er

Bump !!!
ers ary Issue
Anniv VOLUME 3,ISSUE 6

Jan-February 2011

JPN Apex Trauma Centre Newsletter Inside this issue:

Message - MC Misra, Chief, JPNATC Trauma Conference- 2

2010
It gives me immense pleasure to release the anniversary issue
of JPNATC newsletter.
We have completed 3 years of full-fledged operations at JPNATC Department in Fo- 3
. 2010 was a water-
shed year in JPNATC’s short history as we could consolidate cus-Blood bank
all patient care activi-
ties, build a disaster complex and recruit more nurses. With
the dedication of our
faculty, nurses, technicians and all other supportive and cleaning FCCS Course in 4
services, trauma
centre, AIIMS was adjudged the best trauma care hospital in Trauma
the country in the year
2009-10. Just to give everyone overview of the accomplishments,
let me share with
everyone the statistics from the start of trauma care at JPNATC Research Papers 5
– 1,20,251 patients
were seen in our ED, 15,415 patients were admitted to the trauma
centre and 14,117 (Neurosurgery, Or-
thopedics and Trauma Surgery including plastic and reconstr
uctive) major operations were performed in-
cluding some land mark operations (Supratim Dutta, Adamo and Neurosurgical HDU &
Bhubaneshwar). Over 2,27,165 radiological
investigations were performed despite acute shortage of radiogra CCTV 6
phers prevailing at the centre. More than
10,74,899 laboratory tests were performed by laboratory services
which is one of the best laboratories in
the country. Over 20,000 units of packed red cells were issued
by our blood bank and 13,535 voluntary
donations were received. The area, which did not do well, organ
donation from brain dead declared head Celebrations & Fare- 7
injured patients’ families. Religious myths and beliefs of various
kinds are responsible for dismal rate of well Party
conversion. We need to put increased efforts in this area. Dedicat
ed nurse counselors can contribute a lot
towards improving ratio of brain dead and organ donation. Another
area which needs concerted efforts by
all the clinical units (faculty, residents and nurses) in collabor
ation with HIC team, to bring down unproduc-
tive use of antibiotics by formulating empiric and other antibiotic Awardees of Trauma 8
policy of our institution. It will go a long
way to rationalize effective use of antibiotics and as a result 2010
bring down the menace of antibiotic resis-
tance and cost of care to a large extent. I would urge the entire
clinical faculty to take leading role and
cooperate with HIC Unit with an open mind. Antibiotics have
never solved all infection problems and that
is the reason despite extensive use of antibiotics has not brought Highlights of Trauma
down the gigantic problem of infection
related mortality and antibiotic resistance is ever increasin 2010
g. I am happy to welcome newly appointed
nurses in the trauma centre family. With the increase in the number
of nurses, fresh challenges such con-
sistency of nursing care have emerged and continuous training,
upgradation and supervision are required to
maintain the high standards and bring them at par with internat
ional levels. Steps in this direction have
already been taken and I am sure that we will continue to set
new benchmarks in research, nursing and
patient care this year. I would like to see that for all patient
transfers from one area to another in the
hospital, the patient is accompanied by nurse and a doctor to
prevent avoidable complications leading to
untoward outcome. Keeping hospital clean is a Herculean task
and our cleaning services are try their best
but there is always room for improvement and I look forward
cooperation everyone in trauma centre to-
wards achieving this goal. I would urge the entire faculty, nurses,
residents, technicians and everyone to
show compassion and welcome all patients with a smile and empathy.
Patients are our teachers.
I congratulate Dr. Deepak Agrawal and his team of dedicated
nurses for successfully bringing out anniver-
sary issue of newsletter. God bless us all and keep us healthy
to care for others.
FCCS Course in Trauma

FROM THE EDITOR’S DESK

Wow, how time flies! It’s been
one full year since we started and
are already onto the 3rd volume &
sixth issue of the newsletter. We
have received many accolades and
some brickbats and have tried to
consistently improve the quality of content and
printing of the newsletter for your reading pleas-
ure without changing the ‘look’ of the newsletter.
In this issue we bring you the highlights of
‘Trauma 2010’ especially the nursing subcon-
ference, besides showcasing ‘blood-bank’ as
the department to be highlighted this month.
JPNATC website also continues to evolve and I
would like you all to preview the ‘Statistics’
section on the site and about which I will ex- Welcome to Sr Sulekha
pand in the next issue. (Acting NS for JPNATC)
drdeepak@gmail.com

1
 ‘TRAUMA 2010’-3rd International conference
HIGHLIGHTS
also organized to discuss the
3rd International Trauma conference was held
need for emergency trauma
from 26th-28th of Nov 2010 in
nursing as a
JPNATC,AIIMS. Preconference work-
separate spe-
shops were held on 26th which in-
cialization
cluded different areas like Basic life
which included
Support,
faculty, INC
FCCS
personnel's & Inaugration by Maj.Gen J K Bansal
,Trauma Ra-
seniors from
diology, Pre
Release Of Souvenir Of Trauma 2010
nursing field of different hospitals in
emergency
Delhi.
Care, Research Methodology,
Brachial plexus Injury, Pelvic The conference consisted of interactive talks by Ms
Inaugartion Of Trauma Confer-
ence2010 trauma, Spinal injuries, Karen (senior nurse practitioner & manager, Shock
Trauma Centre,
physiotherapy & Baltimore, USA),
Trauma Nursing. Ms Nancy ( trauma
27th & 28th we program director,
had the confer- VCU health sys-
ence at Sirifort tems , medical col-
Auditorium. lege of Virginia ),
Dr Sanjeev Bhoi,
Trauma
Dr Deepak
nursing workshop
Agrawal, Dr San-
was a interactive
jeev Lalwani
initiative which
(Faculty of
brought the dele-
JPNATC )& Faculty
gates more in-
volved in the workshop. Every delegate brought post-
from College
ers related to Trauma Care which was exhibited &
of Nursing ,
evaluated. Workshop was mainly on Research paper
AIIMS.
writing by Dr Deepak Agrawal & Related to the pre-
vention of infections in trauma patients .Along with About 130
the invited speakers we had International faculty nurses from
which exposed the outreach of research studies all over In-
among nurses so as to have an evidenced based prac- dia attended
tice. We had 22 Research paper presentations from the confer-
delegates from all over India. Poster Exhibition was ence which
well appreciated by Our Director Prof R C Deka, Chief made it a
Prof MC Misra & CNO Ms Nirmal Kalra who always sup- great suc- Trauma Nursing Conference-2010
ports us in our all ventures . An advocacy meeting was cess.
Page 2
JPN Apex Trauma Centre Newsletter

2
 Department in Focus-BLOOD BANK,JPNATC
Blood Bank is a vital part of a (PRC).Since Au-
Trauma care centre. Our Blood Bank was gust, 2009 Cryo-
initially designed as a Blood Storage centre precipitate (Cryo)
to care the immediate demands of trauma is also prepared
patients. It was started in November 2006 additionally which
as storage center with the guidance and made the blood
support of the Chief, JPNATC and the bank a 100% com-
blood bank at CN Center, AIIMS and had a ponent separation
skeleton staff of 1 technical officer and 1 facility, some com-
technician. The blood storage center was ponents like Plate-
functional lets and FFP are surplus in the stock. These
only during surplus blood components are issued to the
the routine other government blood banks like Main blood
duty hours bank AIIMS, GB Pant hospital Blood bank,
and emer- Blood Bank Team ESI blood bank etc. where these are issued to
gency hours needy patients.
demands were sent directly to the CNC ACADEMIC ACHIEVEMENTS of staff of blood bank, JPNATC
blood bank. • A Maximum Surgical Blood Ordering Schedule (MSBOS) has
Presently the blood bank has a staff been prepared for the Depart-
strength of 1 Faculty In-charge, 2 ments of Orthopedics, Surgery
Assistant Blood Transfusion Offi- and Neurosurgery. MSBOS for
cers, 1 Technical Officer, 4 Nursing orthopedic trauma surgeries is
staff,11 Technicians, 7 Laboratory published in the Journal of
attendants, 1 Social Worker and 1 Emergency, Shock and Trauma
Data Entry Operator. After the JETS I 3:3 I Jul - Sep 2010
Screened & Packed Blood Products • Patients who undergo mas-
issue of the license the blood bank
was fully functional, complete with a sive transfusion are retrospec-
blood donation complex, component separation laboratory and an tively recorded and their ef-
Infectious marker laboratory, from 28th March, 2008. Since that fects on the clinical outcome
day the blood bank at JPNATC has been functioning as a fully were studied(under publication
fledged blood bank collecting blood from donors, processing the in JETS)
collected blood units • A Trauma patient with M
into various blood com- antibody – a case report was
ponents, doing the man- Assisting Voluntary donors for Blood
published in Indian Journal of
datory testing of the pathology and Microbiology
Donation 2010: volume53; issue 3:580-
collected blood for the
transfusion transmit- 581
ted infections screening • Blood Transfusion Practices in Level I Trauma Centre: One
and issuing of the blood/ year retrospective review published in Singapore Medical
components to the needy Journal 2010; 51(9), pg 736-740
patients admitted in the In the Trauma conferences
trauma center. November 2008, two posters and one paper were presented
• The paper presentation on ‘Blood ordering schedule for elec-
BLOOD DONATION in tive Orthopedic surgeries: one year experience in a tertiary
the blood bank, JPNATC trauma care centre in Northern India won the best paper award.
Counseling Blood Donors The blood donors coming • The poster presentation on ‘Blood Transfusion Services in
into the blood bank are required to fill a questionnaire form after JPNATC- A 20 month retrospective analysis’ won the best poster
which each donor is screened as per rules to confirm if the individual is award.
fit for blood donation or not. Bleeding room has 4 comfort- • A second poster on ‘Occurrence
able blood donor couches and are maintained by well of Cold Antibodies in a Trauma care
trained medical and nursing staff who care for the donor center’ was presented
till he/she is bled and leaves the donation complex with a Trauma Conference 2009
comfortable experience. • Poster presentation on “Challenges
Emergency blood demands of trauma of running emergency transfusion ser-
patients are immediately met and vices in a level 1 trauma center” won
the next day the social worker the best poster award.
posted in the blood bank and the
• An audit of Fresh Frozen Plasma
faculties of the related depart-
(FFP) usage in a tertiary referral
ments motivate the near relatives
trauma care centre was presented
and friends of the trauma patients
orally and won the second prize.
to donate blood in order to replace the units
Trauma Conference 2010
which were previously obtained. Excess blood
demands for unidentified/ unattended trauma • Paper on Elective Blood Ordering Schedule for General Sur-
patients, massively transfused patients who fail gery and Neurosurgery Departments in a Tertiary Trauma care
Screeening and Blood Testing to survive etc are met by the voluntary blood Centre in India- won the best paper award
donation camps held in various places of Delhi • Paper on Influence of Blood Transfusion on the immediate
and nearby areas of Delhi. Occasionally such camps are organized in outcome of trauma patients: Retrospective study in a tertiary
doors within our campus. trauma care centre in Northern India
COMPONENT SEPARATION FACILITY at blood bank, JPNATC,
AIIMS “THE MAIN AIM OF THE BLOOD BANK IN JPNATC, AIIMS IS
The blood bank at JPNATC is a 100% component processing unit. All the THAT NO PATIENT SHOULD BE LOST DUE TO THE NON-
blood units that are collected are separated into 1.Packed Red Blood AVAILABILITY OF SAFE BLOOD/ BLOOD PRODUCTS and the
Cell (PRBC),2.Fresh Frozen Plasma (FFP),3.Platelet Rich Concentrate staff in the blood banks works sincerely towards attaining
this goal “
Page 3
VOLUME 3,ISSUE 6

3
 Fundamental Critical Care Support (FCCS) Course
Dr Babita Gupta
The Society of Critical Care experience made the course an enriching
Medicine’s (SCCM) internationally renowned experience. The FCCS course helped to
FCCS Course was conducted for the first disseminate basic concepts of critical
time in JPNATC, AIIMS on 25th and 26th care to all professionals who might be
November called upon to
2010. We ex- care for se-
press our sin- verely ill pa-
cere grati- tients. Indi-
tude to Prof. viduals who
M.C. Misra, will success-
Chief of the fully complete
JPNA Trauma the provider
Centre, who or instructor
has con- course will re-
stantly sup- ceive a Cer-
ported and tificate of
provided en- FCCS Faculty & Delegates with Chief Prof MC Misra Successful
couragement Completion.
in all academic activities in the centre. The The FCCS course offered an ap-
presence of distinguished national, interna- proach to initial management of the criti-
tional faculty and inquisitive delegates made cally ill patient to providers not formally
the FCCS course at JPNATC, AIIMS par trained in critical care. Participants
excellence. learnt useful information about the ex-
The Society of Critical Care Medi- tended care of critically ill patients, es-
cine’s (SCCM) internationally renowned two pecially care related to mechanical venti-
day FCCS course is the resource for train- lation, monitoring, organ hypoperfusion,
ing non-intensivists, house staff, nurses, or and neurological support. Providers re-
other critical care practitioners on how to ceived guidance for acute problems en-
manage critically ill and injured patients ef- countered in the ICU and for sudden pa-
fectively. Didactic lectures, small group dis- tient deterioration. The FCCS Course
cussions with clinical scenario questions, content is an ideal curriculum for critical
skill stations with hands-on instruction and care residency training programs.

Page 4
JPN Apex Trauma Centre Newsletter

4
 Research :Nursing interaction with patients relatives- effect on satisfaction
with patient care in the ICU Mr Geo Thomas

BACKGROUND- One of the most common reasons test ICU. RESULTS:In the test ICU, 50 relatives
for dissatisfaction with care of critically ill pa- filled the questionnaire and all 50 (100%) reported
tients is the lack of communication between the that patient information was being conveyed to them
healthcare workers and the patients’ relatives. in every shift. All 50 (100%) were also satisfied with
However, the role of nurses as a ‘communication level of communication with the healthcare workers.
bridge’ with the relatives has not properly
studied. Objectives-A study to assess the This Research presentation won First prize
interaction of nursing staff with patient’s in Nursing Conference of Trauma-2010
family of patient admitted in neurosurgery
ICU & common ICU and its results on satisfaction In the control ICU, ten (25%) of the 50 relatives re-
with patient care. METHOD- In this prospective ported that patient information was being conveyed
study carried out over a two month period (June- to them, although not in every shift. The rest (75%)
July 2010), it was made mandatory for nurses in said that no reported that patient information was
neurosurgery ICU (Test ICU) to discuss their pa- being conveyed to them. 100% (50/50) said that they
tients condition with the relatives ion every shift were dissatisfied with level of communication with
and note this down as ‘relative notes’ in the nursing the healthcare workers CONCLUSION- Our study
chart. No such intervention was used in the common shows that timely communication with patient family
ICU (control ICU). Fifty relatives each of both the members by nurses can markedly improve satisfaction
test ICU & control ICU were subjected to a ques- levels and effectively bridge the communication gap
tionnaire during the study period. The ‘relative that exists between healthcare professionals & pa-
notes’ written in nursing record were compared tients’ relatives, especially in the ICU setting.
with the results of the questionnaire in case of the

Research :Does implementation of START triage criteria in emergency depart-

ment reduces over and under-triage of patients presenting to emergency de-
partment of a trauma centre? Mr Rakesh kr
Background and objectives: Appropriate triage triage was defined as patients re-triaged from Y to
shortens the delay in definitive care. We studied R or G to Y within 30min of arrival.
whether implementation of START This Research presentation won Second prize in
triage criteria in emergency
Nursing Conference of Trauma-2010
department (ED) reduces over and
under-triage of patients .To study
the impact of START triage criteria on over and Results: Out of25,928 patients triage was done in
under-triage subjects. 25,468 (98.2%) subjects.. 8303 were triaged in
the morning shift,6994 in evening shift and 9978 in
Methodology: study was done between January to the night shift. 1431(5.6%)subjects were tagged as
15th September 2008. All patients presenting to the R,10,634 (41.7%)with Y and 13424(52.7%) were
ED were recruited. A triage nurse tagged the tagged as G. 474 /25,468 ( 1.9%) patients were
patients with red, yellow and green wrist band as per over-triaged. 220/25,468(0.9%) were under-
START triage protocol. Over triage was defined as triaged. Conclusion: START triage criteria reduces
patients who were re-triaged from red(R) to yellow over and under triage of patients.
(Y) or Y to green (G) within 30min of arrival. Under-

Page 5
VOLUME 3,ISSUE 6

5
 Renovated Neurosurgery High dependency unit
(HDU ) starts functioning at JPNATC
equipments so as to have
Our Trauma Center better patient care.
is having a 30 bedded neurosurgical Every bed is having a
Ward & 20 bedded dedicated ICU.. white board attached to
However, since some patients require the bedside which
step down unit after shifting from includes the Patients
ICU, a new cubicle was renovated as identification ,
high dependency unit (HDU) in the procedures done & Day of Hospital Stay.
ward. We stared it as 6 bedded unit We hope the new methods
which was a bit congested and showed adopted will surely help in reducing the
increase in infection rate. So we again changed the unit as infection rate and help in effective patient care.
4 bedded unit with adequate spacing & monitoring

INTEGRATED CCTV SYSTEM ACTIVE AT JPNATC

We are proud to tem there is a another camera
have inte- network
grated integrated
CCTV sys- with the
tem all ‘Intelligent
over building
JPNATC. manage-
The sys- ment sys-
tem has Intelligent Building Management tem’ which
Software
Central Monitering Station in Computer Facility, several monitors Camera Monitoring all lift entry & exit
JPNATC unique features. the movement of people auto-
matically and ensures
This safety of staff at all
is one times. Cameras in this
of system have been in-
the stalled in all access con-
few trolled lifts as well as
sys- common areas for 24 X
Centralized Moniotering tems 7 surveillance and archi-
for Lift Cameras
which val. Recordings from ALL
is IP based and which makes cameras are automati-
it technologically the most Outdoor Camera In Ambulance Bay Camera inside the lift cally stored for long

advanced in the world. Also the
cameras have full pan, tilt & zoom
capability so that wide & flexible
coverage can be obtained. There
are also 5 outdoor cameras which
are temperature & humidity con-
trolled to cover the whole campus
in all seasons.
In addition to the IP based sys-
Out Door Camera for waiting Hall
Page 6 JPN Apex Trauma Centre
periods for easy retrival in case
of any incident. Many thefts
and incidents have been de-
tected retrospectively using
this system. We are proud to
say that in spite of being one of
the most advanced systems,
this is also one of the most
cost-effective solutions imple- Outdoor Camera for parking area
mented at JPNATC.

6
 NURSING CELEBRATIONS
On 16th Oct whole occasion. The New Computerized
Trauma Family had a get to- store indent system was explained
gether on behalf of the suc- by Ms Poonam Bewal. This is a
cessful completion of com- fully automated system for indent
mon wealth ward and the in- applicable all over JPNATC. Now
auguration of the new store nurses can send computerized in-
indent system. The welcome dents from their wards/ICU’s and
Prof MC Misra welcomed by Ms Sunita anchored
Ms BN Danial, DNS address was given by Ms the program
the
Madhuri Sagar ,NS, JPNATC store
.We had Prof MC.Misra as our chief guest. Nurses can fulfill the inden-
who won the AIIMSONIAN’s of America awards sion of the system
were felicated at the function. These included Ms thus offering unpar-
Metilda CJ (Best nurse of the year alleled ease
2009).Ms Anjusha T & transpar-
Shera (Ms Sheeba ) with Mr Altaf
(Best nurse in re- ency in the (Skit)
search work year indent sys-
2009). Mr Ashish tem. Celebrations were added to its joy
(Best outgoing stu- with the cultural programs performed
dent for –OT techni- by our nursing staff Ms Rimpi Gupta,Ms
Prayer Song by Ms
cian course) was also Aleyama Biju,Ms Kiran Yadav,Mr Altaf & Ms Sheeba.
Welcome Speech by Ms Mad-
felicitated during the Asha & Ms Vilasini
huri Sagar,NS,JPNATC

FAREWELL TO Ms Madhuri & WELCOME TO Ms Sulekha

On 31st Dec 2010 chief Prof MC Misra,
JPNATC Family Medical Superindent Dr
gave the farewell Kamran
Sr Madhuri Sagar for our Nursing & all our
Superintendent Faculty Warm welcome
,Ms Madhuri Sagar & the warm and all to Sr Sulekha
wel- depart- Saha
Gathering..
come Token of Love from Nursing Department to mental
for Ms Sagar personnels.
We made the occasion a memorable one
for our sis-
ter with
Sr Sulekha, Chief Prof MC Misra,Sr celebrations
Madhuri Sagar,MS Dr Kamran & cultural
programs.
the acting NS,Ms Sulekha Sr Madhuri with family members along with
Saha. Invities included our Nsg Staff Cultural Programs By Nsg Dept

Page 7
VOLUME 3,ISSUE 6

7
 Congratulations to all awardees of TRAUMA-2010

Best Oral paper Best Oral Paper Best Oral Paper

I Prize ( Anes- Best Oral Paper Best oral pa- Best oral paper I Best oral pa-
II prize( Anes- I Prize (Sx Best Oral Paper
thesia Track) & II prize per II prize prize (Neuro per II prize
thesia Track ) Track) & Best I prize( Ortho
also Best Poster (Emergency Poster I prize- (Othro surgery)-Dr (Neuro sur-
I Prize-Dr Dr Nita D’souza Ms Venencia Track)-Ms Nidhi Track)-Dr Naufal Basheer gery)-Dr Vivek
Neetu Jain Track ) Dr Tej
Albert Bhardwaj Amit Kapoor Tandon
Prakash Sinha

Best Oral Best Oral Best Poster I

Best Oral Paper III Prize Best Poster II Best Best Poster III
Paper I Prize Paper II Prize Prize (Trauma
(Trauma Nsg)- (Trauma Nsg)- (Trauma Nsg)-Ms Anjusha T Prize - Ms Poster III Prize -Ms Ja-
Nsg ICU Track) &
Mr Geo Tho- Mr Rakesh also Best Oral Sunita A Nair Prize - Mr cinta Gunjiyal
mas Yadav Paper III Amit Kr
(Trauma Nsg) - Gupta
Ms Metilda CJ

Best Poster I Prize Best Poster II Best Poster I prize (Trauma Best Poster I Prize Best Poster II Best Poster II Best Poster II
(Trauma Nsg-pre Prize (Trauma (Trauma Nsg-other (Trauma Nsg Prize (Trauma Prize (Trauma
Nsg-Emergency Care track)-Ms
hospital track)-Ms Nsg- Prehospital Catogary)-Ms Nsg Other Nsg-Emergency
Kondru Shyamala & Mr Balraj ICU Care)-Ms
Rasmi Rekha Bora Track) -Ms Girija Sharma Catogory) Mr Care)-Ms Anu
Shawami Shallu Chauhan
Aleena Don Bala Murugan Susan

RECENT MARRIAGES

Ms Rekha Pal ,Asst Dietician got mar- Ms Metilda CJ working as Nurse informatics Ms Rimpi Gupta working as TNC got
ried on 14th Dec 2010 Specialist got married on 22nd Jan 2011 married on 16th Jan 2011

ARTICLES (MEDICAL/NONMEDICAL) ARE SOLICITED WITH PHOTO OF AUTHOR FOR THE

JPNATC NEWSLETTER & CAN BE SENT TO metildajose@gmail.com
(The decision of the editors for printing will be final and articles’ will not be returned)

Published & printed by Dr Deepak Agrawal on behalf of JPNATC,AIIMS.

8 For internal circulation only