Hospital Training Report Part-I (BP509P)

B.Pharm 5TH Semester

Session 2021-22

Dr. A.P.J Abdul Kalam Technical University

Lucknow

Government Pharmacy College, BRD Medical College Campus

Gorakhpur

Under the guidance of: - Submitted By:-

Dr. Pankaj Kumar Sonar (Asst. Prof.) Name:- ASHUWANI KUMAR
Roll Number:- 2009370509001
B.Pharm 3rd Year (5th sem)
Mob. No. +91 9456869339
 CERTIFICATE

This is to certify that Mr. ASHUWANI KUMAR has submitted the report on Hospital

training for partial fulfilment of B. Pharm V Semester, session 2021-22. The contents of the

report do not form the basis for the award of any other degree to the candidate or to anybody

else from this or any other University/Institution.

Supervisor Principal of Department

Dr. Pankaj Kumar Sonar Dr. GANESH KUMAR
Assistant Professor Professor
Government Pharmacy College Government Pharmacy College
BRD Medical College Campus BRD Medical College Campus
Gorakhpur Gorakhpur

…………………………………………………………………….

EXTERNAL EXAMINER
 ACKNOWLEDGEMENT

The training opportunity I had with BRD medical college, Gorakhpur was a great chance for

learning and professional development. Therefore, I consider myself as a very lucky individual

as I was provided with an opportunity to be a part of it. I am also grateful for having a chance

to meet so many wonderful people and professionals who led me though this training period.

I am using this opportunity to express my deepest gratitude and special thanks to Government

Pharmacy College, BRD Medical College Campus, Gorakhpur who in spite of being

extraordinarily busy with their duties gave us an opportunity so that we could learn something

so important.

I express my deepest thanks to DR. RAKESH KUMAR RAI CMS of BRD Medical College,

Gorakhpur and Mrs. SHOBHA KUMARI (Emergency Department Charge) for taking part in

useful decision & giving necessary advices and guidance and arranged all facilities to make life

easier. I choose this moment to acknowledge his contribution gratefully.

It is my radiant sentiment to place on record my best regards, deepest sense of gratitude to Mr.

D.N. Pandey (Chief Pharmacist) for their careful and precious guidance which were

extremely valuable for my study both theoretically and practically.

I perceive as this opportunity as a big milestone in my career development. I will strive to use

gained skills and knowledge in the best possible way, and I will continue to work on their

improvement.

Thanking You ASHUWANI KUMAR

B.PHARM 3rd YEAR

ROLLNO. 2009370509001

Mob No. 9456869339

 VISION

The vision of the Hospital training is to study the organization of various departments, the

working and development of the organization, the present status of the hospital & future

prospects of the organization. To promote civic sense and shoulder the responsibilities with full

potential by being a ultimate healthcare Professional and a Responsible Pharmacist.

The overall objectives of the study:-

 To study the Hospital structure.

• To know about its products and service activities.

• To know the different functions of all the departments.

• To know the responsibilities of top management and how to execute responsibility.

• To analyses the working of Hospital using by analysis of various departments.

 CONTENTS

1. Object 5

2. Introduction 6

3. Different departments of hospital 7

4. Emergency Department 8

5. First Aid 9-11

6. General ward 12-14

7. Surgical ward 14-17

8. Injection room 18

9. Parentral routes of administration 19-21

10. Pathology 22-27

11. Blood bank 28-30

12. Diagnostic report 31-33

13. Dispensary 33-34

14. Waste management 35

15. Summary 36

16. Observation 37

17. Conclusion 37
 Objectives

Objective of Training

 Hospital training is an observational oriented procedure in which a person

is able to learn practically from their theoretically knowledge."

 Hospital training provides practical knowledge to the student.

 Hospital training helps to study closely the ground level problem regarding

their job profile.

 Hospital training promotes an environment in which student are induced to

adapt themselves quickly to changed circumstances.

 Training provides practical knowledge to the students.

 Training puts the students in real life situation.

 Training removes the hesitation of the student regarding their working skill

and personality development.

 Training is mandatory as per A.I.C.TE. and affiliating universities and

pharmacy council of India.

 About Hospital

 Hospitals are centres of treatment. People from all corners of the society and all walks

of life converge here to cure themselves of their diseases.

 I did my training in BRD Medical College, Gorakhpur [273013]

 This is also known as “Baba Raghav Das Medical College’’ Gorakhpur

It is a centre for all types of medical facilities especially for the poor people.

 This training also made me realize the importance of hospitals for people and how it

affects even the day-to-day lives of them.

 Not only the patients but also the people working in the hospital are truly dependent on
it.
 This training report comprises of the whole summary of my training in this hospital
and what I learned from that.

 It was like a dream come true for citizens of Eastern part of Uttar Pradesh state, that is

Purvanchal, when the first seed of inception of this medical college was sown in

November of 1969.

 Its foundation stone was laid by the then Chief Minister of Uttar Pradesh Late Shri

Chandra Bhanu Gupta.

 It was named after a devoted freedom fighter Baba Raghav Das who was a prominent

Sarvoday Leader of this area and close associate of Mahatma Gandhi and Acharya

Vinoba Bhave.
 Different Departments in Hospital

There are a number of parts in a hospital. This large number of departments is responsible for

treating the patients of their diseases.

The various departments of hospitals covered in the hospital training are:-

1. Out Patient Department (OPD)

2. Emergency wards

3. General ward

4. Surgical ward

5. ICU (Intensive Care Unit)

6. NICU (Nursery Intensive Care Unit)

7. Injection Room

8. Pathology

9. Dispensary

10. Record Room

11. Waste Management

12. Ortho wards

13. Blood bank

EMERGENCY WARDS:-

An emergency department (ED), also known as an accident & emergency Department

(A&E),emergency room(ER ) or casualty department.

An emergency is a medical treatment facility specializing in emergency medicine, the acute

care of patients who present without prior appointment; either by their own means or by that
of an ambulance. The emergency department is usually found in a hospital or other primary
care center. Due to the unplanned nature of patient attendance, the department must provide
initial treatment for a broad spectrum of illnesses and injuries, some of which may be life-
threatening and require immediate attention. In some countries, emergency departments have

become important entry points for those without other means of access to medical care. The
emergency departments of most hospitals operate 24 hours a day, although staffing levels
may be viridian attempt to reflect patient volume.
 FIRST AID

FIRST AID TREATMENT

First aid is the assistance given to any person suffering a sudden illness or injury, with care
provided to preserve life, prevent the condition from worsening, and/or promote recovery. It
includes initial intervention in a serious condition prior to professional medical help being
available, such as performing CPR while awaiting an ambulance, as well as the complete
treatment of minor conditions, such as applying a plaster to a cut. First aid is generally
performed by the layperson, with many people trained in providing basic levels of first aid, and
others willing to do so from acquired knowledge. Mental health first aid is an extension of the
concept of first aid to cover mental health.

Aim:-

The key aims of first aid can be summarized in three key points, sometimes known as 'the three
P's'

Preserve life:-
the overriding aim of all medical care, including first aid, is to save lives and minimize the
threat of death.

Prevent further harm:-

also sometimes called prevent the condition from worsening, or danger of further injury, this
covers both external factors, such as moving a patient away from any cause of harm, and
applying first aid techniques to prevent worsening of the condition, such as applying pressure
to stop a bleed becoming dangerous.
Promote recovery:-

first aid also involves trying to start the recovery process from the illness or injury, and in
some cases might involve completing a treatment, such as in the case of applying a plaster to
a small wound.

Specific disciplines
There are several types of first aid (and first aider) which require specific additional training.
These are usually undertaken to fulfill the demands of the work or activity undertaken.

Aquatic/Marine first aid

It is usually practiced by professionals such as lifeguards, professional mariners or in diver
rescue, and covers the specific problems which may be faced after water-based rescue and/or
delayed MedEvac.

Battlefield first aid takes into account the specific needs of treating wounded combatants
and non-combatants during armed conflict.

Hyperbaric first aid may be practiced by SCUBA diving professionals, who need to treat
conditions such as the bends.

Oxygen first aid is the providing of oxygen to casualties who suffer from conditions
resulting in hypoxia.

Wilderness first aid is the provision of first aid under conditions where the arrival of
emergency responders or the evacuation of an injured person may be delayed due to
constraints of terrain, weather, and available persons or equipment. It may be necessary to care
for an injured person for several hours or days.

Mental health first aid is taught independently of physical first aid. How to support
someone experiencing a mental health problem or in a crisis situation, Also how to identify
the first signs of someone developing mental ill health and guide people towards appropriate
help.

Conditions that often require first aid

• Altitude sickness, which can begin in susceptible people at altitudes as low as 5,000
feet, can cause potentially fatal swelling of the brain or lungs.
 • Anaphylaxis, a life-threatening condition in which the airway can become constricted
and the patient may go into shock. The reaction can be caused by a systemic allergic
reaction to allergens such as insect bites or peanuts. Anaphylaxis is initially treated with
injection of epinephrine
• Battlefield first aid—This protocol refers to treating shrapnel, gunshot wounds, burns,
bone fractures, etc. as seen either in the ‘traditional’ battlefield setting or in an area
subject to damage by large-scale weaponry, such as a bomb blast
• Bone fracture, a break in a bone initially treated by stabilizing the fracture with a splint.
• Burns, which can result in damage to tissues and loss of body fluids through the burn
site.
• Cardiac Arrest, which will lead to death unless CPR preferably combined with an AED
is started within minutes. There is often no time to wait for the emergency services to
arrive as 92 percent of people suffering a sudden cardiac arrest die before reaching
hospital according to the American Heart Association.
• Heart attack, or inadequate blood flow to the blood vessels supplying the heart muscle.
• Heat stroke, also known as sunstroke or hyperthermia, which tends to occur during
heavy exercise in high humidity, or with inadequate water, though it may occur
spontaneously in some chronically ill persons. Sunstroke, especially when the victim
has been unconscious, often causes major damage to body systems such as brain,
kidney, liver, gastric tract. Unconsciousness for more than two hours usually leads to
permanent disability. Emergency treatment involves rapid cooling of the patient.
• Heavy bleeding, treated by applying pressure (manually and later with a pressure
bandage) to the wound site and elevating the limb if possible.
• Hyperglycemia (diabetic coma) and Hypoglycemia (insulin shock).
• Insect and animal bites and stings.
• Poisoning, which can occur by injection, inhalation, absorption, or ingestion.
• Muscle strains and Sprains, a temporary dislocation of a joint that immediately reduces
automatically but may result in ligament damage.
• Wounds and bleeding, including lacerations, incisions and abrasions, Gastrointestinal
bleeding, avulsions and Sucking chest wounds, treated with an occlusive dressing to let
air out but not in.

.
.
GENERAL WARDS:

A general ward is a large room in a hospital where people who need medical
treatment stay general in the wards.

Intravenous simple mean within vein . Therapies administered intravenously are

often included in the designation of specialty drugs

Intravenous infusions are commonly referred to as drips because many system

ad ministration employ to a drip, which prevent air from entering the blood stream

and allows as estimation of flow rate.

Intravenous therapy may be used to correct electrolyte imbalance, to deliver

medication, for blood transfusion are as a fluid replacement to correct, for

example dehydration intravenous therapy can also be used for chemotherapy.

Compare with other route of administration, the intravenous route is the fastest

way to deliver fluids and medication throughout the body. The bioabilability of

the medication is 100% in IV therapy.

During intravenous therapy, it use are as follows:-

1. Administration of drips

2. Administration of cannula

3. Administration of injection
 4. Measurement of blood pressure and temperature

5. Provides oxygen

SURGICAL WARDS:-

Surgical wards contain different types injured patients, accidental patient etc.
Surgical wounds can be classified as follows:

 Clean

 Clean contaminated: a wound involving normal but colonized tissue

 Contaminated: a wound containing foreign or infected material

 Infected: a wound with pus

 Close clean wounds immediately to allow healing by primary intention

 Do not close contaminated and infected wounds, but leave them open toheal by
Secondary intention

 In treating clean contaminated wounds and clean wounds that are more than
six hours old, manage with surgical toilet, leave open and then close 48 hours
later. This is delayed primary closure.

Dressing techniques

The following dressing techniques are easy to do and require no sophisticated

equipment. Clean technique is usually sufficient. Pain medication may be required
as dressing changes can be painful. Gently cleanse the wound at the time of
dressing change.

A. Wet-to-dry

Indication: to clean a dirty or infected wound.

Technique: Moisten a piece of gauze with solution and squeeze out the excess
fluid. The gauze should be damp, not soaking wet. Open the gauze Photo A and
place it over top of the wound to cover it Photo B. You do not need many layers
of wet gauze, Place a dry dressing over top. The dressing is allowed to dry out
and when it is removed it pulls off the debris. It's ok to moisten the dressing if it
is too stuck.
 How often: Ideally, 3-4 times per day. More often on a wound in need of
debridement, less often on a cleaner wound. When the wound is clean, change to
a wet-to-wet dressing or an antibiotic ointment.

B. Wet-to-wet

Indication: to keep a clean wound clean and prevent build-up of exudates.

Technique: Moisten a piece of gauze with solution and just barely squeeze out
the excess fluid so it's not soaking wet. Open the gauze and place it over top of
the wound to cover it. Place a dry dressing over top. The gauze should not be
allowed to dry or stick to the wound.

How often: Ideally, 2-3 times a day. If the dressing gets too dry, poor
saline over the gauze to keep it moist.

C. Antibiotic ointment
Indication: Antibiotic ointment is used to keep a clean wound clean and
promote healing.

Technique: apply ointment to the wound- not a thick layer, just a thin layer
is enough. Cover with dry gauze.

D. How often: 1-2 times per day. When to do which dressing

Remember, the goal is to promote healing. We know that a moist
environment facilitates healing.
 For a clean wound, it is best to use a wet-to-wet or ointment based
dressing
 For a wound in need of debridement the wet-to-dry technique should be
done until the wound is clean and then change to a different dressing
regimen.

Sharp Debridement

When a wound is covered with black, dead tissue or thick gray/green debris,
dressings alone may be inadequate. Surgical removal- sharp debridement-
iS
necessary to remove the dead tissue to allow healing.

Technique:-
 Sedation or general anesthesia may be required. However, usually the
dead tissue has no sensation, so debridement may be done at the bedside
or in the outpatient setting.
 Photos A & B: Using a forceps, grasp the edge of the dead tissue and
use a knife or sharp scissors to cut it off of the underlying wound.
 Bleeding tissue is healthy, so cut away the dead stuff until you get to a
bleeding base.
 The patient may only tolerate this for a short period of time. Additionally,
you don't want to cut off tissue that may be viable. So, you may have to
do this a little at a time, and repeat this procedure as needed until all of
the necrotic tissue has been removed.
 Photo C shows the wound after three weeks of wet-to-dry dressings.
INJECTION ROOM:-
In a word, an injecting room is a place where drug users can inject narcotic
substances in a supervised environment without risking police interference.
But services provided by injecting rooms can also be expanded to include
hygiene-enhancing information, offering clean injection equipment, the presence
of trained health workers and injection advice. When the setting up of injecting
rooms are discussed in Norway, what is meant is specially outfitted rooms either
standing alone or as part of a wider activity and/or care service for drug users,
where heroin users can inject under the supervision of trained health staff and
where guidance and advice are readily available. Health room' may therefore be
a more apt designation of the possible future function of this initiative, and, in
the Norwegian debate, the two names are used more or less in equal measure.
One essential precondition underlying the establishment of injecting/ health
rooms are that the people who make use of them shall avoid risk apprehension by
police authorities in connection with the injection process (possession and use of
drugs).

INTRAVASCULAR:- (IV, IA)

Placing a drug directly into blood stream;-May be intravenous (into a

vein) or intra- arterial (into an artery).Drug solution in injected directly into
the lumen of a vein so that it is diluted in the venous blood. The drug is
carried to the Heart and circulated to the tissues. Drugs in oily vehicle or those
that cause haemolysis should not be given by this route. Since the drug is
introduced directly into blood, the desired concentration of the drug is achieved
immediately which is not possible by any other procedure. This route is of
prime importance in emergency. Also certain irritant drugs could be given by
this route.
Also this is the only route for giving
large volume of drugs e.g. blood transfusion
 Advantages: precise, accurate and immediate onset of action, 100% bioavailability

Disadvantages: risk of embolism, high concentration attained rapidly leading

to greater, risk of adverse effect.

INTRAMUSCULAR:- ( into the skeletal muscle) (I.M.)

In humans, the best site is deltoid muscle in the shoulder or the gluteus
muscle in the buttocks. This method is suitable for the irritating substances
that cannot be given route by subcutaneous.

The speed of absorption from site of injection is dependent on the vehicle used,
absorption is quick from aqueous solutions and slow from oily preparations.
Absorption is complete, predictable and faster than subcutaneous route.
Advantages:-

 Suitable for injection of drug in aqueous solution (rapid action) and

drug in suspension or emulsion (sustained release )
 Disadvantages: -

 pain at the site of injection

SUBCUTANEOUS ROUTES:-(Under the skin)

The drug is dissolved in a small volume of vehicle and injected beneath the skin
from where the absorption is slow and uniform. Substances causing irritation to
the tissues should not be injected otherwise they will cause pain and necrosis
(deadening of tissues) at the site of injection.

This method is particularly useful when continuous presence of the drug in the
tissues is needed over a long period. The usefulness of this method is enhanced
by the use of depot preparations from which the drug is released more slowly
than it is from simple solution rosis (deadening of tissues) at the site of injection.
e.g. insulin

INTRADERMAL ROUTE:-(into the skin )

Drug are injected into papillary layer of skin. For example tuberculin injection
for mantoux test and BCG vaccination for active immunization against
tuberculosis.BC: Bacillus-Calmette-Guerin

INTRATHECAL ROUTE:-(into the spinal canal )

Blood brain barrier often prevents the entry of certain drugs into the central
nervous system. Also the blood SF barrier prevents the approach of drugs to
the meanings. Thus when local and rapid effects of drugs on meanings are
desired the drugs are injected into Subarachnoid (between arachnoids mater
 and piamater) space and effects of the drugs are then localized to the spinal
nerves and meanings e.g. intrathecal injection of streptomycin in tuberculosis
and meningitis used to be used by this route but with the invention of third
generation cephalosporin's it is not used any more to treat these conditions. The
injection of local aesthetics for the induction of spinal anesthesia is given by
this route. (the three membranes covering the brain and spinal cord from
outside to inward are Duramater, arachnoids mater and piamater e.g., spinal
anesthetics

INTRAPERITONEAL ROUTE:-( into the peritoneum cavity)

The peritoneum offers a large absorbing surface area from which drugs enter
circulation rapidly but primarily by way of portal vein. Hence First-Pass effect
not avoided. This is probably the most widely used route of drug administration
in laboratory animals. In human, it is very rarely employed due to the dangers of
infection and injury to viscera and blood vessels. e.g. peritoneal dialysis in case
of renal insufficiency.
 PATHOLOGY

Pathology is a branch of medical science primarily concerning the cause, origin and nature of
disease. It involves the examination of tissues, organs, bodily fluids and autopsies in order to
study and diagnose disease.

In Pathology Lab, Blood Test Report:-

Blood tests allow a doctor to see a detailed analysis of any disease markers,
the nutrients and waste products in your blood as well as how various organs
(e.g., kidneys and liver) are functioning. Below, I've explained some of the
commonly measured indicators of health. During a physical examination, your
doctor will often draw blood for chemistry and complete blood count (CBC)
tests as well as a lipid profile, which measures cholesterol andrelated elements
Here is a brief explanation of the abbreviations used in measurements
followed by descriptions of several common test components

Deciphering Blood Test Measurements: - Blood tests use the metric

measurement system and abbreviations such as the following: -

 cmm----------------cells per cubic millimeter

 fL (femtoliter)-----fraction of one-millionth of a liter
 g/dL-----------------grams per deciliter
 IU/L-----------------international units per liter
 mEq/L--------------mille equivalent per liter
 mg/dL--------------milligrams per deciliter
 mL------------------milliliter
 mmol/L-------------mill moles per liter
 ng/m----------------Lnanograms per milliliter
 Pg(Pico grams)---one-trillionth of a gram

Complete Blood Count (CBC):-

The CBC test examines cellular elements in the blood, including red blood cells,
various white blood cells, and platelets. Here is a list of the components that are
normally measured, along with typical values. If your doctor says you're fine
but our tests results are some what different from the range shown here, don't be
 alarmed.
Some labs interpret test results a bit differently from others, so don't consider
these figures absolutes.

WBC (white blood cell) leukocyte count Normal range: 4,300 to 10,800cm White blood
cells help fight infections, so a high white blood cell
count could be helpful for identifying infections. It may also indicate leukemia,
which can cause an increase in than number of white blood cells. On the other
hand, too few white blood cells could be caused by certain medications or health
disorders. WBC (white blood cell) differential count Normal range:
Neutrophils ------40% to 60% of the total
 Lymphocytes ----20% to40%
 Monocytes--------2% t08%
 Eosinophils ------1% to 4%
 Basophils---------0.5% to 1%

This test measures the numbers, shapes, and sizes of various types of white
blood cells listed above. The WBC differential count also shows if the numbers
of different cells are in proper proportion to each other. Irregularities in this test
could signal an infection, inflammation, autoimmune disorders, anemia, or other
health concerns.

RBC (red blood cell) erythrocyte count Normal range: 4.2 to 5.9 million
Cm, We have millions of red blood cells in our bodies, and this test measures the
number of RBCs in a specific amount of blood. It helps us determine the total
number of RBCs and gives us an idea of their lifespan, but it does not indicate
where problems originate. So if there are irregularities, other tests will be required
Hematocrit (Het)Normal range: 45% to 52% for men; 37% to 48% for women
Useful for diagnosing anemia, this test determines how much of the total blood
volume in the body consists of RBC Hemoglobin (Hgb)Normal range:
 13 to 18 g/dL for men
 12 to 16 g/dL for women
Red blood cells contain haemoglobin, which makes blood bright red. More
importantly, haemoglobin delivers oxygen from the lungs to the entire body; then
it returns to the lungs with carbon dioxide, which we exhale. Healthy hemoglobin
levels vary by gender. Low levels of hemoglobin may indicate anemia.

Mean corpuscular volume (MCV) Normal range: 80 to 100 femtolitters

This test measures the average volume of red blood cells, or the average
amount of space each red blood cell fills.
Irregularities could indicate anemia and/or chronic fatigue syndrome.
Mean corpuscularhemoglobin(MCH)
Normal range: 27 to 32 Picograms
This test measures the average amountof hemoglobin in the typical red blood
cell. Results that are too high could signal anemia,while those too low may
indicate a nutritional deficiency.

Mean corpuscular hemoglobin concentration (MCHC)

Normal range: 28% to 36%The MCHC test reports the average concentration of
hemoglobin in a specific amount of red blood cells. Here again, we are looking
for indications of anemia if the count is low, or possible nutritional deficiencies if
it' shigh.
Red cell distribution width (RDW or RCDW)
Normal range: 11% to 15% With this test, we get an idea of the shape and size of
red blood cells. In this case, "width" refers to a measurement of distribution, not
the size of the cells. Liver disease, anemia, nutritional deficiencies, and a number
of health conditions could cause high or low RDW results.

Platelet count Normal range: 150,000 to 400,000 ml Platelets are small

portions of cells involved in blood clotting. Too many or too few platelets can affect
clotting in different ways. The number of platelets may also indicate a health
condition.

Mean Platelet Volume (MPV) Normal range: 7.5 to 11.5 femtoliters This
test measures and calculates the average size of platelets. Higher MPs mean the
platelets are larger, which could put an individual at risk for a heart attack or stroke.
Lower MPVs indicate smaller platelets, meaning the person is at risk for a bleeding
disorder.
AST (aspartate aminotransferase) Healthy range:10 to 34 IU/LThis
enzyme is found in heart and liver tissue, so elevations suggest problems may be
occurring in one or both of thoseareas.

Bilirubin, Healthy range: 0.1 to 1.9 mg/dL This provides information about liver
and kidney functions, problems in bile ducts, and anemia.
BUN (blood urea nitrogen) Healthy range: 10 to 20 mg/dL. This is another
measure of kidney and liver functions. High values may indicate a problem with
kidney function. A number of medications and a diet high in protein can also raise
BUN levels.
BUN/ creatinine ratio Healthy ratio of BUN to creatinine: 10:1 to
20:1 (men and older individuals may be a it higher) This test shows if kidneys are
eliminating waste properly. High levels of creatinine, a by-product of muscle
contractions, are excreted through the kidneys and suggest reduced kidney
function.
Calcium, Healthy range: 9.0 to 10.5mg/dL (the elderly typically score a bit
lower)Too much calcium in the bloodstream couldindicate kidney problems;
overly active thyroid or parathyroid glands; certain types ofcancer, including
lymphoma; problems with the pancreas; or a deficiency of vitamin D.

Chloride, Healthy range: 98 to 106 mEq/L This mineral is often measured as part
of an electrolyte panel. A high-salt diet and/or certain medications are often
responsible for elevations in chloride. Excess chloride may indicate an overly acidic
environment in the body .It also could be a red flag for dehydration, multiple
myeloma, kidney disorders, or adrenal gland dysfunction. Creatinine Healthy range
0.5 to 1.1 mg/dL for women0.6 to
1.2 mg/dL formen (the elderly may be slightly lower)
The kidneys process this waste product, so elevations could indicate a problem
with kidney function.

Fasting glucose (blood sugar), Healthy range: 70 to 99 mg/dL for the

average adult (the elderly tend to score higher even when they are healthy) Blood
sugar levels can be affected by food or beverages you have ingested recently, your
current stress levels, medications you may be taking, and the time of day. The
fasting blood sugar test is done after at least 6 hours without food or drink other than
 water.

Phosphorus, Healthy range: 2.4 to 4.1 mg/dL Phosphorus plays an important role
in bone health and is related to calcium levels. Too much phosphorus could indicate
a problem with kidneys or the parathyroid gland. Alcohol abuse, long-term antacid
use, excessive intake of diuretics or vitamin D, and malnutrition can also elevate
phosphorus levels.

Potassium, Healthy range: 3.7 to 5.2 mEq/L This mineral is essential for
relaying nerve impulses, maintaining proper muscle functions, and regulating
heartbeats. Diuretics, drugs that are often taken for high blood pressure, can cause
low levels of potassium.

Sodium, Healthy range: 135 to 145mFq/L Another member of the electrolyte

family, the mineral sodium helps your body balance water levels and helps with
nerve impulses and muscle contractions. Irregularities in sodium levels may indicate
dehydration; disorders of the adrenal glands; excessive intake of salt,
corticosteroids, or pain-relieving medications; or problems with the liver or kidneys.
Lipid Panel (or Lipid Profile), The lipid panel is a collection of tests measuring different types
of cholesterol and triglycerides (fats) in your bloodstream.

Here are some common tests performed during the hospital training in hospital.

1. Widal test
2. Pregnancy test
3. Glucose test
4. Blood group test

1:Widal Test

Salmonella typhi and Salmonella paratyphi A, B and C cause enteric fever (typhoid and paratyphoid) in

human. Laboratory diagnosis of enteric fever includes Blood culture, Stool Culture and Serological test.

Widal test is a common agglutination test employed in the serological diagnosis of enteric fever. This

test was developed by Georges Ferdinand Widal in 1896 and helps to detect presence of salmonella

antibodies in a patient’s serum.

 2: Pregnancy test

3:Glucose test

Both low blood sugar (hypoglycemia) and high blood sugar (hyperglycemia) are of concern
for patients who take insulin. It is important, therefore, to carefully monitor blood glucose
levels. In general, patients with type 1 diabetes need to take readings four or more times a
day. Patients should aim for the following measurements:

• Pre-meal glucose levels of 70 - 130 mg/dL

• Post-meal glucose levels of less than 180 mg/dL

Different goals may be required for specific individuals, including pregnant women, very old
and very young people, and those with accompanying serious medical conditions.

Finger-Prick Test. A typical blood sugar test includes the following:  A

drop of blood is obtained by pricking the finger.

• The blood is then applied to a chemically treated strip.

• Monitors read and provide results.

Home monitors are less accurate than laboratory monitors and many do not meet the
standards of the American Diabetes Association. However, they are usually accurate enough
to indicate when blood sugar is too low.

To monitor the amount of glucose within the blood a person with diabetes should test their
blood regularly. The procedure is quite simple and can often be done at home.

Some simple procedures may improve accuracy:

• Testing the meter once a month.

• Recalibrating it whenever a new packet of strips is used.

• Using fresh strips; outdated strips may not provide accurate results.

• Keeping the meter clean.

• Periodically comparing the meter results with the results from a laboratory

4: Blood group test

A test kit can be used to test blood type. It involves pricking finger and placing a drop of blood
on a card that will react to a serum on the card that contains antibodies. Now we will be given
the opportunity to test blood type using this technique.
 Blood Bank

A blood bank is a center where blood gathered as a result of blood donation is stored and

preserved for later use in blood transfusion.

The term "blood bank" typically refers to a division of a hospital where the storage of blood

product occurs and where proper testing is performed (to reduce the risk of transfusion related

adverse events). However, it sometimes refers to a collection center, and indeed some hospitals

also perform collection.

For blood donation agencies in various countries, see List of blood donation

agencies and List of blood donation agencies in the United States.

BLOOD DONATION

"Blood donation refers to the process of collecting, testing, preparing and storing blood and

blood components. Donors are most commonly unpaid volunteers, but they may also be paid

by commercial enterprises. Blood registry refers to the collection and sharing of data about

donated blood and ineligible donors."

Purpose Of Blood Donation

 The purpose of the blood collection and distribution system is to help ensure an

adequate supply of blood for accident victims, people needing surgery, and people

suffering from certain diseases, as well as for medical research.

 Sometimes, donors give blood specifically to benefit a particular person. People

preparing for elective surgery may donate their own blood to be held and then returned

to them during surgery. This is known as autologous blood donation. Directed donor

blood has been donated by someone known to the intended recipient, such as a family

member or friend.

TYPES OF BLOOD BANK SERVICE

• Government blood bank

• Non- government blood bank

• Commercial blood bank

Process of blood donation

ENTRY

BLOOD FORM
DONATION FILLING

SECONDARY INITIAL
SCREENING SCREENING
 Diagnostic Report-

A diagnostic report is the set of information that is typically provided by

diagnostic service when investigations are complete. The information includes a
mix of atomic result, text report, images and codes.
The diagnostic report resources suitable for the following kinds of diagnostic
reports;

 laboratory (clinical chemistry, hematology, microbiology etc.)

 pathology/histopathology
 image investigation (x-ray CT, MRI etc.)
 other diagnostics-cardiology.

Report-1
Report-2 (Cheast x-ray)

Report-3 (ECG)
 Dispensary

Drug dispensing is often portrayed as merely being the process of giving a drug

product to a patient in the hospital.

A dispensary can be defined as the main area where the dispensing of the drugs takes place. It

is mainly present for the OPD patients. The various drugs are being distributed to the patients

here on the basis of their prescription written by the doctors. The dispensary in the district

hospital consists of various pharmacists who are present to hand out the medicines to the

patients. The distribution of the drugs in the district hospital is for free.

1. Alusil-C – Antacid chewable tablets

2. Paracetamol tablets and suspension

3. Calcium tablets

4. Chlorpheniramine Maleate tablets

5. B-Complex tablets

6. Walamycin suspension for children

7. iprofloxacin Capsules
 8. Flamar gel – analgesic

9. Doxycyclin capsules

10. Diclofenac sodium

11. Tramadol

12. Perinorm

13. Metronidazole ointment

14. Atenolol

15. Ciprofloxacin Capsules

16. Flamar gel – analgesic

17. Doxycyclin capsules

18. Diclofenac sodium

19. Tramadol

20. Perinorm

21. Metronidazole ointment

22. Atenolol

The drug distribution in the dispensary takes place through several windows. These windows

are of:-

• Women

• Men

• Elderly i.e. above age 60

• Staff members

The people are required to stand according to these lines only in order to get the prescribed

medicines. The pharmacist also has the job to ex plain the time of administration and the

amount of dose to be given to the patient.

 Waste Management

Biohazard waste must have a way to dispose of it in a safe manner.During the period of hospital

training I have observed the Bins of various colours that contain the biohazard waste.

The disposing off waste carelessly may lead to DEATH.

So, the waste should be dumped in a systematic way.

Procedure :

THERE ARE 5 BINS -

1. Black Bin : General Waste (Dust, Paper, Kitchen waste)

2. Blue Bin : Broken Glass

3. Red Bin : Syringes, Plastic tubes, Urine Bag, Plastic Bottles\

4. Yellow Bin : Animal Tissue, Gloves, Expired Drugs

5. White Bin : Needle, Blade, Scaples

 Practice should be Right

 Handwashing & Cleaning Should be there at the Hospitals

 Problems encounter during the training

There are different problem which I had faced during training period:-‘

 It’s tough to handle children, as they are not cooperative throughout the treatment.

 Most of the patients are illiterate, so were unable to understand the medicine use and
forgot there doses.

Summary

After 1 month of hospital training I came to learn about how to dispense medicines to the

patient, how to inject injections to them, how to handle trauma and emergency cases. I also

learn about dealing with hospital conditions like diseases of the patients, wards, staff members,

different departments, etc. Almost 1000 of prescriptions were received by the dispensary and

we have to treat them with full hospitality services.

Future plan

As I had completed my hospital training from District Hospital, So, I can use my knowledge

in medical field. For ex- if I will be posted in rural area, and if there is no doctor at the time of

emergency, So, I’ll be able to handle the situation by giving proper treatment to the patient at

the time. Another thing that I had learn in my training period about the whole procedure of the

hospital, starting from admitting the patient upto there treatment.

 Observation

Thus, I observed that the hospital is a place where people of all kinds come with their problems

which they believe to be solved by the medical staff. The working in the hospital takes place

by maintaining proper cleanliness in the environment. The staff and the doctors are all hostile

and good-natured towards the patients and listen to their problems. Each and every department

has its own way of working and at the end of the day; all of the work is finished by it. There is

no carelessness towards the patients for their drugs or injections and they are treated on time.

The nursing staffs are present at all times for their care. This type of methodology should really

be applicable in all hospitals so that the public may get treated once and for all to maintain a

healthy country.

Conclusion

The training in a hospital gives us a conclusion that the training in the hospital was really

necessary as it not only helped us to see how a hospital operates, but it also helped me to learn

basic functions of it like first aid care, how to give injections and dispensing of drugs etc. The

conclusion drawn out can be that I have finally learned as to how important role a hospital plays

in peoples’ lives and that the hospital staff can go to any means to save them since its their duty.

Since District Hospital receives only 1 rupees per patient, so it also shows us their good deed

towards mankind and to their service.

THANK YOU