Table 68.AEssential Resources for the Delivery of Emergency Care in Hospitals

Resources Major emergency care center Regional emergency care center District emergency care center Primary emergency care center
Organization and administration
Multidisciplinary emergency care team
Maintenance of statistical data
Resources
Immediate access to radiology or CT and ultrasound scan facility on site
Blood bank on site
Access to blood bank
Radiological technician on site 24 hours a day
Radiological services available promptly
Clinical laboratory services
Laboratory services on site available 24 hours a day (including, but not limited to, the following tests)
 Hemoglobin, glucose, gram stain, blood slide test
 Bacterial cultures
Quality improvement
Evidence of quality improvement program in accident and emergency department
Monthly morbidity and mortality review
Medical nursing audit and utilization review
Personnel
Designated doctor in charge, member of the emergency care team, with special competence in care of critically ill and injured patients, present in the emergency care unit 24 hours a day
Designated doctor in charge, member of the emergency care team, with special competence in care of critically ill and injured patients, available on call
Nursing personnel with special competence in the care of the critically ill and injured patients, designated member of the emergency care team, present in the emergency unit 24 hours a day
All personnel trained in airway, breathing, and circulatory support techniques
Equipment required for resuscitation per station shall include but not be limited to
Bag valve resuscitator with reservoir
Sphygmomanometer (blood pressure cuff)
Cervical collars
Chest decompression set
Cut down set
Delivery pack
Diagnostic peritoneal lavage set open (1)
Dressing trolley
Drip stand
Laryngoscope and blades (adult)
Laryngoscope and blades (pediatric)
McGills forceps (adult and pediatric)
Ophthalmoscope
Overhead x-ray gantry (full access to all beds)
Portable ventilator capable of pediatric vent
Resuscitation patient trolley
Scissors to cut clothing
Scoop stretcher (1)
Spine board (1)
Spot lamp (1)
Sterile basic packs (2 per station)
Stethoscope
Suction apparatus
Wheelchair (1)
X-ray gowns (staff)
X-ray viewing box
Consumables (adult and pediatric)
Catheters (all sizes)
Central lines
Chest drains
Diathermy
Endotracheal tubes
Eye protection for staff
Gloves
Humidification filters
Intraosseous needles
Intravenous cannulas, fluids, lines
Introducers and endotracheal tubes (all sizes)
Lumbar puncture set
Malaria test kits
Masks
Medical waste disposal systems
Nasal cannula
Nasogastric tubes (all sizes)
Nebulization masks
Oropharyngeal airways
Oxygen mask
Suction catheters
Syringes (assorted)
Tracheotomy tubes
Urine dipstick
Wound care products
Drugs shall include but not be limited to the following
Activated charcoal
Adrenaline
Flumazenil (or similar benzodiazepine)
Antihistamine (such as diphenhidramine)
Atropine
Ciprofloxacin or equivalent
Beta-2 antagonist (such as propranolol)
Calcium chloride
Calcium gluconate
Dextrose, 50 percent
Diazepam
Dopamine
Emetic (ipecac)
Metronidazole IV
Furosemide or equivalent
Heparin, 1,000 μg/ml
Hydrocortisone
Lidocaine IV
Magnesium sulfate IV
Midazolam
Morphine
Naloxone
Nitroglycerin
Crystalloids (such as normal saline)
Phenytoin
Polyvalent snake venom
Potassium chloride
Scoline (suxamethonium chloride)
Sodium bicarbonate
Streptokinase
Tetanus toxoid
Vitamin K

Source:

Note: Additional information on recommended drugs is available in the Model List of Essential Medicines (WHO 2002) and the WHO's Complementary Model List.

From: Chapter 68, Emergency Medical Services

Cover of Disease Control Priorities in Developing Countries
Disease Control Priorities in Developing Countries. 2nd edition.
Jamison DT, Breman JG, Measham AR, et al., editors.
Copyright © 2006, The International Bank for Reconstruction and Development/The World Bank Group.

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