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EMERGENCY SERVICES DATE OF ISSUE: 01.01.2017

MANUAL
DATE OF LAST UPDATION:
DOC. No.: NIMS/MAN/03 01.05.2021

DEPARTMENT OF EMERGENCY MEDICINE

SCOPE:
To establish set of written guidelines for the effective management of patient coming to the
department of Emergency medicine

PURPOSE:
 To guide staff members regarding protocols and policies to be adhered to ensure prompt
and error free management of Emergency patients.
 To guide staff members to adhere to hospital policies to comply the national and hospital
safety policies to ensure zero errors as well as to abate any sort of safety risk and
emergencies
 To guide staff members to follow policies and protocols to monitor, manage and handle
all equipments in a safe and effective manner.
 To ensure adherence to Infection control protocols and practices and enable speedy
recovery of all emergency patients.

SCOPE OF EMERGENCY SERVICES

The Department of Emergency Medicine is functioning 24 hours a day and caters to all
types of emergencies.
Scope of services includes but not limited to:
 All Trauma and Polytrauma cases
 Road Traffic Accidents
 Stroke, Cardiac arrest, respiratory arrest etc.
 Burns
 Poisoning and Snake bite
 High Risk pregnancy
 All Type of medico legal cases
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 All paediatric emergency cases

 All neuro and orthopaedic emergency cases
 All medical, surgical and gynaec emergency cases
 All minor emergency procedures.
 Wound management and casting.

ORGANISATION OF THE DEPARTMENT

MANAGING DIRECTOR

MEDICAL ADMINISTRATOR

HOD – DEPARTMENT OF EMERGENCY SERVICES

ER PHYSICIAN

EMERGENCY MEDICAL OFFICERS

ER NURSING INCHARGE

Sr. STAFF NURSE

Jr. STAFF NURSE

AUXILLARY NURSING STAFF / DATA ENTRY OPERATOR

HOUSEKEEPING STAFF / PATIENT ATTENDERS

Responsibilities of Emergency Physician

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 Assess patient medical condition and initiate immediate care to the patient.
 Obtain patient's' histories and gather medical information from electronic records, patient
interviews, dictated reports, or by communicating with patient bystanders.
 Supervise and conduct all relevant documentation pertaining to patient care given at ER.
 Request relevant diagnostic investigations as deemed necessary to assess patient’s
medical condition and ensure immediate conduction of the same.
 Perform, interpret and document the outcomes of diagnostic investigations and supervise
appropriate clinical interventions including life saving measures.
 Communicate examination results or diagnostic information to referring physicians,
patients, or families.
 Communicate detailed medical information to patients or family members.
 Communicate test or assessment results to medical professionals.
 Evaluate medical information to determine patients' risk factors, such as allergies to
contrast agents, or to make decisions regarding the appropriateness of procedures.
 Analyze patient data to determine patient needs or treatment goals.
 Train and supervise Medical officers as well as nursing staff assigned to ER and conduct
periodic performance evaluation.
 Coordinate inhouse skill acquisition programmes to enable others to acquire skill and
knowledge.
 Ensure adequate staffing pattern is ensured in each shift including those of medical
officers to maintain staff patient ratio as per guidelines.

Responsibilities of ER Nursing Incharge.

 Conduct periodic departmental training for existing staff and orientation training for new
staff members.
 Ensure adequate staffing pattern to meet the patient flow and as per the ER guidelines.
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 Improves quality results by evaluating accuracy and quality of images; providing technical
assistance; implementing new techniques, equipment and procedures.

 Provides statistical reports by controlling the collection of treatment and clinical data.

 Updates job knowledge by participating in educational opportunities; reading professional

publications; maintaining personal networks; participating in professional organizations.

 Act as liaison between department and administrative office to ensure smooth functioning of
the department.

 Allocate staff responsibilities and train them on inventory management, equipment control,
Ambulance medicine and equipment maintenance etc.

 Ensure adherence to hospital infection prevention and control protocols and environment
surveillance protocols.

 Equip and observe readiness to meet any community emergency, internal and external
disasters, mass casualty etc.

 Supervise during maintenance and test procedures on systems and components or in areas
where radiation safety may be affected or where service/maintenance personnel may need to
be given special protection.

 Ensure that monitoring instruments are calibrated periodically.

 Maintain servicing, operation log books and associated QA records.

 Developing suitable emergency response plans to deal with accidents and maintaining
emergency preparedness.

 In case of any software/hardware complaints report to IT dept.

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 In case of any untoward incident in the department, initiate an incident report timely.

 Adhere to NABH standards, Quality and Infection control practices and take part in
Quality improvement activities.

ACCESSIBILITY OF EMERGENCY DEPARTMENT

 The Accident and Emergency department is easily accessible with earmarked
ambulance bay for easy transportation of patients.
 Appropriate signage and directions boards are displayed for easy guidance to and fro
ER department.
 All supportive facilities like Pharmacy, Laboratory, Radiology, lift are available and
easily accessible from ER.
 Triage area is located at the entrance with adequate facilities to triage and transport
the patients.
 Adequate manpower and equipments are made available for the smooth functioning
of the department
 Basic resuscitation equipments, equipments for monitoring vitals, appropriate
consumables, life saving and emergency drugs are maintained with appropriate
inventory control measures.
 Emergency department is manned by Emergency physicians, emergency medical
officers, nursing coordinator, nursing staff, nursing assistants and housekeeping staff.
 The staffs working in emergency department is adequately privileged by the
credentialing and privileging committee constituted by the hospital management

PATIENT FLOW MANAGEMENT

 Patient reaches Emergency department through Emergency entrance and is received

at Triage area. Triaged patients are taken to respective beds as per the severity of
patient condition.
 Medical attention is rendered as per Emergency protocol.
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 Bystanders are requested to register the patients at front office.

 In case of no bystanders or patient identity is unknown, patient registration is done
with Patient name as Unknown and approximate age. Such admissions are intimated
to police.
 Samples are collected and send to laboratory for patients requiring laboratory
investigations.
 Patients requiring radiology investigations like Xray/ CT/ MRI are shifted to
radiology for scan.
 Emergency patients are retained only for a period of 4 hours in emergency
department and patients requiring prolonged stay is either admitted or shifted to
observation bed based on the patient condition
 Periodic reassessments are done for early identification of deterioration or
improvement in patients and care plan is modified accordingly.
 Every patients are reassessed every half an hour by the emergency medical officer
and nursing reassessments are done every 15 minutes.
 Documentation and change in care plan is documented every hour based on the
reassessment findings by doctors and nurses in ER assessment sheets
 Patients who need excessive management are either admitted or shifted to ward for
observation.
 Patients who need specialty consultation are seen by Specialist and documentation is
done in ER Assessment sheets.

CROWD MANAGEMENT IN ER

 Prevention of patient over-crowding in emergency department is of utmost

importance.
 Only triaged patients are allowed inside ER.
 Bystander restrictions are implemented. Only one bystander is allowed inside ER at a
time
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 Security personnel are deployed at ER entrance to manage patient and bystander

crowd.
 Footfall trend is analyzed and peak time is identified.
 Triaging is done at ER entrance and patient is directed to OPD in case of non-
emergent patient arriving at ER.
 More securities and ER staff will be assigned for management of patients during peak
hours.

TRIAGING

Triage is a process of prioritizing patient based on the severity of their condition so as to treat
as many as possible when resources are insufficient for all to be treated immediately.
i. Triage is done by trained staff in the department Emergency and Accident care.

ii. Repeat training is being ensured by the involvement of specialist doctor through
supervision in most of the cases as a daily routine.

Triaging is of two types:

i.Triaging during Multiple Casualty

a. Number of patients does not exceed the resources available in the department.

b. In case of multiple casualties, most life threatening cases are attended first.

ii.Triaging during Mass Casualty

a. Number of patients exceeds the resources available in the department. Cases like
Natural calamities, bomb blast and epidemics

b. Patients with greater chances of survival are treated first.

Triaging protocol

i.When call or information regarding any mass casualty is received a fully equipped
ambulance with drugs and sufficient staffs including doctors are sent to the spot
immediately.
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EMERGENCY SERVICES DATE OF ISSUE: 01.01.2017
MANUAL
DATE OF LAST UPDATION:
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ii.All beds in the Accident and Emergency Medicine are made vacant to the best extent
possible to accommodate the patients. If possible a general ward is also vacated to the
extent possible to accommodate mass casualty.

iii.Patients in the emergency area are shifted to ICU, ward or OP depending on the patient
condition and accommodation available.

iv.All doctors and staffs are alerted

v.Emergency department is prepared with crash cart, drugs and equipments to receive the
patients.

vi.Tagging of patients with colour coded tag is done in ambulance itself. A person should be
in charge for this. Tag consists of patient’s name, address and phone number in case of
stable patients.

vii.Details of patient and condition is informed to hospital emergency department through

ambulance communication system and steps are taken to initiate treatment within
ambulance itself by carrying out orders given by Emergency medical officers.
Documentation of the same is maintained in the ambulance communication sheet.

viii. In case of unstable or passing out patients numbers are given in the tag for
identification.

ix. Patients’ ornaments, clothes etc. are collected in a sealed bag and stored with patient
details or number.

Triaging Process

i.Emergency drugs and IV fluids are kept ready.

ii.Emergency equipments like defibrillator, cardiac monitors, Ventilators and airway

equipments are gathered for use to the extent possible.

(1)Most urgent
i.First priority patients.
ii.Triage area denoted by Red colour
iii.Life threatening shock or hypoxia and needs resuscitation.
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iv.ABC absent or feeble

v.Patient can be stabilized if given immediate care.
vi.Doctor should reassess every 5 min.
(2)Urgent
i.Second priority patients
ii.Triage area denoted by Yellow colour
iii.Patients are not yet in life threatening shock or hypoxia.
iv.ABC sustainable but have symptoms and signs of impending danger
v.If given appropriate care patients can withstand 45 to 60 minutes without immediate risk
vi.Dr. Should re assess every 15- 30 minutes
(3)Non Urgent
i.Third priority patients
ii.Triage area denoted by green colour
iii.Patient stable and can be sent for Observation or dealt as OP consultation as per patient
condition.
(4)Dead Patients
i.Unresponsive patient who has no spontaneous ventilation or circulation.
ii.Denoted by black colour
REQUESTING INVESTIGATIONS

 All requests for Radiology investigations are sent to the lab / radiology department in a
standardized requisition format for each investigation as X-ray, Ultrasound, CT etc.
 The referring doctor ensures that patient details in the requisition form along with
provisional diagnosis are entered. The details required include:
o Patient Name
o MRD Number
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o Age/ sex
o Date and time of reporting
o Name and signature of requesting doctor with seal
o Investigation to be performed with specifications on view of the image
o Part to be investigated with side / views, directional specifications etc.
 In case of Outpatients and patients from emergency department, the request form is sent
to concerned department via patient / bystander / hospital patient relations staff /
secretaries of OPD.
 ER Patients reporting at CT/MRI whether stable or unstable, is given priority for
scanning irrespective of token number of other waiting patients.
 Patient identity is duly confirmed and taken for scanning upon registering and
entry in daily register maintained.
 Stable patients if vulnerable the following shall be followed;
 They shall be transported in a wheel chair / bed with belt fastened.
 It shall be ensured that no body parts are projecting outside liable for hit and
causing injury.
 Transport shall be with bystander accompanying the patient.
 If no patients from emergency department or priority notice for a patient waiting
for scan from their doctor, then vulnerable patients are given priority for
undergoing CT/MRI Scan.

ADMISSION OF EMERGENCY PATIENTS

Emergency patients requiring admission are admitted as per hospital policy.

Patients are visited by the specialist consultants under whom the patient will be
admitted or patient’s condition is discussed with the specialist by the Emergency
medical officer and lab / radiology investigations results are discussed.

Patient file is opened through registration process directing by-stander for the same or
ER nurse does the same if no by-stander is with the patient.
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EMERGENCY SERVICES DATE OF ISSUE: 01.01.2017
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Patient registration is done at Front office as per hospital protocol.

Inpatient’s medical records documentation is initiated from ER by Medical officer or

the consultant visiting the patient at ER.

All entries by the Medical officer or junior doctors are countersigned by the primary
consultant within 24 hours of admission.

While handing over the patient from ER to ward, the patient is accompanied by an
ER nurse and hand over is given as per ISBAR tool and documentation of same is
done in patient medical record as well as patient hand over register maintained in
ward.

POLICY FOR REFERRAL OF PATIENTS TO OTHER HOSPITALS

 Those patients who do not match the hospitals scope or if the patient request shifting to
another hospital, the patient is referred to Medical college hospital or the hospital of
choice of patient and bystander as per hospitals Referral policy.
 All referral cases are given Referral Note duly filled in and signed by the emergency
medical officer on duty.
 Referral note comprise of the following details
 Patient identification details
 Date and time of presentation
 Date and time of referral
 Patient condition at admission and at time of referral
 Co morbidities if any.
 Treatment and medications given
 Resuscitation / intubation status.
 Reason for referral
 Name, signature and seal with Register Number of doctor
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DISCHARGE POLICY

 All patients discharged from Emergency department are given Discharge summary note
which includes the following:
 Patient name
 Age / sex
 MRD number
 Date and time of presentation
 Patient condition at admission, co-morbidities if any
 Investigations done with result
 Treatment given and medication administered
 Procedures done
 Patient condition at discharge
 Advice on Review/ admission / consultation at OPD
 How and when to obtain urgent care
 Name and signature of doctor discharging the patient
 Discharge to home/ other hospital
 Discharge process is complied with as per IPD/OPD or transfer defined in the respective
processes

PROTOCOL FOR BROGHT DEAD CASES

 Do not assume cases of death on arrival / brought dead cases as a natural death, unless
there is valid reason to believe it.
 In the first instance, vigorous attempts must be made to resuscitate the patient. The body
is examined thoroughly i.e. pulse, blood pressure, respiration, heart sound, reflexes,
pupils, etc.
 Meanwhile patient is to be registered and MRD Number is to be generated.
 Recording of all the events including resuscitation in CPR Resuscitation form is to be
entered as per CPR Protocol.
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 After all attempts have failed to revive the patient, then he/she is declared dead
(cardiopulmonary resuscitation should be tried for a period of 20 min).
 ECG should be taken, preferably in the presence of the relative to assurance of death of
the person.
 After death is confirmed, the doctor should inform the relatives compassionately
following the Effective Communication policy of the hospital.

The following should be done after declaration of death:

 The dead body should never be released to the relatives; it should only be handed over to
the police. 
 The death certificate should not be given. 
 A police Intimation (PI) should be issued at the earliest to the police, to take necessary
action and documented promptly in Police Intimation Register.
 A Medicolegal Report should be prepared mentioning “Brought dead at ……… (time)
on …………..(date)” along with his/her name, age, address and relative’s signature and
mobile phone number.
 Wounds, if present, should not be examined or clothing should not be removed.
 Belonging of the deceased (jewellery, cash, wrist watch etc.) shall be handed over to the
relatives attending on the patient (after verifying the nature of relationship) or to the
police officer dealing with the case and this fact should be recorded in the file
acknowledged by the recipient of the items.
 The 12 lead ECG should be preserved in the Brought Dead File (it may be required in
future).
 In Brought Dead Register, recording of name, age, sex, date, time, identification marks of
the deceases, relatives name, valuables and the relative’s signature and mobile phone
number is compulsory.
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 Decision on Autopsy or temporary storage has to be confirmed by the doctor declaring

death and senior nursing staff on duty in coordination with the Police officer attending
the MLC. (Autopsy will not be conducted at NIMS Medicity).
 MLC medical records are to be preserved lifelong under lock and key in the medical
records department.

UNCLAIMED / UNACCOMPANIED BODIES

 On receiving and unclaimed / unaccompanied body (brought dead / found dead on
arrival), police intimation is to be initiated as mentioned above.
 Registering of the deceased should be done only to generate MRD Number and no other
procedures will be carried out.
 Searching the body, wallet, and dress for possible identification document will be
conducted either by Police officer or staff nurse in the presence of police officer as per
his instructions.
 Decision on Temporary storage / Autopsy will be done by the Police Officer attending
the MLC.
 Brought dead register will be completed for date, time, Sex, Identification marks on
body, colour of dress, approximate age and build, details of documents available in the
patient wallet if present, jewellery details, wound details if present, details of those who
brought the deceased to hospital ER, time of arrival, mode of transport, mobile phone
numbers and time they left.
 All other procedures will be carried out as per Brought dead case handling procedure.

Policy on Found Dead

 Means that the person who found the body itself noticed that there was no life in it.
 There was no sign of life when the body was found elsewhere (road side or in an house
unattended)
 The body is being brought to the hospital (usually by the police or other government
agency or Ambulance or Bystanders) for Autopsy or for temporary storage in the hospital.
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 The doctor need not start treatment.

 An entry is made in MLC Register, Police are informed about the MLC and the body sent
to mortuary.

Policy on Brought Dead, Brought in Dead, Death on Arrival

 Refer to a patient who has been brought to the emergency department for treatment
 Presumably at the time, when they started the journey to the hospital, the patient was
alive (or at least that is what those who accompanied the patient thought so)
 On reaching the hospital, examination reveals that the patient is dead.
 In such case, when history reveals that the patient was alive few minutes ago, the doctor
has to admit the patient and start CPR.
 Registration of the patient has to be done as per hospital protocol and MRD number shall
be generated.
 CPR Should be done for minimum of 20 minutes and DC Shock may be given.
 If the patient is a child, CPR Should be done for at least one hour before the child is
declared dead.
Entry is made in MLC Register and Police are informed about the MLC and an official Police
Intimation (PI) will be issued to the nearest police station by EMO / ER nursing staff / Public
Relations Officer

TREATMENT PROTOCOLS

 Clinical protocol / Standard Treatment protocol are distributed to Emergency department

for reference by doctors and nurses.
 Emergency management algorithm are displayed in priority beds.
 Standard treatment guidelines (STGs) are a systematically developed statement
designed to assist practitioners and patients in making decisions about appropriate health
care for specific clinical circumstances
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 STGs also known as standard treatment schedules, standard treatment protocols,

therapeutic guidelines, and so forth—list the preferred pharmaceutical and non-
pharmaceutical treatments for common health problems experienced by people in a
specific health system. Each pharmaceutical treatment should include for each health
problem the name, dosage form, strength, average dose (pediatric and adult), number of
doses per day, and number of days of treatment.
 An important intervention in the management of common infections is the
implementation of and strict adherence to standard treatment guidelines. This has been
proven to reduce both morbidity and mortality rates associated
 The Clinical Establishments (Registration and Regulation) Act, 2010 specifies standard
treatment guidelines for the following :

1. Guidelines for Cardiovascular Diseases

 
2. Guidelines for Critical Care
 
3. Guidelines for Gastroenterological Diseases
 
4. Guidelines for Obstetrics and Gynaecology
 
5. Guidelines for Haemodialysis
 
6. Guidelines for Ophthalmology
 
7. Guidelines for ENT
 
8. Guidelines for Orthopaedics
 
9. Guidelines for Medicine (Respiratory)
 
10. Guidelines for Medicine (Non Respiratory Medical Conditions)
 
11. Guidelines for Paediatrics and Paediatrics Surgery
 
12. Guidelines for General Surgery
 
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13. Guidelines for Interventional Radiology

 
14. Guidelines for Oncology
 
15. Guidelines for Organ Transplant - Liver
 
16. Guidelines for Urology
 
17. Guidelines for Laboratory Medicine
 
18. Guidelines for G. I. Surgery
 
19. Guidelines for Neurology
 
20.Guidelines for Management of Epilepsy in India
 
21. Guidelines for Endocrinology

22. Standard Treatment Guidelines for Other Medical Conditions

(i) Guidelines for Major Trauma

(ii) Guidelines for Hypertension
(iii) Guidelines for Alcohol Dependence
(iv) Guidelines for Dry Eye Disease
(v) Guidelines for Snake-bite
(vi) Guidelines for Diabetic Foot
(vii) Management of Acute Respiratory Infection in Children
(viii) Management of Recurrent Spontaneous Abortion
(ix) Management of Sinusitis in Adults
(x) Feeding of Low birth weight babies
(xi) Management of Jaundice in New Born
(xii) Management of Osteoarthritis Knee
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MAINTENANCE OF CRASH CART IN ER

 Crash cart loaded with all emergency drug prescribed by the hospital Pharmaco
Therapeutic committee is maintained in ER.
 Duty assignment is done by ER incharge to ensure that crash cart maintenance is done on
regular basis and documentation of which is done in Inventory Register maintained.
 Designated duty nursing staff in the patient care is responsible for:
 To carry out daily check of cart contents based on a check list.
 To replenish the medicines and used equipments based on the above check list.
 To check external contents of cart.
 To ensure one drawer of each crash cart contain supplies and equipment to for pediatric
life-support measures.
 To verify expiry date of medicine in the cart and to return and replenish of medicines
from pharmacy as per pharmacy protocols.
 To carryout daily checks as per check sheet.
 Pharmacy store is responsible for replenishment on expired and used medicines and
equipments of crash cart based on the request received from the cash cart operating region.

QUALITY ASSURANCE PROTOCOL;

a. Checking of defibrillator and cardiac monitor and recording for performance on

both battery and electrical current once in every 24 hours except when the unit is
closed.

b. The defibrillator to remain plugged into an electrical outlet at all times, except
during battery testing.
c. To liaise with Biomedical Department when a defibrillator problem is detected to
get loaner defibrillator.
d. All external contents of cart are checked documented once every 24 hours.
e. Crash carts are used only for emergency purpose and not for routine use.
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f. High risk medicines are not be stored in the crash cart as they are to be stored
under lock and key arrangements on identified locations.
g. No narcotic drugs or psychotropic substances are allowed to keep open in the cart
other than under lock and key complying to the protocol of narcotic/psychotropic
substance control.

CRASH CART ITEMS

INJ. ADENOSINE  -3 INJ. PERINORM -1

INJ. BETNESOL -2 INJ. DICLOFENAC -1

INJ. AVIL – 2 INJ. AMIKACIN -1

INJ.BUSCOPAN -2 INJ. METROGYL -1

INJ. CALCIUM GLUCONATE -1 INJ. LEVOFLOX -1

INJ. DERIPHYLLINE – 2 INJ. FINAMAC - 2

INJ. DEXONA  -1 INJ.LABETALOL -1

INJ. EMESET -2 INJ. PHENOBARBITONE-1

INJ. KETANOV – 2 INJ VOLUVEN -1

INJ. DOLONEX – 2 IVF NS 500ML-3

INJ.  POLYBION- 2 DNS 500ML-3

INJ . PANTOCID – 1 RL 500ML-3

INJ. PARACETAMOL -1 5%D 500ML- 2

INJ. RANTAC -2 10%D 500ML-1

INJ. SERENACE -2 1/2 NS 500ML-2

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INJ. TRANOSTAT -1 INJ.3% NS -2

INJ. POTASSIUM CHLORIDE -2 NIRLYTE -P 500 ML -1

INJ. TRAMADOL -2 1/2 DNS 500ML- 1

INJ. PHENERGAN -1 KABILITE -1

INJ. STEMETIL -1 NS 100ML -2

D/S 50CC  -1 ECG LEADS - 5

D/S 20CC -2 IV CANNULA SIZE  18 G -2

D/S 10CC -5 IV CANNULA SIZE 16G - 2

D/S  5CC -10 IV CANNULA SIZE 20G  -2

D/S  1CC – 2 IV CANNULA SIZE 22G - 2

BLOOD SET -2 IV CANNULA SIZE 24G -2

I V SET -3 IV CANNULA SIZE 26G -2

RYLES TUBE SIZE 16 -1 SV SET – 1

                        SIZE 14 -1
EASY FIX -4
                        SIZE 12 -1
3 WAY ADAPTOR-1
                        SIZE 10 -1
SUCTION CATHETER SIZE  16 - 2 OXYGEN MASK ADULT-1

                         SIZE 14 – 4 OXYGEN MASK PAEDIATRIC -1

                         SIZE 12-1 NEBULISATION MASK ADULT -1

                         SIZE 8 -1 NEBULISATION MASK PAEDIATRIC -1

LARYNGEAL AIRWAY MASK SIZE 4-1
NASAL PRONGS -1
LMA SIZE 5- 1
STERILE WATER -4
AIRWAY SIZE 2- 1
NIMS LOGO
EMERGENCY SERVICES DATE OF ISSUE: 01.01.2017
MANUAL
DATE OF LAST UPDATION:
DOC. No.: NIMS/MAN/03 01.05.2021

ENDOTRACHEAL TUBE  SIZE 5 - 1

AIRWAY SIZE 3- 1
                                            SIZE 6.5-1
AIRWAY  SIZE 4- 1
                                            SIZE 7- 1
FLOW REGULATOR - 1
                                            SIZE 7.5- 1
PRESSURE MONITORING LINE - 1
                                            SIZE 8- 1
LOX 2% JELLY - 1
                                            SIZE 8.5 - 1

Registers Maintained:
Sl.No. REGISTER
1. MASTER PATIENT REGISTER
2. TRIAGE REGISTER
3. INVENTORY REGISTER – EQUIPMENT
4. INVENTORY REGISTER – MEDICINE
5. NARCOTIC REGISTER
6. WOUND REGISTER
7. MEDICO LEGAL REGISTER
8. POLICE INTIMATION REGISTER
9. BROUGHT DEAD REGISTER
10. DEATH REGISTER
11. REFERRAL REGISTER
12. AMBULANCE INVENTORY REGISTER – EQUIPMENT
13. AMBULANCE INVENTORY REGISTER – MEDICINE
14. AMBULANCE DAILY CHECKLIST
15. AMBULANCE COMMUNICATION REGISTER
16. MINOR OT REGISTER
17. RESUSCITATION REGISTER
DISASTER MANAGEMENT /CODE ORANGE KIT INVENTORY
18. REGISTER
19. TT INJECTION REGISTER
20. VACCINATION REGISTER
NIMS LOGO
EMERGENCY SERVICES DATE OF ISSUE: 01.01.2017
MANUAL
DATE OF LAST UPDATION:
DOC. No.: NIMS/MAN/03 01.05.2021

21. LINEN REGISTER

22. STAFF DUTY REGISTER
23. LINEN REGISTER
24. BIOMEDICAL EQUIPMENT DAILY CHECKLIST
25. EQUIPMENT CALIBRATION REGISTER
26. OXYGEN DAILY CHECKLIST

-End of document-