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48 Emergency care of VIPs: Need for a protocol The All India Institute of Medical Sciences (AIIMS) being a premier medical institution carries the obligation to provide medical cover- age to VVIPs (Very very important persons) as well as VIPs. The Institute has a protocol for the management ofVVIP medical emergencies but none for VIPs. Moreover, I have been told that the VVIP management protocol should not be invoked for VIPs. VIPs visit a hospital much more frequently than VVIPs and I suggest that to streamline functioning our hospital should have a protocol for their emergency care. Here is a scenario that is commonly witnessed during the visit of a VIP to the emergency service of AIIMS. The hospital authorities are informed that a VIP is being brought from a nearby state. A private room is kept ready, the emergency staff are told that the concerned consultant should be called as soon as the patient arrives. The VIP patient then arrives along with at least 20 attendants. Though the patient is walking and does not require any emergency treatment, his entourage stays with him inside the limited space of the emergency room. This not only disrupts the routine casualty activity but hampers the care of other patients. Notices THE NATIONAL MEDICAL JOURNAL OF INDIA VOL. 8, NO.1, 1995 The VIP is, according to me, anyone who has, by virtue of his fame or the level of public interest in him, the capacity to substantially disrupt routine patient care. He may be a minister, senior bureaucrat, local politician or even a businessman well known to the authorities. Most problems arise not because of the VIP himself but because his entourage has unreasonable expectations, makes im- possible demands and takes the efforts of the treating doctors for granted. VIPs are here to stay and their management and that of other patients can be made much more efficient if we pay attention to a few details. l.It must be made explicit to everybody work- ing in the casualty department exactly who is in charge. 2.The clinican should follow standard clinical procedures in the evaluation and management of the medical problem of the VIP. He or she should not allow himself to get entangled with administrative issues or be swept away by the VIP's aura. 3. While making clinical decisions it is probably safest to give the benefit of doubt to the patient, i.e. pander a little to his whims but the physician should not ask for too many consultations just to protect himself. There is a well known phenomenon of senior faculty members, who are usually not seen around the casualty depart- ment, interfering with the work of the casulty team so that the VIP registers their presence. 4. The VIP's personal security guards should have close and effective liason with the hospital security staff so that all those who are not needed in the emergency department are kept out. This will minimize the circus-like atmos- phere that is quite often generated by powerful clinical administrators, physicians and other personnel who get attracted towards the emergency room. 5. Though hospitals have their own designated spokesmen to brief the press about the medical problems of a VIP, the primary responsibility of the casualty team is to safeguard the patient's privacy. The other patients or hospital staff have no right to know the medical details of the VIP and they must not be divulged even in a casual manner. 6. It is against fundamental medical ethics to care for one patient at the cost of others. The physician incharge should see that the human. and material resources are evenly distributed. 30 November 1994 L. R. Murmu Department of Emergency Medicine All India Institute of Medical Sciences New Delhi 1. X Annual Convention of the Indian Virological Society, Trivandrum, Kerala 16-18 January 1995 Information: J. Shanmugam Department of Microbiology Sree Chitra Tirunal Institute of Medical Science and Technology Trivandrum 695011 Kerala India 2. First International Conference on Lifestyle and Health, New Delhi 20-21 January 1995 Information: Bimal K. Chhajer Department of Physiology All India Institute of Medical Sciences Ansari Nagar New Delhi 110029 India 3. Second International Conference on Dietary Assessment Methods, Boston, Massachusetts, USA 22-24 January 1995 Information: Conference on Dietary Assessment Methods Harvard School of Public Health 677 Huntington Avenue LL-23 Boston, MA 02115-6023 USA 4. Third International Congress on Biological Response Modifiers, Cancun, Mexico 26-29 January 1995 Information: CME Inc. POBox 712 Princeton Junction NJ 08550 USA 5. Forty-ninth Indian Dental Conference, Ludhiana, Punjab 27-31 January 1995 Information: Bahgwant Singh A-6 Gurudwara Shaheedan Road Model Town Ludhiana Punjab India 6. Fifth International Congress on Anti-Cancer Chemotherapy: Neoadjuvant, adjuvant, and experimental, Paris, France 31 January-3 February 1995 Information: David Khayat SOMPS-Hopital de la pitie-salpetriere 47 Boulevard del'Hopital . 75651 Paris Cedex 13 France 7. Fifty-third All India Ophthalmological Society Conference, Bombay, Maharashtra 2-5 February 1995 Information: Kirit K. Mody Salil Eye Clinic 506 Om Chambers 123 August Kranti Marg Kemps Comer Bombay 400036 Maharashtra 8. Molecular Biology of Cancer: Implications for Prevention and Therapy, Maui, Hawaii 13-18 February 1995 Information: American Association for Cancer Research Public Ledger Bldg 620 Chestnut St Suite 816 Philadelphia PA 19106 USA 9. XII International Conference on Calcium Regulating Hormones, Melbourne, Australia 14-19 February 1995 Information: Secretary, XIith ICCRH c/o St Vincent's Institute of Medical Research 411 Victoria Parade Fitzroy Victoria 3065 Australia

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Page 1: NOTICES - The National Medical Journal of Indiaarchive.nmji.in/approval/archive/Volume-8/issue-1/... · 2016-01-15 · 7. Fifty-third All India Ophthalmological Society Conference,

48

Emergency care of VIPs: Need for a protocol

The All India Institute of Medical Sciences(AIIMS) being a premier medical institutioncarries the obligation to provide medical cover-age to VVIPs (Very very important persons) aswell as VIPs. The Institute has a protocol forthe management ofVVIP medical emergenciesbut none for VIPs. Moreover, I have been toldthat the VVIP management protocol shouldnot be invoked for VIPs. VIPs visit a hospitalmuch more frequently than VVIPs and Isuggest that to streamline functioning ourhospital should have a protocol for theiremergency care.

Here is a scenario that is commonly witnessedduring the visit of a VIP to the emergencyservice of AIIMS. The hospital authorities areinformed that a VIP is being brought from anearby state. A private room is kept ready, theemergency staff are told that the concernedconsultant should be called as soon as thepatient arrives. The VIP patient then arrivesalong with at least 20 attendants. Though thepatient is walking and does not require anyemergency treatment, his entourage stays withhim inside the limited space of the emergencyroom. This not only disrupts the routine casualtyactivity but hampers the care of other patients.

Notices

THE NATIONAL MEDICAL JOURNAL OF INDIA VOL. 8, NO.1, 1995

The VIP is, according to me, anyone whohas, by virtue of his fame or the level of publicinterest in him, the capacity to substantiallydisrupt routine patient care. He may be aminister, senior bureaucrat, local politicianor even a businessman well known to theauthorities. Most problems arise not becauseof the VIP himself but because his entouragehas unreasonable expectations, makes im-possible demands and takes the efforts of thetreating doctors for granted.

VIPs are here to stay and their managementand that of other patients can be made muchmore efficient if we pay attention to a fewdetails.

l.It must be made explicit to everybody work-ing in the casualty department exactly who isin charge.2.The clinican should follow standard clinicalprocedures in the evaluation and managementof the medical problem of the VIP. He or sheshould not allow himself to get entangled withadministrative issues or be swept away by theVIP's aura.3.While making clinical decisions it is probablysafest to give the benefit of doubt to the patient,i.e. pander a little to his whims but the physicianshould not ask for too many consultations justto protect himself. There is a well known

phenomenon of senior faculty members, whoare usually not seen around the casualty depart-ment, interfering with the work of the casultyteam so that the VIP registers their presence.4. The VIP's personal security guards shouldhave close and effective liason with the hospitalsecurity staff so that all those who are notneeded in the emergency department are keptout. This will minimize the circus-like atmos-phere that is quite often generated by powerfulclinical administrators, physicians and otherpersonnel who get attracted towards theemergency room.5. Though hospitals have their own designatedspokesmen to brief the press about the medicalproblems of a VIP, the primary responsibilityof the casualty team is to safeguard the patient'sprivacy. The other patients or hospital staffhave no right to know the medical details ofthe VIP and they must not be divulged evenin a casual manner.6. It is against fundamental medical ethics tocare for one patient at the cost of others. Thephysician incharge should see that the human.and material resources are evenly distributed.

30 November 1994 L. R. MurmuDepartment of Emergency Medicine

All India Institute of Medical SciencesNew Delhi

1. X Annual Convention of the IndianVirological Society, Trivandrum,Kerala 16-18 January 1995Information:

J. ShanmugamDepartment of MicrobiologySree Chitra Tirunal Institute of

Medical Science and TechnologyTrivandrum 695011KeralaIndia

2. First International Conference onLifestyle and Health, New Delhi20-21 January 1995Information:

Bimal K. ChhajerDepartment of PhysiologyAll India Institute of Medical

SciencesAnsari NagarNew Delhi 110029India

3. Second International Conference onDietary Assessment Methods, Boston,Massachusetts, USA22-24 January 1995Information:

Conference on Dietary AssessmentMethods

Harvard School of Public Health677 Huntington Avenue LL-23Boston, MA 02115-6023USA

4. Third International Congress onBiological Response Modifiers,Cancun, Mexico 26-29 January 1995Information:

CME Inc.POBox 712Princeton JunctionNJ 08550USA

5. Forty-ninth Indian DentalConference, Ludhiana, Punjab27-31 January 1995Information:

Bahgwant SinghA-6 Gurudwara Shaheedan RoadModel TownLudhianaPunjabIndia

6. Fifth International Congress onAnti-Cancer Chemotherapy:Neoadjuvant, adjuvant, andexperimental, Paris, France31 January-3 February 1995Information:

David KhayatSOMPS-Hopital de la

pitie-salpetriere47 Boulevard del'Hopital

. 75651 Paris Cedex 13France

7. Fifty-third All India OphthalmologicalSociety Conference, Bombay,Maharashtra 2-5 February 1995Information:

Kirit K. ModySalil Eye Clinic506 Om Chambers123 August Kranti MargKemps ComerBombay 400036Maharashtra

8. Molecular Biology of Cancer:Implications for Prevention andTherapy, Maui, Hawaii13-18 February 1995Information:

American Association for CancerResearch

Public Ledger Bldg620 Chestnut StSuite 816 PhiladelphiaPA 19106USA

9. XII International Conference onCalcium Regulating Hormones,Melbourne, Australia14-19 February 1995Information:

Secretary, XIith ICCRHc/o St Vincent's Institute of

Medical Research411 Victoria ParadeFitzroy Victoria 3065Australia

Page 2: NOTICES - The National Medical Journal of Indiaarchive.nmji.in/approval/archive/Volume-8/issue-1/... · 2016-01-15 · 7. Fifty-third All India Ophthalmological Society Conference,

THE NATIONAL MEDICAL JOURNAL OF INDIA VOL. 8, NO.1, 1995 NOTICES

10. Second International Congress on 15. Fifth International Symposium on 21. The International Society of MagneticVitamins and Biofactors in Life Highway Pollution, Copenhagen, Resonance, Sydney, AustraliaSciences (ICVB), San Diego, Denmark 22-25 May 1995 15-20 July 1995California, USA Information: Information:1~19 February 1995 Ron Hamilton Les FieldInformation: Middlesex University ISMAR-95

Susan J. Buntjer Bounds Green Rd Department of Organic ChemistryConference Co-ordinator and London N11 2NQ University of Sydney

Supervisor UK Sydney NSW 2006The Scripps Research Institute Australia10666 North Torrey Pines Road 16. Ninth Congress of the WorldLa Jolla, CA 92037 Association of Emergency and 22. Ninth International Congress ofUSA Disaster Medicine, Jerusalem, Immunology, San Francisco,

Israel 28 May-2 June 1995 California, USA 23-29 July 199511. Fifteenth International Symposium Information: Information:

on Intensive Care and Emergency KENES American Assciation ofMedicine, Brussels, Belgium POB 50006 Immunologists21-24 March 1995 Tel Aviv 61500 9650 Rockville PikeInformation: Israel Bethesda, MD 20814

J. L. Vincent USADepartment of Intensive Care 17. International Society of TechnologyErasme University Hospital Assessment in Health Care, Eleventh 23. Tenth International Congress ofRoute de Lennik 808 Annual Meeting, Stockholm, Sweden Virology, Jerusalem, IsraelB-1070 Brussels 5-7 June 1995 11-16 August 1995Belgium Information: Information:

CONGREX (Sweden) AB Organizing Secretary12. Fourth International Congress on Au: ISTAHC, P.O. Box 5619 PO Box 50006

Travel Medicine, Acapulco, Mexico S-114 86 Stockholm Tel Aviv 6150023-27 April 1995 Sweden IsraelInformation:

ICTM4 8000 Westpark Dr 18. Eighth International Symposium on 24. Fourth National NeurotraumaSuite 130 Mclean Loss Prevention and Safety Conference, Cochin, KeralaVA 22102 Promotion in the Process Industries, 12-14 August 1995USA Antwerp, Belgium 19-22 June 1995 Information:

Information: A. N. Subba Rao13. Eighth International Conference on clo Ingenieurshuis vzw Department of Neurosurgery

Antiviral Research, Santa Fe, Desguinlei 214 Medical Trust HospitalNew Mexico, USA B-2018 Antwerpen Cochin 68201623-28 April 1995 Belgium KeralaInformation: India

Earl J. Kern 19. World Confederation for PhysicalDepartment of Pediatrics Therapy Congress, Washington 25. Thirty-seventh International CongressChildren's Hospital Tower D.C., USA 25-30 June 1995 on Alcohol and Drug Dependence,Suite 653 Information: San Diego, California, USAUniversity of Alabama American Physical Therapy 20-25 August 1995Birmingham Association Information:AL 35294 1111 North Fairfax Street San Diego, Alcohol, Tobacco andUSA Alexandria Other Drug Studies

VA 22314-1488 UCSD Extension14. Sixth International Centre for USA University of California

Biotechnology Symposium on 0176, 9500 Gilman DriveCytoplasmic Protein-Tyrosine 20. Third Endodontic World Congress, La JollaKinases, Stockholm, Sweden Rome, Italy 28 June-l July 1995 CA 92093-0176

12-14 May 1995 Information: USA

Information: Congress PresidentC. I. Edvard Smith and Mauno Viale Ippocrate 26. XXI International Congress of

Vihinen 97-00161 Roma Pediatrics, Cairo, EgyptKarolinska Institute Centre for Italy 10-15 September 1995

Biotechnology Information:Novum S 141 57 Huddinge Congress SecretariatSweden P. O. Box 161 Magles EI Shaab

Cairo 11516Egypt