Technological advances in emergency patient care.

1. Dr Soumar Dutta
Consultant & Coordinator– Emergency Medicine
Narayana Superspeciality Hospital, Guwahati
TECHNOLOGICAL ADVANCES IN
EMERGENCY PATIENT CARE

2. WHY FOCUS ON EMERGENCY DEPARTMENT?
Front Door To The Health Care System
 Major feeder to the hospital.
• Greatest source of admissions.
• 40-80% of Inpatient and Observation patients come from the ED
 Easy way to compete with less efficient hospitals
 Improves Market Share: Extraordinary Patient Focused Care.
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3. INTRODUCTION
Emergency medicine – As a field of practice based on the knowledge and skills required for the
prevention, diagnosis, and management of the acute and urgent aspects of illness and injury affecting
patients of all age groups with a full spectrum of undifferentiated physical and behavioral disorders.3
Knowledge
Skills
Prevention Diagnosis Management
EMERGENCY
MEDICINE

4. EMERGENCY CARE SYSTEM
Disposition
Pre –Hospital
Care
Definitive care - surgical, medical
Community lay-person first response
Ambulance service response
Acute care - Emergency Department
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5. Improve patient care
Improve patient satisfaction with care
Lessen stress on E.D staff
Limit financial costs to hospital
Allow more available staff time for teaching
GOALS OF EMERGENCY CARE
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6. TECHNOLOGICAL ADVANCEMENT IN PRE
HOSPITAL CARE
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Care before or during transportation to a hospital.
Trained personals Resources Communication
To consider policy, legal, organizational and regulatory challenges that must be
addressed before the use of new digital data, medical devices and software applications.

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911 -EMS Continuum of Care

8. DETECTION
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9. NOTIFICATION
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10. DISPATCH AND COORDINATION
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Advantage:
Cuts down on the deployment of
expensive trauma ambulances in
situations where they end up not
being required.

11. DISPATCH AND COORDINATION
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12. ON SCENE AND INTRANSIT CARE
12Managing Information in Medical Emergencies

13. DRONES IN EMERGENCY
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14. EMS IN 2030 ?
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Field Labs and Imaging
Point-of-care labs and portable imaging to all prehospital providers.
Smart, driverless ambulances won't be in collisions
EMS providers won't lift patients
Connecting patients closer to technology

15. TECHNOLOGICAL ADVANCES IN
EMERGENCY ROOM
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Location in the Hospital
Design
Staffing
Resources
Triage

16. Infant
Child
ED DESIGN
Adult
Ortho
Neuro
Obstetrics
Poisoning
Burns
Vascular
Injury
Medical
Problem
Geriatric
Trauma
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17. ED DESIGN
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Patient care is the key focus of ED Design.
ED design should engender a sense of caring, efficiency and safety.
Good design will promote efficient workflows and ensure an optimal
environment for patients and staff alike
The patient’s right to confidentiality and privacy must be protected

18. MINIATURIZATION OF IMAGING AND
DIAGNOSTIC EQUIPMENT
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Point of care ultrasound machines
POCUS
• Identification of an immediately life-threatening cause for
hemodynamic failure
• Categorization of shock state and initial management strategy.

19. MINIATURIZATION OF IMAGING AND
DIAGNOSTIC EQUIPMENT
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STAT Lab
POCTS
• Glucometers/Ketones
• ABG with electrolytes/KFT
• Cardiac Markers
• Sepsis
• AKI
• HF
• VTE
• Toxicology Screenings

20. TELEMEDICINE
Suitable for small towns and rural
population.
Fills gaps created by absence of
specialist emergency care
providers.
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22. EMR - COWS
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Patient datas are fed in a computer based system
Extract patient previous dates – past illness, lab reports

23. SITUATION
Elderly
Obese
Apprehensive lady
with acute severe abdominal pain
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24. DIFFICULT IV ACCESS
o IV access is a frequent challenge faced in all EDs.
o A difficult IV that requires physician involvement whether it be ultrasound, central
access or other interventions can put the brakes on a smooth-running department.
Nurses dislike the amount of time consumed by difficult IVs
Multiple attempts
Delay
in care
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25. NEWER IV ACCESSTOOL
Handheld device using laser to visualize veins
Absorption of light by hemoglobin to enhance blood vessels.
Device perpendicular to the vessels.
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26. HUMERAL IO ACCESS
Sites of insertion:
 Tibia-malleolus
 Sternum
 Humerus
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While interosseous (IO) access is not a new topic, its use in
adults is still not widely utilized.

27. HUMERAL IO ACCESS
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28. SITUATION
Typical Chest pain consistent with AMI
ECG and Cardiac markers not significant
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Diagnosis

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30. ICH SCREENING
Dedicated to detect intra-cranial bleed in suspected cases.
This device is simply a screening tool, not a CT replacement
Infrascannar: portable device, triage patient with possible bleed
and evaluate within “Golden Hour”
Devise uses near Infrared Spectroscopy (NIRS) by detecting
hemoglobin in the brain using its light absorbing properties.
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Size > 3.5 cc in volume

31. BRAIN SCOPE
Handheld EEG monitoring device which acquires
data from 5 frontal head leads instead of the usual
21 electrodes of the Standard International system.
Simple results:
Normal or abnormal
Global/lateralized
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32. FB REMOVAL
Blindly curetting in the ear canal or nasal passage can result in pushing the object
deeper, which can cause damage and swelling making removal difficult, especially
with an uncooperative child.
Bionix Lighted Forceps combine illumination and magnification to help healthcare
providers take less time to see and safely remove ear canal and nasal passage
obstructions.
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34. THANKYOU
www.narayanahealth.org