INTRODUCTION Specialist

By Dr Shahid Bashir Chaudhary ED

Dr............................ ..................... Con/Sp/Res. The Head of Department Dr.welcome you on joining ED. The Emergency Department is a clinical unit of King Saud Hospital Unaizah and the experience of patients attending the emergency department significantly influences patient satisfaction and the public image of the hospital. Its function is to receive, triage, stabilize and provide emergency management to patients who present with a wide variety of critical, urgent and semi urgent conditions whether self or otherwise referred. Our departmental status has enabled us the ability to provide our Medical Staff a level of access to patient care and procedures that can be found at few other institutions The Objective of Orientation is to inform you to develop self-efficiency, & focused continuous learning in order to function safely, effectively and competently.

Mission
Emergency Department ensures unrestricted access with out any discrimination by
providing the best available resources for appropriate, uncompromising and compassionate medical care.

VISION
To be the national center of excellence in medical readiness education, training, and provision of care.To maintain our capability for the best level of performance in medical services by latest Information technology.

A. Scope of Service B. Emergency Department (ED) Safety Orientation C. Infection Control Policy D. Professional/ Technical Skills

A. SCOPE OF SERVICE 1. Monthly Rota

The doctors are working in three shifts. The duty of the doctors are arranged according to the volume and acuity of the patients.Departmental roster is prepared by senior Physician or Chief of Department and is distributed after signatures before 28th of every Hegira month.

2. DUTY TIMINGS
The duty timings are from 730 to 330 for morning shift,3.30 PM to 11.30 PM evening shift and 11.30PM to 7.30 AM for night shift, but for the chief of Department is from 730 to 5 pm

3. CLINICAL AREAS Patients are stratified by acuity into different clinical areas. a. The management of pediatric patients b. The management of major trauma patients c. The management of psychiatric patients d. The management of patients following sexual assault

e. The management of infectious patients f. The extended observation and management of patients g. The management of prisoners in custody

4. DESIGNATION

All the doctors irrespective to their contract are named as ED Physician except Consultants who will be designated as ED consultant . Duty doctor in resuscitation room is designated as Supervisor.

5. DUTY ASSIGNEMENT Physicians perform their duties in the resuscitation room while other in the male, Female and Pediatric clinic. Due to the pediatric expertise, these Physicians are not assigned duties in adult side and their Rota is different from adult. Along with these clinic there are OB/GYN clinic , Plaster room and treatment room. The OB/GYN clinic is covered 24 hours by the Female doctor who is from Gynecology department, but its administrative affairs are monitored by ED Department, In the plaster room On call orthopedic Resident/specialist do the 6. LIST OF ER DOCTORS

Chief of ED
DR ABDUL AZIZ ABULELA Con. Neurosurgeon 1) 2) 3) 4) 5) 6) 7) 8) 9) 10) 11) 12) 13) 14) 15) 16) 17) 18) DR. SHAHID BASHIR CHAUDHARY DR. NEEL KAMAL SRIVASTAVA DR. HESHAM EL BEDEWI DR. SUBIR DUTTA DR. YASIR NASIF DR. AYMAN YOUSEF DR. MAHMOOD. SAAD DR. RAJIB DUTTA DR. A/GHADER A/KARIM DR. NAWAL SALAH DR. MAI SAIED MOHD DR. MOHD. SAADI DR. ALI SAIED DR AHMED MUNIUM DR MUHAMMOD QADIR DR. FADAL ULLAH DR TARIQ DR.TAHA Senior ED Physician Senior ED Physician Senior ED Physician ED Physician ED Physician ED Physician ED Physician ED Physician ED Physician ED Physician ED Physician ED Physician ED Physician ED Physician ED Physician ED Physician ED Physician ED Physician

19) 20) 21) 22)

DR LIMIA DR.KHALID BARAKA DR ASHRAM ABU TALIB DR MOAAZ

ED Physician ED Physician ED Physician ED Physician

7. CONTACT NUMBERS Contact number for both mobile and local line for all staff is listed in the office of ED Secretary

8. ORGANIZATIONAL STRUCTURE

9. IMMEDIATE SUPERVISOR Chief of Emergency Department is immediate supervisor. The Senior ED Physician assigned by Chief of ED is 2nd supervisor. NB. For non Arabic doctors ED Physicians will help in translation to communicate with the patient 10. ADMINISTRATOR

Hospital has appointed Saudi administrators who also look after the patients affairs in collaboration with the ED Physicians. Try to cooperate maximally within your job description so that the rights of the patients may not be breached. To protect the rights of the patient is your top priority, in case of any violence or other problem; you can approach through your immediate supervisor. 11. ROLE AND RESPONSIBILTIES

Emergency department has Job Description for all staff and you have to read and sign , in brief you have : i) To examine the patient according to the triage priority. ii) To document initial history and physical examination of patient as per ED sheet column. iii) To undertake minor skills like suturing, stomach wash. Catheterization, ABG, removal of superficial foreign bodies. iv) To examine all emergency cases according to assigned duty place. v) While in resuscitation , a. Start management of critical cases according to ACLS &ATLS protocols. b. To attend code blue .code yellow in resus.

c. To supervise and guide the junior Physician d. To Receive FAXES and transferred patient, from other hospital e. To liaise between ED and other on call specialties vi) To ensure all medico legal requirements regarding Trauma case, Physical assault , Alcohol&Narcotice , Drug overdose , Poisoning etc, as per policy vii) To follow up the patient that is sent to observation room until the disposal. 12.EVALUATION PROCESS There is checklist, according to that score is given and final report is forwarded through Medical Director to authority(Supervisor General).The Basis of evaluation is appropriate , safe and updated use of professional skill. 13. TRAINING

All ED Physicians have to complete emergency courses including BLS, ACLS, PALS. and ATLS. within one year of joining the department. 14. ATTANDANCE AND PUNCTUALITY

i) A monthly roster is made by the Chief of ED, place of assigned duty and timings are clearly mentioned. ii) Morning shift is from 7.30 am. to 3.30 pm iii) Evening shift is from 3.30 pm to 11.30 pm iv) Night shift is from 11.30 pm to 7.30 am. v) All the ED Physician will sign attendance sheet in the resuscitation room that includes both sign in and sign out. vi) It is strictly prohibited to sign before finishing the duty. vii) If ED Physician has to leave its assigned duty place, then he/she should inform Chief of ED to arrange substitution. viii) To change duty, prior permission of ED Chief is mandatory. 15. MEETINGS i. ii. iii. 16. Morning meeting is held daily except Thursday, Friday and Monday in the office of Chief of ED . The schedule of monthly meeting is displayed in notice board three days before and copy is annexed in attendance sheet. Quality improvement committee meeting is held as per advise of Chief of ED or when necessary.

ANNUAL VACATION

i) ii) iii) iv) v)

Vacation plan is made yearly Only two doctors from male side, one from pediatric and one from female side can go for vacation at one time. The vacation papers are submitted three months before the schedule. The vacation booking is provided by the employee from the Fursan office to the Personal department who issue the ticket as per contract. In case of cancellation of vacation , prior information is provided to the department Chief and schedule is to be resigned by Authority.

17.

SICK LEAVE

There is sick leave policy that is strictly followed to award sick leave to any patient . 18. POLICY AND PROCEDURES

Hospital is accredited by CBAHI and is in process with Joint commission international , therefore all policies and procedures laid in view of standard set by them , copies are available in the department and before to start regular work , you need to go through all policies . 19. MEMOS

All memos issued from Administration or department are to be signed and be followed. 20. Work contarct

The ED Physician will complete 48 hours per week and in the roster after every four days there will be one off or as per necessary 21. a. b. c. d. COMMUNICATION

Always greet the patient never use rough language dont be violent with the patient in any condition Dont discuss governmental/political or religious issues with patients or his/her attendant. e. Dont attend female patient with out the presence of female staff nurse. f. Provide clear, concise information and instruction. g. Respond to Patients concerns, complaints and criticism patiently and timely. h. For translation Arabic speaking doctors will help. I Bleeping on call doctor dial 2512 or 2510 , then bleep number and telephone no. B- EMERGENCY DEPARTMENT SAFETY ORIENTATION

1-PROCEDURE FOR ANNOUNING AN EMERGENCY A. How to call a code (Blue/yellow) 1. Code blue(cardiac arrest) and yellow(PolyGram) is announced in resuscitation room 2. Call central telephone operator on 1199 3. Clearly explain to operator in English or Arabic which code he has to announce. B. How to announce code (Red/Black) 1. Both these codes are announced by the permission of Hospital director by the Chief of ED in hot line 2. Chief of ED will tell central operator to announce code RED / BLACK. 3. Operator will repeat it three times 4. After finishing the disaster Operator will again announce, code is over. II- INFORMATION ON HAZARDOUS MATERIAL MANGEMENT Hazardous material is one that poses a hazard to health , property or the environment. in In the emergency department there is no hazardous material. III- COMPONANTS OF FIRE SAFETY SYSTEM The fire plan is component of disaster plan but the key points that you will observe during such incidence are: A) When code red is announced 1. Remain calm especially when with patient 2. Close patient doors, windows and fire doors 3. Ask visitor/patients to remain in the room B) R.A.C.E R-Rescue ,Remove all persons A-alarm, activate nearest fire alarm. C-Confine, confine fire to smallest area. E-Extinguisher, Extinguish fir only. C) How to use fire extinguisher To operate a fire extinguisher is P.A.S.S. P-Pull the pin located in the handle A- Air the extinguisher at the base of the fire. S- Squeeze the handle S-Sweep the base of the fire.

C- PROFESSIONAL /TECHNICAL SKILLS Triage process.

1. Evidence based triage process is used to prioritize patients with immediate needs 2. Canadian triaging and acuity system is followed 3. Staff are trained use of the triage process. 4. Patient in the triage room is waiting not more than 5 minutes 5. Digital apparatus is used to monitor the vital signs. 6. Male and Female triage rooms are different due to local social and culture values D- OBSERVATION ROOM The Patient are kept in observation room for short term management or and for revaluation and the examinee Physician is responsible to discharge or refer within one hour from the time of registration.

E LAB RESULTS Basic investigations are required to do are CBC, BIO ,ECG and X-Rays , the results are available with in 45 minute time.

F.EMERGENCY DRUGS
Dont write any medication from out side. Dont accommodate medical representatives Only write ED medications, these medications list is available in ED Pharmacy

G DEPARTMENTAL MANNUAL Departmental manual describes all the policies, guidelines and medico legal procedures.

H. INFECTION CONTROL POLICY

1. 2. 3. 4. Hospital has infection control policy Manual is present in the ED Chief and nursing office Hand washing is the top priority in infection control Personal protective equipments are not commonly used but in case of Epidemics or other infectious cases preliminary measures are taken including face mask, disposable gloves and shoe covers.