Don’t fall sick on a Sunday if you want the emergency care of a doctor

July 13, 2013 01:30 am | Updated 01:30 am IST - KOCHI:

Critical patients are bounced from hospital to hospital on weekends as there are not enough specialty doctors around.  — Photo: Vipin Chandran

Critical patients are bounced from hospital to hospital on weekends as there are not enough specialty doctors around. — Photo: Vipin Chandran

The city prides itself in being the medical capital of the State, with about ten superspecialty hospitals in and around the city. But if you fall sick on Saturday evening or Sunday, do not always expect to get emergency medical care, unless you are a VIP or you have the right connections.

A cardiac patient had to hop from hospital to hospital on a Sunday night, and finally died at the fifth hospital that took in the patient but was too late for treatment. The man’s journey from home had started around 9.30 p.m. The local 50-bed hospital had arranged for an ambulance to take him to a hospital with cardiac care facility.

But the patient’s relative was in for a shock when the superspecialty hospital refused to admit the patient saying there were no beds vacant in the intensive care or the cardiac care unit.

Directed to another hospital, the patient failed to get admitted there, too, as the intensive care unit beds were full. Yet another hospital was suggested and here the patient got admitted, but only to be told that no specialty doctor was available. After another hour, the patient was taken to yet another hospital where there was a bed and a doctor, but it was too late to save the 55-year-old man who died around 3 a.m.

Another case is that of an 80-year-old woman accompanied by her daughter and a young nephew in an ambulance. The local hospital took some time to pack them off to the specialty hospital. But after hopping two hospitals they were finally admitted in the third because of the pleas of the bystander. From there the patient was taken to another hospital where cardiac care facility was available, but she died just as they reached there, says her daughter. “I felt my mother breathed her last as we entered the casualty there, but she was put on a ventilator and even charged us Rs. 12,000 straight away.”

“It was terrifying to go around pleading to be admitted to take care of my mother,” said the lady who did not want to be named. “We will have to go to these very hospitals in case of emergencies,” she added.

The son of a 74-year-old patient found that a medical college hospital in the district did not have enough emergency care facility. On a Sunday, even doctors were not available. An ambulance brought them into the city where a superspecialty hospital refused to admit the woman because of lack of ICU beds. While they were about to move to another hospital, the woman’s bystander made the right calls.

The hospital that had refused to admit earlier, made arrangements for emergency care.

The preventive medicine in cardiac and neurological disorders specify that time is of essence. However, all the golden hour specifics get wasted when hospitals are not prepared to meet these emergencies.

Some of the leading hospitals in the city said they had an emergency plan, but also agreed that such incidents might have happened. A public relations official (PRO) in one of the superspecialty hospitals said that once the patient is rolled out of ambulance, the hospital has to meet the emergency care. However, the PROs play safe by turning the patient away to another hospital, mainly because the beds are full.

The medical superintendent of one of the hospitals said, “The hospital follows the principal of distributive justice. We try to make arrangement here to save the patient. If informed earlier, we would ask the hospital to hold the patient there or let the patients’ bystanders decide whether they would let the patient be in casualty for a few hours while arrangements are made for ICU”.

The superintendent of a medical college hospital said all superspecialist hospitals should have a specialist on duty 24x7 or should have preparedness for on-call duty. A hospital cannot send a patient away because of non-availability of specialists or beds.

The medical college in-charge said there should be a mechanism within the hospital to make a bed available. Such a plan should exist for emergency medicine as it may happen that their ICUs are already having critically ill patients.

The guidelines of National Accreditation Board for Hospital says that the patient needs to be stabilised first and then sent to another hospital with all procedures documented so that the patient need not pay again for the procedures and results already done at the previous hospital.

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