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Emergency, Trauma & Critical Care

Overview

Continental Institute of Critical Care

Critical Care, as the name suggests, is required for patients facing a life-threatening health condition. Critical care deals with emergency services, especially for vital system organs that may be under risk of failure and can cause a fatality. Critical Care teams used advanced therapeutic, monitoring and diagnostic technologies to maintain organ systems and stabilize the patient’s condition for further treatment of the underlying condition. Continental Hospitals is the best hospital for critical care in Hyderabad, where doctors and patients have access to the most advanced tools and techniques available in acute care medicine.

An Intensive Care Unit (ICU) is at the heart of a Critical Care department. It needs a highly qualified and specialised team of doctors supported by a well-trained team of nurses and hospital staff. The ICU is headed by our Critical Care specialist who works in close coordination with experts and specialists of all specialities depending on the need of the patients. Experts at Continental Hospitals are the best doctors in critical care having experience in managing different kinds of emergency situations across patients of all ages.

Conditions like Sepsis, Trauma, Heart Attack, Respiratory Failure are dealt by critical care units. Handling such situations requires the most advanced high-precision equipment and instruments. It is also imperative that ICUs be maintained with a very high standard of infection control measures while providing round-the-clock services. At Continental Hospitals we pride ourselves in being the best hospital for emergency services in Hyderabad and being at the forefront of critical care in the country.

Why Choose Continental Hospitals for Critical Care?

Continental Hospitals is one of the few hospitals in Southern India to have a Level I trauma centre. This means that we can provide total and comprehensive care for patients in every aspect like

  • 24 hours in-house care by general surgeons and prompt availability of care in multiple medical specialities
  • Provide continuing education of the trauma team members
  • Incorporate a comprehensive quality assessment program
  • Operate an organized teaching and research effort to help direct innovations in trauma care
  • Meet minimum requirement for annual volume of severely injured patients
  • Provide leadership in the prevention, public education to surrounding communities

This makes Continental Hospitals the best hospital for emergency in Hyderabad.

We have the best doctors in critical care who have received extensive training in A&E services and ACLS protocols. It is key for critical care teams to have the ability to think on their feet and take spontaneous decisions. This is ingrained in each doctor, surgeon and nursing staff at Continental Hospitals, which is the best hospital for critical care in Hyderabad. Time is of utmost importance in the treatment of a patient who is brought in the emergency area, so availability of a multidisciplinary team of specialists round-the-clock at our hospital ensures good quality care and safety for the patient.

We have ultra-modern single room ICUs that are fully prepared with the latest ventilators, monitoring devices and other life support devices to provide the best care. Operation theatres at Continental Hospitals are equipped with seamless modular systems, controlled air and 3D monitoring systems to provide an optimum environment for our surgeons and staff in patient care.

Our Continental Life Care on Wheels Ambulance Service is efficient and has a high-tech line of ambulances that are available 24*7 to transport critically ill or injured patients. At Continental Hospitals, the emergency and trauma team provide individual patient care for acute care medicine, from emergency resuscitation, surgery, and intensive care, to rehabilitation. 

Critically ill or injured patients are admitted for treatment to the emergency department. There have been immense advancements in emergency diagnostics in the healthcare sector, which help critical care teams in making quick decisions and performing procedures that save precious time for critical patients. Diagnostic tests in the emergency department are done to rule out any conditions such as intracranial hemorrhage, pulmonary embolus, aortic aneurysm or dissection, and more. Continental Hospitals is the best hospital for emergency in Hyderabad providing the latest in critical care.

  • When is Critical Care required?

As ICU services are reserved for critical cases, it is important to evaluate carefully whether a patient needs critical care services. For this the process of sorting people based on their need for immediate medical treatment as compared to their chance of benefiting from such care is done which is called Triage. This is based on the ABCDE principles recommended by WHO’s Emergency and Essential Surgical care (EESC) program.

The ABCDE principles are:

  • A=airway obstruction to be cleared
  • B=breathing and ventilation -any chest decompression
  • C=circulation with hemorrhagic control
  • D=Disability or neurological damage
  • E=exposure/environmental control

Assessment of patients for critical care needs an array of diagnostic equipment.

  • Assessing the airway of the patient for blockages and clearing the airways need 
  • functioning laryngoscope with light
  • appropriate endotracheal tube
  • bag-valve-mask
  • oxygen source
  • suction
  • Breathing and ventilation of the patient is checked for respiratory distress, indication of chest decompression. The diagnosis includes
  • open pneumothorax or open chest wound to be treated
  • tension pneumothorax-air leakage from a punctured lung
  • hemothorax-collection of blood in the space between the chest wall and the lung
  • Defibrillators, that are devices that restore a normal heartbeat by sending an electric pulse or shock to the heart. They are used to prevent or correct an arrhythmia, a heartbeat that is uneven or that is too slow or too fast.
  • Circulation assessment due to hemorrhagic shock
  • Large volumes of blood may be hidden in thoracic, abdominal and pelvic cavities, or from femoral shaft fractures.
  • Assessment is done on physical parameters like the level of consciousness, skin color, pulse, confusion, and blood loss in adults, children, elderly and athletes vary
  • Disability or neurological damage to be checked by
  • level of consciousness using the Glasgow coma score (GCS)
  • pupils size and symmetry
  • any spinal cord injury
  • radycardia, hypertension may indicate worsening condition
  • Exposure/ environmental control
  • This involves examining the whole patient, child or adult, by removal of clothing but prevent hypothermia (exposure to extreme cold)

Some other diagnostics tests required for Critical Care patients are 

  • Blood gas test– This test measures the amount of oxygen and carbon dioxide in the blood. It may also be used to determine the pH of the blood, or how acidic it is.
  • Coagulogram- This is an analysis to find out about the main indicators of coagulation and anticoagulation systems of blood.
  • Capnography- It is the monitoring of the concentration or partial pressure of carbon dioxide in the respiratory gases and helps to determine the oxygen supply at the tissue level. 
  • Blood glucose monitoring– This is done with the help of using glucometers
  • Pulse oximetry- It is a method used to estimate the percentage of oxygen bound to hemoglobin in the blood.
  • Nerve conduction study– This measures how fast an electrical impulse moves through your nerve. NCV can identify nerve damage.

All these tests are performed rapidly to provide immediate diagnosis and make decisions regarding treatment of the critical care patients. Only the best doctors in Critical Care can make split second decisions to save lives in such stressful situations. Continental Hospitals is the best hospital for critical care in Hyderabad equipped with the people and procedures for providing emergency care and trauma care to the people who need immediate diagnosis and care.

Intensive care is required in emergency cases when the person is seriously ill and needs immediate treatment and close monitoring. Critical Care is also necessary for surgery patients who need to be observed during recovery. Continental Hospitals is the best hospital for critical care in Hyderabad offering the most sophisticated services for emergency cases.

There are many conditions and situations in which a person may need critical care. This could be

  • Accident – such as a serious road accident, a severe head injury, a serious fall or severe burns
  • Short-term emergency condition – such as a heart attack or stroke
  • Infection – such as sepsis or severe pneumonia
  • Major surgery – in this case ICU admission can also be planned as a part of your recovery or it can be an emergency measure in case there are complications

Conditions requiring critical care

Some of these conditions have been explained below.

  • Sepsis

    Sepsis is a potentially life-threatening condition in which an infection, bacterial, fungal or viral, has spread throughout the body. It is caused as a result of chemicals released in the body to fight the infection, which trigger an inflammation through out the body. This can cascade into multiple organ failure and sometimes result in death. Symptoms include fever, difficulty in breathing, low blood pressure, increased heart rate, and mental confusion. Antibiotics and intravenous fluids are administered to treat this condition.

  • Traumatic Brain Injury

    A traumatic brain injury is usually caused by a violent blow to the head. This may happen due to a sever sports accident or road accident etc. Serious TBIs can result in physical damage to the brain, which is why immediate critical care is required. Symptoms of TBI include blurry vision, confusion, and difficulty in concentrating. Paediatric patients may be irritable or cry persistently. Treatments include rest, medication and in some cases, surgery.

  • Heart Attack (Myocardial Infarction)

    Heart attack is the blockage of blood flow to the heart muscle, usually due to a blood clot. Without blood, the heart tissue cannot receive oxygen and dies. Patient experiences pain in the chest, neck, back or arms, fatigue, abnormal heartbeat and anxiety. In emergency unit, the damage to the heart is assessed by critical care specialists while cardiologist focus on clearing the blockage to allow blood flow to the heart muscles. Invasive procedures like inserting stents and bypass surgery may be required.

  • Trauma

    Injuries caused due to severe impact result in trauma. Trauma can affect any part of the body, including internal organs, brain, bones, and other soft tissues of the body. Trauma can be minor, due to small injury, or major, due to severe accident or mishap like car crash or fall. In case of polytrauma, patient is at risk of losing limb and life and needs immediate multi- speciality and critical care.

  • Respiratory Failure

    Respiratory failure happens when the oxygen level in blood becomes dangerously low or carbon dioxide levels increase. Blocking of airways, damaged lung tissue, weak chest muscles are the main causes of respiratory failure. In this case patient may need advanced oxygen therapy and artificial ventilator to restore respiratory function.

Critical care Procedures

Continental Hospitals has one of the largest Emergency departments in the country. We are the best critical care hospital in Hyderabad with ability to handle all types of medical and surgical emergencies, including trauma and toxicological cases. Being the best hospital for emergency in Hyderabad, we conduct many procedures that need multi-speciality involvement of our specialists and critical care experts. Some of these have been listed below.

  • Mechanical Ventilation

    Many patients in critical care may need assistance with breathing. Mechanical ventilation is a form of artificial respiration that uses a breathing machine, or ventilator. When lungs of the patient are not functioning properly, this breathing support helps in providing oxygen to the body and removing carbon dioxide. Extreme care is taken to ensure that patients do not develop infections of the lung, especially pneumonia. In case of Mechanical Ventilation, an airway tube instrument is positioned though the mouth into the lungs. Mechanical ventilation can be of two types

    • Positive Pressure Ventilation, where air is pushed into the trachea
    • Non-invasive Ventilation, where the breathing of the patient is partially assisted
  • Electrocardiogram (ECG)

    ECG is commonly performed to check the activity of the heart. An ECG shows the electrical activity of the heart by tracing waves on a paper, that have spikes and dips. The pattern of the waves enables doctors to check whether the patient’s heart is functioning properly. ECG is helpful in finding cause of chest pain, which may also be a heart attack. It can also be useful in detecting heart disease, thickness of the walls of the heart, monitoring efficacy of medication and check the health condition of the heart in presence of other conditions.

  • Arterial Line and Central Line

    It is essential to constantly monitor the blood pressure of a patient in critical care for safe treatment. For this purpose, the Arterial line is inserted for monitoring blood pressure by inserting a catheter into an artery of the wrist or groin. It can be used to monitor very high or very low blood pressures and also allow frequent blood sampling, as blood can be withdrawn easily from the catheter.

    Central line is for long term delivery of drugs and nutrition. It is place in a major vein of the body, such as the jugular vein or the subclavian vein.

  • Cardio-pulmonary Resuscitation (CPR)

    CPR is combination of life saving techniques to revive the lung and heart function of a critical patient. CPR is administered on patients whose heart or lungs have stopped functioning. Usually in case of cardiac arrest. CPR may include application of pressure on the chest, including with electric shock. Medications may also be used and artificial respiration be given using a face mask or breathing tube.

    Lack of oxygenated blood for a longer period of time can cause brain damage and can result in death within 5-10 minutes. With CPR, life can be saved as blood supply is restored to the brain and other vital organs.

Critical care is an essential part of hospital services. At Continental Hospitals, we have state-of-the-art ICUs led by the best doctors in critical care and well-trained staff. As the best hospital for critical care in Hyderabad, we pride ourselves in having an excellent track record of saving lives in critical conditions.

The Continental Institute of Critical Care has onboard the best critical care doctors in Hyderabad who are well-trained emergency physicians and have immense experience in handling emergency and trauma patients. Nurses at our hospital are also well qualified and ACLS trained. Our team is comprised of Competent Intensivists, Emergency Personnel, and Emergency Medical Trauma Technicians. We are the best hospital for critical care in Hyderabad and one of the only centres that has emergency medical services with advanced cardiac and life support ambulances. We maintain our standards by conducting regular mock drills for handling mass casualties on periodic basis. As a responsibility to the community at large, our emergency physicians and trauma technicians are especially trained to educate the general public and ORR patrolling police on handling trauma patients.

Critical care doctors at Continental Hospitals are reputed, knowledgeable and experienced in the area of emergency medicine and come from some of the most prestigious institutions in the country. Having won many accolades for their quality medical care and presence of mind during emergencies, they are internationally trained. They are part of many prominent societies and federations of Emergency medicine in India and overseas. Our doctors are the backbone of the emergency services at Continental Hospitals and make us the best critical care hospital in Hyderabad.

Dr Palepu Brindavana Naga Gopal

MBBS, MD (Anaesthesiology), FRCA,CCST,FICCM,FCCM

Chief of Critical Care and Senior Consultant Intensivist

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