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When should I use the ED services?

We evaluate everyone who comes to us. This means that we see patients with anything from sprained ankles to heart attack.
The most often conditions we see are as follow:
- Airway Obstruction.
- Respiratory Distress.
- Chest Pain
- Severe abdominal pain
- Sudden severed headache
- Uncontrolled bleeding
- Change in level of consciousness
- Sudden onset of any neurological disorder-paralysis, speech difficulties.
- Burns
- Fall or fractures.
- Asthma Attack
- Lacerations (Cuts)
- Allergic reactions.
- Highs fever over 38 degrees that does not decrease with analgesia

What happens when I arrive at the ED?
As soon as you arrive, a medical assistant evaluates your illness or injury and ranks your treatment needs based on the severity of yours symptoms or injuries. This process is called triage. Triage allows doctors to see the most seriously ill or injured patient first.
The Medical Assistant will ask about your illness or injury and some brief medical history as part of the primary triaging process. Colour coded triage card are given according to the severity of your illness or injury and you will be directed to the various zones of the department.

After your initial medical evaluation, for those whose are triaged green, you will be directed to the registration counter. The registration staff will ask for information such as your name, address, telephone number and names of persons to contact in an emergency. After registration you are then called to be first examined by a nurse and then the doctor.

Why do I have to wait so long?
There are varieties of reasons why you must wait. The ED does not schedule appointments, so it has no control over how many patients arrive at a given time. You may arrive at an especially busy time, and therefore, wait. Additionally the ED staff prioritises patients as they arrive, ensuring that patient who need the most immediate medical attention see a doctor first. If your situation is less urgent, you may have to wait to see a doctor.

How long will treatments take?
The length of time for treatment depends on a number of factors:
• The seriousness of the illness or injury (Multiple injuries involving many organs)
• The number and types of test or procedures necessary.(X-ray, laboratory investigations ,scan)
• The number of patients who are currently being treated in the emergency department.
• The need for referral doctors consultation.

Each of these factors plays a key role in your treatment time. Please feel free to ask your nurse what is happening as you are being treated. To ensure that we provide the most accurate diagnosis and treatment available, it is necessary to wait until all tests are completed

Do you know?
• We have approximately 100,000 visits to our ED each year.
• Visit may range from 250 to 300 visits a day.
• We are generally the busiest from 8.00pm to 11.00pm and from 10am to 6.00pm at weekends
• You can also seek minor treatment at your nearest government health clinic in your area.
• Selayang Health Clinic (Klinik Kesihatan Selayang Baru) is open daily from 8.00am to 9.00pm except Sunday & public holiday.

Ambulance Service

The Emergency Department provides 24 hrs emergency ambulance services to its surrounding area. A call centre within the Emergency department operates and coordinate all the emergency ambulances response and hospital interfacility transfer and referral.

Triage System at the Emergency Department

Triage is the dynamic process of categorising the patient according to treatment priority.
The Triage Center, located infront of the entrance of the Emergency Department , is manned on a 24 hour basis by well trained Triage Officers.
All cases arriving at he Emergency Department are triaged and sent to the respective areas/zones based upon the Zoning Concept.

Triage Criteria :

1. Non Critical Cases.
• All walk-in and stable cases.

2. Semi-Critical Cases.
• All hemodynamically stable cases but are unable to walk.

3. Critical Cases.
• Critically ill cases requiring urgent treatment.

Zoning Concept at the Emergency Department.

All zones in the department are designed and equipped specifically to cater for the different level of care and patient needs.

Resuscitation Zone
This zone is dedicated and confined to the critically ill patients with unstable hemodynamics and in need of urgent emergency life saving treatment.
The philosophical concept of the “Golden Hour ” which stipulates that all trauma patients requiring prompt and urgent treatment within a prescribed and stipulated time as in the “Advanced Trauma Life Support ” is observed strictly.

Infrastructure and Facilities :
1. Resuscitation Bays.
• There are 6 resuscitation bays in the zone , two of which are dedicated to pediatric resuscitation and 4 are for adult resuscitation.
• The resuscitation bays are specifically designed so as to allow all resuscitative procedures to be carried out easily based upon the ‘ Trauma Team’ concept.

2. Critical Care Bays.
• This area is dedicated for the management and observation of critically ill patients prior transfer to ICU/Operation theatre for the definitive treatment.
• Four intensive care bays with central monitoring and life suppotr facilities are available in theses bays.

Immediate Care Zone.
This zone is dedicated to receive patients that are in a semicritical condition and are hemodynamically stable.
Infrastructure and Facilities :
1. Immediate Bays :
• There are 12 Immediate bays in the Emergency Department which serve as active bays for incoming semicritical patients.
• The bays also serve as an observation area if the need arises

Observation Bays.
This area is dedicated for the observation of semi –critical patients with labile physiological and clinical conditions.
• There are 12 beds available in the Observation Bay
• The duration of patient stay in this area is not more than 12 hours.

Green Zone.
This zone caters for patients with minor injuries or those with uncomplicated medical problems.
Infrastructure and Facilities.
• Consultation Rooms.
There are 6 consultation rooms which are equipped with minor treatment facilities.
• All patients undergo simple treatment management such as injection, strapping or wound dressing
in the consultation room itself prior to being discharged.

Asthma Bay.
This area is dedicated for asthmatic patients with mild to moderate attacks of asthma.
• There is no waiting time for asthmatics patients.
• Following triage at the Triage Center , the patients aren directed straight to the Asthma Bay for emergency treatment.

One Stop Crisis Center.
Two consultation rooms in the Green Zone are specially dedicated for the One Stop Crisis Center
• This center caters for all victims of domestic violence , rape and child abuse.
• After triage , the patients are accompanied by a department staff straight to the OSCC without registration. Registration is done by either emergency staff or accompanying person.

Scope of service of the OSCC.
• Medical Social Welfare services .
• Provision of temporary shelter while awaiting ‘save shelter.’
• Referral to SCAN team for child abuse cases.
• Availabilty of in house Hospital police station for the ease of the victims to lodge police report .

Emergency Imaging Unit.
• This unit is located in the Emergency Department .
• It is manned by a team of radiographer and attendant and functions on a 24 hour basis.
• Only plain X-ray imaging is available in the Emergency Department.

Disaster and Mass Casualty Incident Management.
The Emeregncy department has its own external disaster plan. In the event of a disaster or mass casualty incident the Emergency Department will respond accordingly by activating its external disaster management protocol.

Services Provided

The Emergency Service provided encompasses a comprehensive treatment plan that includes Pre Hospital care, resuscitation, and stabilization and definitive care management. Other services provided include disaster management, management of child abuse, domestic violence and acute asthma attack. All patients are treated according to the urgency and need of emergency care. In order to facilitate this, the ED has introduced the zoning concept based on the principles of triaging.
Other services include Emergency Imaging and the Observation Ward that caters for patients requiring short-term observation up to 6 hours that would otherwise be admitted as inpatient. Such patients include those requiring rehydration, mild head injury, renal colic and abdominal pains.

A Call Centre that shall act as point for facilitation and networking of the emergency ambulance call services in its surrounding area is currently under construction.This comprehensive and integrated service is provided and coordinated by the ED Control and Dispatch Centre(CDC) and operates 24 hrs a day.

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