At about 3 am on Friday 16 December, a landslide occurred along the Jalan Batang kali Genting highlands road. The medical team of Hospital Selayang had been activated and responded to the site. A campsite with visitors from a local school including families and children who were hit by a landslide was reported missing and trapped in the area. Of the 92 victims, and survivors were 61, the number of deaths was 31. The search and rescue team used equipment such as excavators as well as the help of the K9 unit to help locate the victims in the landslide. The media was present at the cold zone or green zone and had 24-hour coverage of the scene to spread the necessary and accurate information to the public. Regular briefings were done by the SAR teams together with the incident commander to the media to keep the public updated on the real information about the scene.
Introduction: Procedural sedation and analgesia are common procedures in the emergency department, performed almost daily on a large cohort of patients. Despite their frequency, safety profiles have been a concern due to sentinel cases of complications leading to adverse outcomes. Consequently, the term "safe procedural sedation and analgesia" has been adopted to emphasize safety as a crucial component of the procedure. Methods: To ensure a robust safety profile, we implemented the mnemonic BACSACS, providing a guided protocol for procedural sedation and analgesia. This mnemonic was designed to enhance safety and standardize the procedure. Results: Data from the implementation of the BACSACS protocol were analyzed to assess its effectiveness and impact on patient outcomes. Conclusion: The use of the BACSACS mnemonic in procedural sedation and analgesia helped instil a safety-focused approach. Data analysis confirmed its effectiveness, demonstrating improved safety profiles and positive patient outcomes.
The emergency department of Malaysia has been greatly affected by overcrowding, longer waiting times, and longer admission times ever since the world was hit by the COVID-19 pandemic. Thus, it is essential for the emergency department to obtain an accurate diagnosis early and provide earlier treatment for better outcomes for patients. The use of bedside lung ultrasound is useful in these scenarios in differentiating different causes of respiratory symptoms, and further management and definite treatment can be provided accordingly.
The emergency department structure and treatment services deal with critical, semi-critical, and urgent care cases. Among these cases are medical and surgical cases. The surgical cases can be divided into trauma and non-trauma-based cases. Trauma cases, therefore, are a sub-specialized field and services provided within the emergency department deal with patients presenting with acute bodily harm. A proper system of traumatology must be in place to recognise patients presenting with major trauma, relay accurate and timely information provide a pre hospital care alert to the emergency staff, conduct a proper Passover of cases to handle information precisely, activate the trauma team and trauma physicians in two tiers so that emergency trauma care does its job before intervention by primary teams of different disciplines unique to the case, investigate the patient with trauma panels and quick trauma protocols, and final disposition of the patient to the operation theatre, wards or discharge after observation and adequate pain control.
Introduction: Emergency and trauma departments have been managing accident cases and providing care for trauma patients as a fundamental service. Over time, emergency trauma care has evolved into a specialized area of interest and subspecialty within many healthcare sectors. The primary goal is to enhance the care system for trauma patients to achieve higher standards and outcomes. Methods: One initiative to improve trauma care is the development of a trauma panel of blood. This panel is intended to assist in determining patient outcomes and guiding treatment decisions, whether conservative or operative. Results: For patients treated conservatively, having comprehensive information from the trauma blood panel could facilitate the transition from critical care units to general wards, ensuring appropriate and timely care adjustments. Discussion: The introduction of a trauma panel of blood is expected to streamline clinical decision-making in trauma care. This tool can influence treatment pathways and patient management strategies, potentially improving overall patient outcomes. Conclusion: Implementing a trauma panel of blood aims to enhance the quality of trauma care by providing critical information that supports informed and timely clinical decisions, ultimately leading to better patient outcomes and more efficient use of healthcare resources.
Medical standby is an event that was assigned to the emergency department to orchestrate the flow of medical management and the safety of the people who were involved during the event. The challenge started weeks or sometimes months before the occasion, as it may include more than one team for the event according to the requirements that have been standardized by the governing bodies. The preparedness of medical standby becomes more challenging as it requires dedicated and state-of-the-art resuscitation equipment to perform maximum medical life-saving procedures prior to the patient's dispatch to the selected hospital. This is a report of the Selayang medical team, which led multiple medical agencies to stay alert 24 hours a day during the first Thaipusam’s medical stand-by after the pandemic.
Introduction: Emergency bronchoscopy was not a routine procedure in the emergency department. However, its use is being significantly advocated in the setting of emergencies. Case study: A middle aged male patient presented to them with shortness of breath. Discussion: Bronchoscopy performed by emergency physicians who have been certified and who have an area of interest in emergency critical care among the patients who are critically ill, especially those with respiratory impairments have started to become an important therapeutic as well as diagnostic tool. In this article we discuss the procedure involved in emergency bronchoscopy in the emergency department of Hospital Selayang. Conclusion: Emergency bronchoscopy services have taken its importance in emergency critical care management of patients.
Strokes are a common presentation to emergency departments all over the world. Early recognition of strokes is essential which is followed by ruling out stroke mimics, going for a radiologic investigation and decision making for thrombolysis. To create a fully functioning Neuro emergency stroke team in assisting in stroke thrombolysis, a dry run was done for a month in the emergency department which saw the common challenges and pitfalls to tackle before the actual thrombolysis is started to prevent or minimize the risk of complications of stroke management.
The emergency department deals with many critical cases daily being surgical or medical based. Waiting times for the critically ill patients in the emergency departments are increasing because of surge capacities especially during these challenging covid-19 times1. Applying an evidence based approach to the management of critically ill patients is important to ensure the risk and benefit ratio of treating patients is preserved2. Critical care evidence based p[practice can be found via many resources and easily via web based in a computerised hospital management system3. In order to transform the emergency department into an essential emergency critical care management centre, it must also incorporate evidence based practices to ensure the most appropriate treatment be instituted in our patients4. Education also plays an important role in improving services in the emergency department making it evidenced based and incorporation of research related evidence will help justify treatments and management of the critically ill5. In this article we discuss research articles that we believe can be essential to improve critical care services in the emergency departments.
Mental health screening is an important parameter to measure and treat in the emergency department. Though it may not be as acute or life and limb threatening as other illnesses, it may pose danger to the patient if risk assessment is not done adequately that can lead to mortality and morbidity. Recognition of common mental health disorders in the emergency department is important and early, quick screening methods must be applied to assess the severity and improve recognition. A quick treatment method must also be applied and proper disposition and referral system must be applied for the patient to get adequate help they need.
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