Non-emergency patients hindering patient care at SKIMS Casualty
Srinagar: A group of people with a teenager in their arms barge noisily into the medical emergency of SKIMS Soura. They place the patient on one of the stretchers in the area, and beckon one doctor to attend to the patient immediately.
“He vomited twice. He is very sick,” one of them shouts. Two doctors are trying to find a vein of an elderly unconscious woman. One doctor is adjusting an oxygen mask on another patient, apparently struggling to maintain saturation, evident from his SpO2 levels on the monitor. The Casualty is so full of people, patients and their attendants, that there is hardly any space to walk. However, the teenager and his relatives create the scene of being the most serious of the cases.
One of the doctors is forced to leave the patient he was taking a history of and attend to the teenager. After a few minutes, the doctor tells the family that the patient has mild gastritis and would be alright in a day.
“Avoid outside food,” the doctor advises while handing the prescription over to the family. Meanwhile, the patient whose saturation was low appears more distressed, insists that he sits up, and fiddles with the mask. He is rushed for an ECG.
This is a common scene at the SKIMS Soura Emergency where patients with no serious ailment compete with the serious emergency cases, for attention of doctors. For doctors, it is a difficult call to decide who needs attention first without assessing everyone first.
“We have to do the triaging in the emergency only. That takes a lot of our attention,” said a SKIMS Soura resident doctor. Triaging is the process of categorizing and prioritizing patients based on the urgency of their medical condition.
It involves assessing and sorting individuals to determine the order in which they should receive medical care, ensuring that those with the most critical needs are treated first.
The SKIMS Soura, Kashmir’s premier-most multi-specialty tertiary care hospital, is a victim of uncontrolled patient flow. As per the hospital administration, on an average, 300 patients report to the Casualty daily.
This mostly includes people from the adjoining areas, nearby areas of Ganderbal district and patients seeking medical attention outside the OPD Hours from any part of Kashmir.
A senior specialist at the hospital said that limited access to primary care providers and long waiting times for appointments push individuals to seek immediate care in the ED for minor ailments and non-urgent concerns.
Director SKIMS Soura, Prof Parvaiz Koul believes that over the years the peripheral healthcare has strengthened enough to cater to patient needs, even serious conditions. “Right now, there is a round-the-clock healthcare facility in every district, and also in the City (Srinagar). A patient may need to see the doctor at any time, and may consider it an emergency,” he said.
He said that the peripheral institutes are “doing procedures that were previously unheard of”. Prof Koul said that it will take time till people are weaned off the central institutes, after they develop total confidence in these institutes.
“It is also important that people develop the sense of responsibility and not put undue pressure on Emergency Care. Please think, someone may be struggling for life. Do I need to visit the emergency room for my complaint,” he said.
He said that SKIMS Soura administration had deputed adequate staff for emergencies. “However, definitely, our capacities are not infinite,” he said.
Medical Superintendent SKIMS Soura, Dr Farooq Jan said that the hospital could not refuse any case. “We have to treat every patient that comes to us, minor ailment or serious ailment,” he said. He said that a Triage System had been created during the Pandemic and the hospital had been designated as a referral center only. “During that period, we only received patients that had been referred to us from some other hospital,” he said.