Pakistan: A race against time in emergency departments
“I still remember there was a big bomb blast in April 2010, about 300 metres away from our hospital. Within a few minutes, dozens of injured patients were already outside the emergency room. We needed to quickly identify who needed to be attended first,” recalls Dr Muhammad Zaher, who is working with Médecins Sans Frontières (MSF) as assistant medical focal person in Timergara, in the Lower Dir district of Khyber Pakhtunkhwa (KPK) province, northwestern
Until a few years ago, Lower Dir, on the border with
Traffic accidents are another major cause of serious injury in this rugged and hilly region. “The roads are very bad,” explains Dr Zaher. ”Each small passenger van here usually carries up to 25 or even 30 people. When there is a car crash, it can easily cause many injuries.”
A routine triage system
MSF has been supporting the District Headquarter (DHQ) Hospital in Timergara since 2009. The team has implemented a new routine triage system in the emergency department, and has also developed a plan to deal with the arrival of many people in need of emergency care.
Handling such incidents is a race against time. The mass casualty plan allows medical staff to rapidly identify and prioritise patients’ medical needs based on a few vital signs. Patients are then categorised: green means the patient is stable and can wait for few hours, yellow means he or she can wait for an hour, red means lifesaving treatment is required within one minute, while black means deceased or beyond help. ‘Red’ patients are immediately sent to the resuscitation room. “This allows us to provide good quality medical care to a maximum number of patients and save a maximum of lives within a minimum of time,” says Dr Zaher.
A routine triage system, using the South African Triage Score (SATS), has also been implemented to improve day-to-day patient care in the emergency department. Upon arrival, every patient receives an initial screening, where staff measure blood pressure, heart rate and clinical conditions to help prioritise patients’ medical needs. In the first three months of 2012, a total of 12,162 patients passed through the triage system, and 3,271 patients were treated in the resuscitation room.
Serious lack of good specialised healthcare
There is a serious lack of good-quality specialised healthcare in
“I got shot by my business partner. I was in a hilly area bordering with
“We borrowed 5,000 PKR [€ 43] from the doctor in Samar Bagh hospital. We thought we would need to pay for the surgery here. We are glad that it’s free of charge. Otherwise, even if we sold our house and all the cattle, we would still not have enough money to pay for it,” says Anwar’s uncle.
MSF currently supports the emergency department, emergency surgery, and the mother-and-child department in the
MSF has been working in
For all its activities in
* The patient’s name has been changed to protect his anonymity.