What is casualities?

A casualty is a person who has been hurt,

even killed, in an accident, or an act
of violence.

Ex: A train wreck with many casualities

 (medicine) The casualty department of
a hospital is where people who have been
hurt are first taken for medical treatment.

Casualty department = Emergency department

Ex: Casualty was crowded with injured people

after the accident
 An emergency department (ED), also
known as an accident & emergency
department (A&E), emergency room (ER)
or casualty department, 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.
 Fleet of well equipped ambulances
 Emergency medical technicians (EMTs
 )Ambulance drivers
 EMS Administrator
 Biomedical technicians
 Radio and telephone operators manning the
central call & coordination center
 And the emergency department itself
 The EMS administrator must be a qualified
emergency medicine physician himself or at
least be well trained in EM. Most often the the
head of the EM department will be the EMS
administrator. EMS systems administered by
non medical personnel are known to be
highly inefficient.
 Every emergency department has a triage or
triaging area to sort incoming patients.
 Triage can be defined as the prioritization of
patient care based on the severity of injury /
illness, prognosis, and availability of resources.
 For those responsible for the triage of patients
arriving in the emergency department, the
purpose of triage is to determine to which
predesignated patient care area the patient
should be sent.The locations to which the
patients are 'triaged' establishes priorities for
care.
 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.
 Priority I (Immediate) - Patients have life
threatening injuries or conditions that are
survivable with immediate treatment. Examples :
Airway compromise, tension pneumothorax,
shock, cardiac arrest, seizures, etc.
 Priority II (Delayed) - Patients require definitive
treatment but no immediate threat to life exists.
Patients may remain stable for 10 to 20 mins.
Examples : Limb injuries, lacerations with
hemorrage controlled, high fever, altered
sensorium, severe pain, etc
 Priority III (Minimal) - Patients have minimal
injuries or minor conditions, and are
ambulatory. Examples : Sore throat, abrasions
and superficial lacerations, chronic self
limiting disorders, etc.
 Priority 0 (Expectant / Dead) - Victims are
dead or have lethal injuries and will die
despite treatment. Examples : Devastating
head and chest injuries, 3rd degree burns
over most of the body, destruction of vital
organs, etc.
 EMS (Ambulance)
 Coordination Center
 TriageResuscitation
 AreaMajor Trauma / Medical Areas
 Consultation Rooms
 Patient Waiting Area
 Minor Procedure Rooms
 Major Operating Room
 Observation Units
 Injection Room
 24 hour Pharmacy
 Prayer Room
 Library and Reading Rooms
 Doctors Restroom
 Cafeteria
 24 hour internet access to online journals and
medical information
 This area is dedicated to the immediate care of
patients and victims in cardiac arrest, airway,
breathing and circulation compromise. The
'Resus' area consists of two or more resuscitation
beds (sometimes upto 12) with all resuscitative
equipment (monitors, defibrillators, airway,
intubation & surgical equipment) available at an
arm's distance including pediatric resuscitation
kits.
 A patient maybe shifted to the Resus area from
outside or from an area within the hospital or
emergency department itself.
 All priority I patients are managed here.
 All priority II patients are managed here. This
area will have dedicated EM physicians (along
with EM nursing staff) looking after the
patients directed here. Majority of the ED
admitted patients are assessed and managed
here.
 Since majority of the patients coming to an
ED do not have an emergent problem, they
are assessed and treated on outpatient basis
in the consultation rooms.
 Procedures like washing, dressing & suturing
of wounds, reduction & splinting of fractures
& dislocations, and other minor surgical
procedures are done here.
 Any major emergency surgery can be
conducted here by the operating team.
 Emergency physicians are usually not
involved in any major surgery, even though
they maybe qualified in that field.
 Patients who need to be admitted and
observed for less than 24 hours are placed
here. Such patients are those with non
cardiac chest pain, acute asthma, vague
abdominal pain, minor head injury, acute
depression, febrile convulsions, dehydration,
etc. Dedicated staff from emergency medicine
look after these patients
 Prayer room is an important part of any
emergency department since patients and victims
are very sick or dying. It provides privacy for the
relatives and attenders of the patients to perform
any religious activities or prayers. The prayer
room usually is an empty room without any
pictures or images so that people from any
religious background can use it. Bad news is
sometimes broken here. Patients who have died
are kept here temporarily to be viewed by
grieving relatives and attenders.
 A 24 hour internet access is a must to any ED
since patients with unknown and difficult
diagnoses must be dealt with in short spans
of time. Internet provides access to online
journals, poison and toxicological
information, other emergency departments
and various reading material.