU and NICU with isolation ward, 5 state of the art major OT’s,
spacious general wards with adequate privacy, deluxe rooms, premium rooms
and private rooms and a 24hrs ambulance service.

SECTION IN S.V.B.P. Hospital :-
1) OPD (Out Patient Department)
2) Emergency wards
3) General wards
4) Surgical wards
5) ICU (Intensive CareUnit)
6) NICU (Nursery Intensive Care Unit)
7) Injection Room
8) Pathology
9) Dispensing
10) Diagnostic center
11) Operation Theater
12) Blood Bank

EMERGENCY WARDS:-
An emergency department(ED), also known as an accident & emergency
Department (A&E),emergency room(ER ) or casualty department.
An emergency is a medical treatment facility specializing in emergency medicine,
the acute care of patients who present without prior appointment; either by their
own means or by that of an ambulance. The emergency department is usually
found in a hospital or other primary care center. Due to the unplanned nature of
patient attendance, the department must provide initial treatment for a broad
spectrum of illnesses and injuries, some of which may be life-threatening and
require immediate attention. In some countries, emergency departments have
become important entry points for those without other means of access to
medical care. The emergency departments of most hospitals operate 24 hours a
day, although staffing levels may be viridian attempt to reflect patient volume.
FIRSTAIDS
First aid is the assistance given to any person suffering a sudden illness or injury,
with care provided to preserve life, prevent the condition from worsening,
and/or promote recovery.
`
Aims:-
The key aims of first aid can be summarized in three key points, sometimes
known as 'the three P's
*.Preserve life: the overriding aim of all medical care, including first aid, is to
save lives and minimize the threat of death

*.Prevent further harm: also Sometimes called prevent the condition from
worsening, or danger of further injury, this covers both external factors, such
as moving a patient away from any cause of harm, and applying first aid
techniques to prevent. worsening of the condition, such as applying pressure to
stop a bleed becoming dangerous.
*.Promote recovery: first aid also involves trying to start the recovery
process from the illness or injury, and in some cases might involve completing
a treatment, such as in the case of applying a plaster to a small wound.
Key Skills:-
In case of tongue fallen backwards, blocking the airway, it is necessary to
hyperextend the head and pull up the chin, so that the tongue lifts and clears the
airway. Certain skills are considered essential to the provision of first aid and are
taught ubiquitously. Particularly the "ABC"s of first aid, which focus on critical
life-saving intervention, must be rendered before treatment of less serious
injuries.

ABC stands for Airway, Breathing, and Circulation. The same mnemonicis
used by all emergency health professionals. Attention must first bebrought
to the air way to ensure it is clear. Obstruction (choking) is a life-threatening
emergency. Following evaluation of the airway, a first aid attendant would
determine adequacy of breathing and provide rescue breathing if necessary.
Assessment of circulation is now not usually carried out for patients who are
not breathing, with first aiders now trained to go straight to chest
compressions (and thus providing artificial circulation) but pulse checks may
be done on less serious patients.
Some organizations add a fourth step of "D" for Deadly bleeding or
Defibrillation, while others consider this as part of the Circulation step. Variations
on techniques to evaluate and maintain the ABCs depend on the skill level of the
first aider. Once the ABCs are secured, first aiders can begin additional
treatments, as required. Some organizations teach the same order of priority
using the"3Bs": Breathing, Bleeding, and Bones (or "4Bs": Breathing, Bleeding,
Burns, and Bones). While the ABCs and 3Bs are taught to be performed
sequentially, certain conditions may require the consideration of two steps
simultaneously. This includes the provision of both artificial respiration and
chest compressions to someone who is not breathing and has no pulse, and the
consideration of cervical spine injuries when ensuring anopen airway.
Preserving life:-
In to stay alive, all persons need to have an open airway—a clear passage where
air can move in through the mouth or nose through the pharynx and down into
the lungs, without obstruction. Conscious people will maintain their own airway
automatically, but those who are unconscious (with a GCS of less than 8) may
be unable to maintain a patent airway, as the part of the brain which automatically
controls breathing in normal situations may not be functioning. If the patient was
breathing, a first aider would normally then place them in the recovery position,
with the patient leant over on their side, which also has the effect of clearing
the tongue from the pharynx. It also avoids a common cause of death in
unconscious patients, which is choking on regurgitated stomach contents.

The airway can also become blocked through a foreign object becoming lodged
in the pharynx or larynx, commonly called choking. The first aider will be taught
to deal with this through a combination of ‘back slaps’ and ‘abdominal thrusts’.
Once the airway has been opened, the first aider would assess to see if the
patient is breathing. If there is no breathing, or the patient is not breathing
normally, such as artificial breathing, the first aider would
undertake what is probably the most recognized first aid
procedure—cardiopulmonary resuscitation or CPR, which involves
breathing for the patient, and manually massaging the heart to promote
blood flow around the body.
Promoting recovery:-
The first aider is also likely to be trained in dealing with injuries such as cuts,
grazes or bone fracture. They may be able to deal with the situation in its
entirety (a small adhesive bandage on a paper cut), or may be required to
maintain the condition of something like a broken bone, until the next stage of
definitive c are (usually an ambulance) arrives.
Conditions that often
require first aid:-
Medical emergency
*.Altitude sickness, which can begin in susceptible people at altitudes as low as
5,000 feet, can cause potentially fatal welling of the brain or lungs.
*.Anaphylaxis, a life-threatening condition in which the airway can become
constricted and the patient may go into shock. The reaction can because by a
systemic allergic reaction to allergens such as insect bites or peanuts. Anaphylaxis
is initiallytreated with injection of epinephrine.
*.Battle field first aid—This protocol refers to treating shrapnel, gunshot
wounds, burns, bone fractures, etc. as seen either in the ‘traditional’ battlefield
setting or in an area subject to damage by large-scale weaponry, such as a
bomb blast.
*.Bone fracture, a break in a bone initially treated by stabilizing the fracture
with asplint.

*.Burns, which can result in damage to tissues and loss of body fluids through
the burn site.
*.Cardiac Arrest, which will lead to death unless CPR preferably combined
with an AED, is started within minutes. There is often no time to wait for the
emergency services to arrive as 92 percent of people suffering a sudden cardiac
arrest die before reaching hospital according to the American Heart Association.
*.Choking, blockage of the airway which can quickly result in death due to
lack of oxygen if the patient’s trachea is not cleared, for example by the Heimlich
maneuver. *.Heart attack, or inadequate blood flow to the blood vessels
supplying the heart muscle.
*.Heat stroke, also known as sunstroke or hyperthermia, which tends to
occur during heavy exercise in high humidity, or with inadequate water, though it
may occur spontaneously in some chronically ill persons. Sunstroke, especially
when the victim has been unconscious, often causes major damage to body
systems such as brain, kidney, liver, gastric tract. Unconsciousness for more
than two hours usually leads to permanent disability. Emergency treatment
involves rapid cooling of the patient
*.Hair Tourniquet, a condition where a hair or other thread becomes tied
around a toe or finger tightly enough to cut off blood flow.
*.Heavy bleeding, treated by applying pressure (manually and later with a
pressure bandage) to the wound site and elevating the limb if possible.
*.Hyperglycemia (diabetic coma) and Hypoglycemia (insulin shock).
*.Hypothermia, or Exposure, occurs when a person’s core body temperature
falls below 33.7 °C (92.6°F). First aid for a mildly hypothermic patient includes
re-warming, which can be achieved by wrapping the affected person in a blanket,
and providing warm drinks, such as soup, and high energy food, such as
chocolate. However, re-warming a severely hypothermic person could resulting
a fatal arrhythmia, an irregular heart rhythm.
*.Insect and animal bites and stings.
*.Joint dislocation.
*.Poisoning, which can occur by injection, inhalation, absorption, or ingestion

*.Seizures, or a malfunction in the electrical activity in the brain. Three types
of seizures include a grand mal (which usually features convulsions as well as
temporary respiratory abnormalities, change in skin complexion, etc.) and petit
mal (which usually features twitching, rapid blinking, and/or fidgeting as well as
altered consciousness and temporary respiratory abnormalities).
*.Muscle strains and Sprains, a temporary dislocation of a joint that
immediately reduces automatically but may result in ligament damage.
*.Stroke, a temporary loss of blood supply to the brain.
*.Toothache, which can result in severe pain and loss of the tooth but is Rarely
life- threatening, unless over time the infection spreads into the bone of the jaw
and Start sosteomelitis.
*Wound sand bleeding, Including lacerations, incisions and abrasions,
Gastrointestinal bleeding, avulsions and Sucking chest wounds, treated with an
occlusive dressing to let air out but not in.

GENERAL WARDS:-
A general ward is a large room in a hospital where people who need medical
treatment stay general in the wards.
Intravenous simple mean within vein . Therapies administered intravenously are
often included in the designation of specialty drugs .
Intravenous infusions are commonly referred to as drips because many system
administration employ to a drip, which prevent air from entering the blood stream
and allows as estimation of flow rate .
Intravenous therapy may be used to correct electrolyte imbalance, to deliver
medication, for blood transfusion are as a fluid replacement to correct, for
example dehydration intravenous therapy can also be used for chemotherapy.
Compare with other route of administration, the intravenous route is the fastest
way to deliver fluids and medication throughout the body. The bioabilability of
the medication is 100% in IV therapy.

During intravenous therapy, it use are as follows:-
(1) Administration of drips
(2) Administration of cannula
(3) Administration of injection

(4) Measurement of blood pressure and temperature
(5) Provides oxygen

SURGIACL WARDS:-
Surgical wards contain different types injured patients, accidental patient
,etc
Surgical wounds can be classified as follows:
Secondary intention
than
six hours old, manage with surgical toilet, leave open and then close 48 hours
later. This is delayed primary closure.
Dressing techniques
The following dressing techniques are easy to do and require no sophisticated
equipment. Clean technique is usually sufficient. Pain medication may be required
as dressing changes can be painful. Gently cleanse the wound at the time of
dressing change.
Mahaveer College of Pharmacy
with pus
present.

Hospital training project
A. Wet-to-dry
Indication: to clean a dirty or infected wound.
Technique: Moisten a piece of gauze with solution and squeeze out the excess
fluid. The gauze should be damp, not soaking wet. Open the gauze Photo A and
place it over top of the wound to cover it Photo B. You do not need many layers
of wet gauze. Place a dry dressing over top. The dressing is allowed to dry out
and when it is removed it pulls off the debris. It’s ok to moisten the dressing if it
is too stuck.
How often: Ideally, 3-4 times per day. More often on a wound in need of
debridement, less often on a cleaner wound. When the wound is clean, change to
a wet-to-wet dressing or an antibiotic ointment.
B. Wet-to-wet
Indication: to keep a clean wound clean and prevent build-up of exudates.
Technique: Moisten a piece of gauze with solution and just barely squeeze out
the excess fluid so it’s not soaking wet. Open the gauze and place it over top of
the wound to cover it. Place a dry dressing over top. The gauze should not be
allowed to dry or stick to the wound.
How often: Ideally, 2-3 times a day. If the dressing gets too dry, poor
saline over the gauze to keep it moist.
C. Antibiotic ointment
Indication: Antibiotic ointment is used to keep a clean wound clean and
promote healing.

Technique: apply ointment to the wound- not a thick layer, just a thin layer
is enough. Cover with drygauze.
D. How often: 1-2 times per day. When to do which dressing
Remember, the goal is to promote healing. We know that a moist
environment facilitates healing.
 For a clean wound, it is best to use a wet-to-wet or ointment based
dressing
 For a wound in need of debridement the wet-to-dry technique should be
done until the wound is clean and then change to a different dressing
regimen.
Sharp Debridement
When a wound is covered with black, dead tissue or thick gray/green debris,
dressings alone may be inadequate. Surgical removal- sharp debridement– is
necessary to remove the dead tissue to allow healing.
Technique:-
 Sedation or general anesthesia may be required. However, usually the
dead tissue has no sensation, so debridement may be done at the bedside
or in the outpatient setting.
 Photos A & B: Using a forceps, grasp the edge of the dead tissue and
use a knife or sharp scissors to cut it off of the underlying wound.
 Bleeding tissue is healthy, so cut away the dead stuff until you get to a
bleeding base.
 The patient may only tolerate this for a short period of time. Additionally,
you don’t want to cut off tissue that may be viable. So, you may have to
do this a little at a time, and repeat this procedure as needed until all of
the necrotic tissue has been removed.
 Photo C shows the wound after three weeks of wet-to-dry dressings.

INJECTION ROOM:-
In a word, an injecting room is a place where drug users can inject narcotic
substances in a supervised environment without risking police interference.
But services provided by injecting rooms can also be expanded to include
hygiene-enhancing information, offering clean injection equipment, the presence
of trained health workers and injection advice. When the setting up of injecting
rooms is discussed in Norway, what is meant is specially outfitted rooms either
standing alone or as part of a wider activity and/or care service for drug users,
where heroin users can inject under the supervision of trained health staff and
where guidance and advice is readily available. ‘Health room’ may therefore be
a more apt designation of the possible future function of this initiative, and, in
the Norwegian debate, the two names are used more or less in equal measure.
One essential precondition underlying the establishment of injecting/ health
rooms is that the people who make use of them shall avoid risk apprehension by
police authorities in connection with the injection process (possession and use of
drugs).
FIG;-different route of injection

INTRAVASCULAR:- ( IV , IA )
Placing a drug directly into blood stream;-May be intravenous (into a
vein) or intra- arterial (into an artery).Drug solution in injected directly into
the lumen of a vein so that it is diluted in the venous blood. The drug is
carried to the Heart and circulated to the tissues. Drugs in oily vehicle or those
that cause haemolysis should not be given by this route. Since the drug is
introduced directly into blood, the desired concentration of the drug is achieved
immediately which is not possible by any other procedure. This route is of
prime importance in emergency. Also certain irritant drugs could be given by
this route.
Also this is the only route for giving
large volume of drugs e.g. blood
transfusion
fig; intravenous injection in vein
Advantages: precise, accurate and immediate onset of action, 100%
bioavailability
Disadvantages: risk of embolism, high concentration attained rapidly leading
to greater, risk of adverse effect.
INTRAMUSCULAR:-( into the skeletal muscle )(I.M.)
In humans, the best site is deltoid muscle in the shoulder or the gluteus
muscle in the buttocks. This method is suitable for the irritating substances
that cannot be given route by subcutaneous.

Fig:-intramuscular injection in deltoid and gluteal muscles
The speed of absorption from site of injection is dependent on the vehicle used,
absorption is quick from aqueous solutions and slow from oily preparations.
Absorption is complete, predictable and faster than subcutaneous route.
Advantages:-
- Suitable for injection of drug inaqueous solution ( rapid action) and
drug in suspension or emulsion (sustained release )
Disadvantages:-
- -pain at the site of injection
SUBCUTANEOUS ROUTES:-( Under the skin)
The drug is dissolved in a small volume of vehicle and injected beneath the skin
from where the absorption is slow and uniform. Substances causing irritation to
the tissues should not be injected otherwise they will cause pain and necrosis
(deadening of tissues) at the site of injection.
This method is particularly useful when continuous presence of the drug in the
tissues is needed over a long period. The usefulness of this method is enhanced
by the use of depot preparations from which the drug is released more slowly
than it is from simple solution rosis (deadening of tissues) at the site of injection.
e.g. insulin

INTRADERAMAL ROUTE:-(into the skin )
Drug are injected into papillary layer of skin. For example tuberculin injection
for mantoux test and BCG vaccination for active immunization against
tuberculosis.BCG: Bacillus-Calmette-Guerin
INTRATHECAL ROUTE:-(into the spinal canal )
Blood brain barrier often prevents the entry of certain drugs into the central
nervous system. Also the blood CSF barrier prevents the approach of drugs to
the meanings. Thus when local and rapid effects of drugs on meanings are
desired the drugs are injected into Subarachnoid (between arachnoids mater
and piamater) space and effects of the drugs are then localized to the spinal
nerves and meanings e.g. intrathecal injection of streptomycin in tuberculosis
and meningitis used to be used by this route but with the invention of third
generation cephalosporin’s it is not used any more to treat these conditions. The
injection of local anesthetics for the induction of spinal anesthesia is given by
this route.(the three membranes covering the brain and spinal cord from
outside to inward are Duramater, arachnoids mater and piamater e.g. spinal
anesthetics
INTRAPERITONEAL ROUTE:-( into the peritoneum cavity)
The peritoneum offers a large absorbing surface area from which drugs enter
circulation rapidly but primarily by way of portal vein. Hence First-Pass effect
not avoided. This is probably the most widely used route of drug administration
in laboratory animals. In human, it is very rarely employed due to the dangers of
infection and injury to viscera and blood vessels. e.g. peritoneal dialysis in case
of renalinsufficiency.

PATHOLOGY
Pathology is the branch of medical science primarily concerning the examination
of organ, tissue and bodily fluids in order to make a diagnosis of disease.
Hospital pathology concerns the laboratory analysis of blood, urine and tissue
sample to examine and diagnose disease. Typically ,laboratories will process
samples and provides result concerning blood counts, blood clotting ability or
urineselectrolytes.
In Pathology Lab , Blood Test Report:-
Blood tests allow a doctor to see a detailed analysis of any disease markers,
the nutrients and waste products in your blood as well as how various organs
(e.g., kidneys and liver) are functioning. Below, I’ve explained some of the
commonly measured indicators of health. During a physical examination, your
doctor will often draw blood for chemistry and complete blood count (CBC)
tests as well as a lipid profile, which measures cholesterol andrelated elements.
Here is a brief explanation of the abbreviations used in measurements
followed by descriptions of several common test components.

Deciphering Blood Test Measurements:-Blood tests use the metric
measurement system and abbreviations such as the following:-
cmm-----------------cells per cubic millimeter
fL (femtoliter)-----fraction of one-millionth of a liter
g/dL-----------------grams per deciliter
IU/L-----------------international units per liter
mEq/L---------------mille equivalent per liter
mg/dL----------------milligrams per deciliter
mL--------------------milliliter
mmol/L--------------mill moles perliter
ng/m------------------Lnanograms per milliliter
pg(Pico grams)-------one-trillionth of a gram
Complete Blood Count (CBC):-
The CBC test examines cellular elements in the blood, including red blood cells,
various white blood cells, and platelets. Here is a list of the components that are
normally measured, along with typical values. If your doctor says you’re fine
buty our tests results are somewhat different from the range shown here, don’t be
alarmed.
Some labs interpret test results a bit differently from others, so don’t consider
these figures absolutes.
WBC (white blood cell) leukocyte count Normal range: 4,300 to
10,800cm White blood cells help fight infections, so a high white blood cell
count could be helpful for identifying infections. It may also indicate leukemia,
which can cause an increase in than number of white blood cells. On the other
hand, too few white blood cells could be caused by certain medications or health
disorders.WBC (white blood cell) differential count Normal range:
Neutrophils ------40% to 60% of thetotal
Lymphocytes ----20% to40%
Monocytes--------2% to8%
Eosinophils ------1% to 4%
Basophils---------0.5% to 1%
This test measures the numbers, shapes, and sizes of various types of white
blood cells listed above. The WBC differential count also shows if the numbers
of different cells are in proper proportion to each other. Irregularities in this test
could signal an infection, inflammation, autoimmune disorders, anemia, or other
healthconcerns.

RBC (red blood cell) erythrocyte count Normal range: 4.2 to 5.9 million
cm ,We have millions of red blood cells in our bodies, and this test measures the
number of RBCs in a specific amount of blood. It helps us determine the total
number of RBCs and gives us an idea of their lifespan, but it does not indicate
where problems originate. So if there are irregularities, other tests will be required.
Hematocrit (Hct)Normal range: 45% to 52% for men; 37% to 48% for women
Useful for diagnosing anemia, this test determines how much of the total blood
volume in the body consists of RBC Hemoglobin (Hgb)Normal range:
 13 to 18 g/dL for men
 12 to 16 g/dL for women
Red blood cells contain haemoglobin, which makes blood bright red. More
importantly, haemoglobin delivers oxygen from the lungs to the entire body; then
it returns to the lungs with carbon dioxide, which we exhale. Healthy hemoglobin
levels vary by gender. Low levels of hemoglobin may indicateanemia.
Mean corpuscular volume (MCV) Normal range: 80 to 100 femtolitters
This test measures the average volume of red blood cells, or the average
amount of space each red blood cell fills.
Irregularities could indicate anemia and/or chronic fatigue syndrome.
Mean corpuscularhemoglobin (MCH)
Normal range: 27 to 32 Picograms
This test measures the average amountof hemoglobin in the typical red blood
cell. Results that are too high could signal anemia,while those too low may
indicate a nutritional deficiency.
Mean corpuscular haemoglobin concentration (MCHC)
Normal range: 28% to 36%The MCHC test reports the average concentration of
hemoglobin in a specific amount of red blood cells. Here again, we are looking
for indications of anemia if the count is low, or possible nutritional deficiencies if
it’shigh.
Red cell distribution width (RDW or RCDW)
Normal range: 11% to 15%With this test, we get an idea of the shape and size of
red blood cells. In this case, “width” refers to a measurement of distribution, not
the size of the cells. Liver disease, anemia, nutritional deficiencies, and a number
of health conditions could cause high or low RDW results.

Platelet count Normal range: 150,000 to 400,000 ml Platelets are small
portions of cells involved in blood clotting. Too many or too few platelets can affect
clotting in different ways. The number of platelets may also indicate a health
condition.
Mean Platelet Volume (MPV) Normal range: 7.5 to 11.5 femtoliters This
test measures and calculates the average size of platelets. Higher MPVs mean the
platelets are larger, which could put an individual at risk for a heart attack or stroke.
Lower MPVs indicate smaller platelets, meaning the person is at risk for a bleeding
disorder.
AST (aspartate aminotransferase)Healthy range:10 to 34 IU/LThis
enzyme is found in heart and livertissue, so elevations suggest problems may be
occurring inone or both of thoseareas.
Bilirubin, Healthy range: 0.1 to 1.9 mg/dL This provides information about liver
and kidney functions, problems in bile ducts, and anemia.
BUN (blood urea nitrogen) Healthy range: 10 to 20 mg/dL. This is another
measure of kidney and liver functions. High values may indicate a problem with
kidney function. A number of medications and a diet high in protein can also raise
BUN levels.
BUN/ creatinine ratio Healthy ratio of BUN to creatinine: 10:1 to
20:1 (men and older individuals may be a it higher) This test shows if kidneys are
eliminating waste properly. High levels of creatinine, a by-product of muscle
contractions, are excreted through the kidneys and suggest reduced kidney
function.
Calcium, Healthy range: 9.0 to 10.5mg/dL (the elderly typically score a bit
lower)Too much calcium in the bloodstream couldindicate kidney problems;
overly active thyroid or parathyroid glands; certain types ofcancer, including
lymphoma; problems with the pancreas; or a deficiency of vitamin D.

Chloride, Healthy range: 98 to 106 mEq/L This mineral is often measured as part
of an electrolyte panel. A high-salt diet and/or certain medications are often
responsible for elevations in chloride. Excess chloride may indicate an overly acidic
environment in the body .It also could be a red flag for dehydration, multiple
myeloma, kidney disorders, or adrenal gland dysfunction. Creatinine Healthy range
0.5 to 1.1 mg/dL for women0.6 to
1.2 mg/dL formen (the elderly may be slightly lower)
The kidneys process this waste product, so elevations could indicate a problem
with kidney function.
Fasting glucose (blood sugar), Healthy range: 70to 99 mg/dL for the
average adult (the elderly tend to score higher even when they are healthy) Blood
sugar levels can be affected by food or beverages you have ingested recently, your
current stress levels, medications you may be taking, and the time of day. The
fasting blood sugar test is done after at least 6 hours without food or drink other than
water.
Phosphorus, Healthy range: 2.4 to 4.1 mg/dL Phosphorus plays an important role
in bone health and is related to calcium levels. Too much phosphorus could indicate
a problem with kidneys or the parathyroid gland. Alcohol abuse, long-term antacid
use, excessive intake of diuretics or vitamin D, and malnutrition can also elevate
phosphorus levels.
Potassium, Healthy range: 3.7 to 5.2 mEq/L This mineral is essential for
relaying nerve impulses, maintaining proper muscle functions, and regulating
heartbeats. Diuretics, drugs that are often taken for high blood pressure, can cause
low levels of potassium.
Sodium, Healthy range: 135 to 145mEq/L Another member of the electrolyte
family, the mineral sodium helps your body balance water levels and helps with
nerve impulses and muscle contractions. Irregularities in sodium levels may indicate
dehydration; disorders of the adrenal glands; excessive intake of salt,
corticosteroids, or pain-relieving medications; or problems with the liver or kidneys.
Lipid Panel (or Lipid Profile), The lipid panel is a collection of tests measuring different types
of cholesterol and triglycerides (fats) in your bloodstream.

Report by;Dr…………
******* End of the report*****
Date…….
Sex:-MaleAges:-21yearName of patient; Suraj Mandal Ref.
By ; Dr. A. K. Gupta HAEMATOLOGY
REPORT
S.V.B.P. Hospital, Meerut
Diagnostic Report-
A diagnostic report is the set of information that is typically provided by
diagnostic service when investigations are complete. The information includes a
mix of atomic result, text report, images and codes.
The diagnostic report resources suitable for the following kinds of diagnostic
reports;
*laboratory (clinical chemistry, hematology, microbiology etc.)
*pathology/histopathology
*image investigation (x-ray CT, MRI etc.)
*other diagnostics-cardiology.
Report-1

Hospital training project
Report-2cheast x-ray
Report-3 ECG

DRUGS DISPENSING
Drugs dispensing is often portrayed as merely being the process of
giving a drug product to a patient in the hospital.
Dispensing procedure
• Ensure that the prescription has the name and signature of the prescriber and
the stamp of the health centre.
• Ensure that the prescription is dated and has the name of the patient.
• If the prescription has not been written in a known (local)health centre, the
prescriber of the centre should endorse it.
• Avoid dispensing without a prescription or from an unauthorized prescriber.
• Check the name of the prescribed drug against that of the container.
• Check the expiration date on the container.
• Calculate the total cost of the drug to be dispensed on the basis of the
prescription where applicable.
• Inform the patient about the cost of thedrug.
• Issue a receipt for all payments.
Suraj

Dispensing prescriptions on part-payment
Where a patient does not have enough money to pay for all the drugs as
prescribed, the dispenser is faced with a difficult situation. Consider the
following scenario to resolve this situation:
(a.) Cotrimoxazole 400/80 mg tab2 bd × 5 days
(b.) Chloroquine 150 mg tab 4 stat, then 2 tab bd × 2/7
• Either dispense all the 20 tablets of cotrimoxazole or the 10 tablets of
chloroquine as prescribed and insist that the patient completes the dose
dispensed.
• In case a patient is unable to pay for allthe prescribed drugs, go to the
prescriber and ask which of the two drugs should bedispensedfirst.
• Do not dispense a few tablets of cotrimoxazole and a few tablets of
chloroquineas the patient will not come back to complete the prescription if
he feels better.
• When the temporary relief passes, the cotrimoxazole or chloroquine
may not Beeffective again in that particular condition.
Guiding principles in dispensing on cash basis
• Dispense drugs only on payment.
• Do not give free drugs to any person in the community, no matter what the
person’s social standing.
• Issue receipts for drugs sold.
• Display a price list of drugs for transparency and accountability, and to
help patients crosscheck.

CONCLUSION
The project Hospital Training is the working in a hospital. The process takes care
of all the requirements of an average hospital and is capable to provide easy and
effective storage of information related to patients that come up to the hospital.
It generates test reports; provide prescription details including various tests, diet
advice, and medicines prescribed to patient and doctor. It also provides injection
detail and billing facility on the basis of patient’s status whether it is an indoor or
outdoor patient.
The system also provides the facility of backup as per the requirement. Patients who
are non-local language speakers or come from migrant populations or ethnic
minority groups often are not able to communicate effectively with their clinicians to
receive complete information about their care. At the same time, clinical staff is often
not able to understand the patients’ needs or to elicit other relevant information from
the patient.
Professional interpreter services should be made available whenever necessary
to ensure good communication between non-local language speakers and clinical
staff.
The task force brings together practitioners, managers, scientists and community
representatives with specific expertise and competence in policy-relevant
knowledge in the field.
Suraj Mandal

REFRENCES
1.âbc"Injection safety ".Health Topics A to Z. World Health
Organization. Retrieved 2011-05-09.
2.^David Healy. Psychiatric Drugs Explained: Page 19.
3.Ûsichenko, TI; Pavlovic D; Foellner S; Wendt M. (2004).
"Reducing venipuncture pain by a cough trick: a randomized
crossover volunteer study". Anesthesia and Analgesia99(3): 952–
3.doi:
4.^Thomas, AC; Wysocki, AB (February 1990)."The healing wound: a
comparison of three clinicallyuseful methods of measurement."
.Decubitus3(1): 18–20, 24–5.PMID 2322408. Retrieved15 June2013.
5.âbcFernandez R, Griffiths R, (15 February 2012). "Water for wound
cleansing" .Cochrane Database of Systematic Reviews2:
CD003861.doi:10.1002/14651858.CD003861.pub3.PMID
22336796.3.^Simple
wound managementon patient.info website, viewed 2012-01-
08
6.^Maton, Anthea; Jean Hopkins; Charles William
McLaughlin; Susan Johnson; MaryannaQuon
Warner; David LaHart; Jill D. Wright (1993).Human Biology and Health.
Englewood Cliffs, New
Jersey, USA: Prentice Hall.ISBN0-13-981176-1.
8. help to department of hospital staff

Hospital Training report

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