Emergency department of Northern Railway Central Hospital is one of the largest state of art Emergency of Indian Railways providing round the clock emergency care to all the Railway Beneficiaries and first aid to Non Railway cases.
It is a 20 bedded well equipped unit with latest machines/technologies catering to all sorts of medical and surgical emergencies. It provides care for approximately 35,000 seriously ill patients annually. Aprox 10 percent of the patients seen are admitted, around 25% go for minor surgical procedures, 50% are given day care treatment kept under observation while 10% are referred to departments like paediatrics and gynae.
There is a qualified team of doctors and paramedics available round the clock to provide 24*7 emergency services. A Consultant of every department is available round the clock to deal with any sorts medical and surgical emergencies.
We have 4 well equipped patient transport Ambulances available to transport the patients to and fro from their residences for emergency purposes. It also transports the patients to the hospitals empanelled of NRCH for advanced patient care.
Emergency Department of Northern Railway Central Hospital is also Disaster Management Nodal Centre of the Hospital. In case of any accident we are the first to provide services and co- ordinate with various departments of hospital for medical aid to the injured.
There are 2 operation theatres functional round the clock to deal with any orthopaedic and surgical emergency. We have a dedicated X ray room for expediting the radiological procedures involved in patient care. An emergency lab along with the blood bank is always functional to cater to the needs of emergency patients and aid us to reach to the diagnosis and manage patients at the earliest. They are all fully staffed with technicians and radiologists 24 hours a day. An on-site pharmacy provides for rapid access and distribution of medications.
We even provide OPD procedures like ECG, Nebulisation, Wound dressing, Emergency Catheterisation, dressing of burn injuries, cast and slab application for orthopaedic injuries and Management of Animal Bites round the clock. All the patients attending emergency are examined, investigated and treatment initiated according to their ailments and then admitted/ discharged. We also make Medico legal case as and when required.
The Department provides clinical training opportunities for our DNB residents, JRs and Interns enrolled in the hospital.
With a patient input of approximately 35000/ year the emergency department of Northern Railway Central Hospital is committed to provide best patient care at par with any Hospital.
What do I do if I'm having chest pains?
IF YOU THINK YOU ARE HAVING A HEART ATTACK, TRY TO REACH NEAREST HOSPITAL IMMEDIATELY.
Chest pain may be a sign of a heart attack.
Patients complaining of chest pain receive an electrocardiogram ("heart tracing" or ECG) within few minutes of arrival at the Emergency Department, NRCH. After evaluation by emergency doctors and cardiologists, if a patient is a candidate for medical intervention or requires balloon angioplasty/CABG, they are admitted in the ICU then treated/reffered to empanelled hospitals of NRCH.
Signs of a heart attack:
Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It commonly feels like uncomfortable pressure, squeezing, fullness or pain.
Discomfort in other areas of the upper body. Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or abdomen.
Shortness of breath with or without chest discomfort.
Other signs may include breaking out in a cold sweat, nausea or lightheadedness.
It is extremely important to seek immediate medical care if you suspect you are having a heart attack. If you or someone you know is experiencing symptoms of a heart attack, seek emergency help immediately.
What do I do if I think I might be having a stroke?
Do not delay. Seek emergency medical care immediately if you think you are having a stroke.
Signs of a stroke:
Sudden numbness or weakness of the face, arm or leg, especially on one side of the body
Sudden confusion, trouble speaking or understanding
Sudden trouble seeing in one or both eyes
Sudden trouble walking, dizziness, or loss of balance or coordination
What is the first aid treatment for dog bite?
Try to keep the injured area elevated. Wash the bite carefully with soap and water for 10 minutes. Apply a sterile bandage to the wound. Report to NRCH Emergency for Anti-Rabies Treatment.
How to manage Snake Bite before reaching Hospital/NRCH Emergency?
There are about 236 species of snakes in India, most of which are nonpoisonous. Their bites, apart from causing panic reaction and local injury, do not harm the patient.
The case management at the field level should include reassurance, immobilizing the bitten limb and transporting the victim to nearest treatment facility at the earliest where definite treatment can be provided.
Make the victim lie flat with bitten limb below the heart level. Remove shoes, rings, watches, jewelry and tight clothing from the bitten area as they can act as a tourniquet when swelling occurs. Immobilize the victimís bitten limb using a splint and lightly put a bandage.
Do not wash the bite site with soap or any other solution to remove the venom. Do not make cuts or incisions on or near the bitten area. Do not freeze or apply extreme cold to the area of bite. Do not apply any kind of potentially harmful herbal or folk remedy. Do not attempt to suck out venom with your mouth. Do not give the victim drink, alcohol or other drugs. The initial management includes dealing with airway, breathing and treatment of shock. Administer tetanus toxoid if skin is breached and antibiotics if there is cellulitis or local necrosis.
For further Management and administration of Anti Snake Venom it is advisable to reach Emergency as soon as possible.
How do I manage Epistaxis?
Epistaxis is bleeding from nose. It might be because of increased Blood Pressure, any injury or any pathology in the nose. The steps in management of epistaxis are as follows.
Examine/Ensure secure airway : Attempt to visualize site of bleeding. Have patient gently blow nose to clear the clots. Pressure: As with any bleed, compression is key, Irrigation : Irrigation of the nares can improve visibility. Warm-water irrigation has been demonstrated to facilitate hemostasis in posterior bleeds by causing mucosal edema that constricts vessels.4Tampons/Packing: Nasal tampons, often made of Merocel, are used for nasal packing.,
Caution should be taken to avoid packing if there is concern for facial fractures.
Medication : Oxymetazoline has been shown to be an effective vasoconstrictor even for posterior bleeding.10 Use cautiously in hypertensive patients because elevated blood pressure may contribute to further bleeding. Tranaxemic Acid may be used for controlling nasal bleeding.
ENT consultation should be obtained in a timely manner for severe, refractory bleeding that may require intravascular embolization or surgical ligation.
What do I do in case of burn?
Most minor burns can be treated at home. They usually heal within a couple of weeks.For serious burns, after appropriate first aid and wound assessment, treatment may involve medications, wound dressings, therapy and surgery. The goals of treatment are to control pain, remove dead tissue, prevent infection, reduce scarring risk and regain function.
To treat minor burns, follow these steps:
Cool the burn. Hold the burned area under cool (not cold) running water or apply a cool, wet compress until the pain eases. Don't use ice. Putting ice directly on a burn can cause further damage to the tissue.
Remove rings or other tight items. Try to do this quickly and gently, before the burned area swells.
Don't break blisters. Fluid-filled blisters protect against infection. If a blister breaks, clean the area with water (mild soap is optional). Apply an antibiotic ointment. But if a rash appears, stop using the ointment.
Apply lotion. Once a burn is completely cooled, apply a lotion, such as one that contains aloe vera or a moisturizer. This helps prevent drying and provides relief.
Bandage the burn. Cover the burn with a sterile gauze bandage (not fluffy cotton). Wrap it loosely to avoid putting pressure on burned skin. Bandaging keeps air off the area, reduces pain and protects blistered skin.
Take a pain reliever. Over-the-counter medications, such as ibuprofen or acetaminophen can help relieve pain.
Consider a tetanus shot. Whether your burn was minor or serious, use sunscreen and moisturizer regularly once
How to manage fracture?
A fracture is a broken bone. It requires medical attention. Also call for emergency help if:
There is heavy bleeding.
Even gentle pressure or movement causes pain.
The limb or joint appears deformed.
The bone has pierced the skin.
The extremity of the injured arm or leg, such as a toe or finger, is numb or bluish at the tip.
You suspect a bone is broken in the neck, head or back.
Don't move the person except if necessary to avoid further injury. Take these actions immediately while waiting for medical help:
Stop any bleeding. Apply pressure to the wound with a sterile bandage, a clean cloth or a clean piece of clothing.
Immobilize the injured area. Don't try to realign the bone or push a bone that's sticking out back in. If you've been trained in how to splint and professional help isn't readily available, apply a splint to the area above and below the fracture sites. Padding the splints can help reduce discomfort.
Apply ice packs to limit swelling and help relieve pain. Don't apply ice directly to the skin. Wrap the ice in a towel, piece of cloth or some other material.
Treat for shock. If the person feels faint or is breathing in short, rapid breaths, lay the person down with the head slightly lower than the trunk and, if possible, elevate the legs.
How do I manage a case of wound?
Wash your hands. Stop the bleeding. If needed, apply gentle pressure with a clean bandage or cloth and elevate the wound until bleeding stops. Clean the wound. Rinse the wound with water. Remove any dirt or debris with a tweezers cleaned with alcohol. Apply an antibiotic . Apply a thin layer of an antibiotic ointment to keep the surface moist Cover the wound. Apply a bandage, rolled gauze or gauze held in place with paper tape. Change the dressing if there is soakage. Do. Get a tetanus shot. Get a tetanus shot if you haven't had one in the past five years and the wound is deep or dirty. Watch for signs of infection. See a doctor if you see signs of infection on the skin or near the wound, such as redness, increasing pain, drainage, warmth or swelling.
How to give first aid in Poisoning?
Poisoning is injury or death due to swallowing, inhaling, touching or injecting various drugs, chemicals, venoms or gases.
Call for help if:
Drowsy or unconscious
Having difficulty breathing or has stopped breathing
Uncontrollably restless or agitated
Known to have taken medications, or any other substance, intentionally or accidentally overdosed (in these situations the poisoning typically involves larger amounts, often along with alcohol).
Take the following actions until help arrives:
Swallowed poison. Remove anything remaining in the person's mouth. If the suspected poison is a household cleaner or other chemical, read the container's label and follow instructions for accidental poisoning.
Poison on the skin. Remove any contaminated clothing using gloves. Rinse the skin for 15 to 20 minutes in a shower or with a hose.
Poison in the eye. Gently flush the eye with cool or lukewarm water for at least 15 minutes or until help arrives.
Inhaled poison. Get the person into fresh air as soon as possible.
If the person vomits, turn his or her head to the side to prevent choking.
Begin CPR if the person shows no signs of life, such as moving, breathing or coughing.
Call for help and try to shift the patient to the nearest Emergency.
How Do I Manage a patient with seizure at home?
Seizure usually involves convulsions and sometimes leads to loss of consciousness.. Causes of Seizures include brain diseases, illness, genetic disorders, or injury, but the cause of many seizure disorders is unknown.
Common symptoms of seizures include unconsciousness, muscle contractions and convulsions, clouded awareness, weakness, loss of sensation, strange sensation in the stomach, lip smacking, fidgeting, confusion, and sleepiness after the seizure.
First aid for seizures is aimed at keeping the person safe,ensure airway,prevent tongue bite until the seizure stops on its own. Stay calm, loosen anything around the person's neck, do not restrain them or put anything in their mouth, clear the area around them, and stay with them after the seizure stops.
After I am discharged from the emergency department, who do I follow up with?
After your Emergency Department visit you will receive discharge instructions that provide information about appropriate follow-up and accordingly you are asked to visit concerned department OPDs.
Can I call to schedule an appointment to ensure a spot in line?
Unfortunately you cannot make an appointment to be seen in the emergency department. All patients who arrive for care are evaluated by doctors who determine which patients are sickest or most injured and require immediate care. These patients may be seen ahead of your patient.
Can I use my cell phone in the emergency department?
The experience of the patients and families is important to us. Though use of cell phones in the Emergency Department is allowed, we ask that you make your best efforts to minimize phone calls and keep your conversations as quiet as possible.
How do I avail Ambulance Services in Emergency?
Almost all Health Units of New Delhi have Ambulance Services available for transporting patients.It is advisable to contact the nearest Health Unit for prompt services.In case Ambulance is not available at your Health Unit or Divisional Hospital then call for Ambulance at Northern Railway Central Hospital on 011-23744009.