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ACCIDENT AND
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EMERGENCY CARE
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• ARATHY DARVIN
• 1ST YEAR MHA
 INFLUENCING FACTORS WHILE PLANNING
FACILITIES

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Architectural design
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Site, location, resources and its conservation
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Rules, regulations, codes and laws
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Technology
 ACCIDENT AND EMERGENCY CARE

Ø Emergency Medical Service is an integral part of any

hospital. The Emergency Department is frequently
thought as a microcosm of the hospital as whole.
Ø It also the “Front Door” of the hospital, the portal of
entry that interacts with the highest volume of
patients requiring critical care.
 AIM OF PLANNING

Ø Ensure an architectural design – that support easy acces, patient load, separate access to ambulance,
free movement of people, staff and equipments, resuscitation arrangements, demarcated triage
area, separate categories with expansion facility during disaster management
Ø Ensure maximum safety of patients and staff : occupational, electrical, mechanical etc
Ø Ensure maximum utilisation of ED
Ø To provide environmental control with support of architectural design
• Various criteria in planning
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Ø Environmental : protection, safety and security
Ø Economic : design should establish relation between all other departments
Ø Work flow : specific circulation routes
Ø Functional : institutional policies and rules
FACTORS DETERMINING PLANNING OF ED

Ø Location of hospital

Ø Accessibility of hospital from main road

Ø Hospital facilities

Ø Type of hospital and availability of specialities

Ø Hospital policy
 ED DESIGN (ARCHITECTURAL DESIGN)

Ø Entrance : easy accessible and separate access to ambulance

Ø Door : should be wide enough that, access to at least 2 trollies simultaneously

Ø Reception and billing : friendly face to ensure accountability

Ø Waiting area : visually appealing with appropriate amenities

Ø Triage area : should have wider area with monitor and other facilities

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Ø Store room : non perishable , cold storage, utensils etc

Ø Red area : should be close to entrance or straight to the doors, centralised connections, 360degree
access , radiation safe

Ø Procedure room :for putting slab, reduction etc

Ø Minor OT: aseptic, for minor procedures like suturing

Ø Green and yellow area :separated by curtains and yet visible to nurses station , availability of oxygen
supply, monitor etc
Ø Other facilities needed : X ray , laboratory, USG scanning machine etc

Ø Floor : non slippery and easy to clean

Ø Near by facilities: OT complex , ICUs, Blood bank etc.

Ø Toilets : disabled patient friendly and separate for staffs

Ø Isolation room :

Ø Helipad facility : depend on the type of hospital and availability of air ambulance facility

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Ø Ceiling : it should be done carefully so that surgical lights, x ray tracks , curtains and iv
racks don’t interfere with each other

Ø Decontamination room : should have a flexible hose shower

Ø Trolley : radiolucent resuscitation trolley

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 OTHER SPACE REQUIREMENTS
Ø Employee facilities : lockers, staff toilet, changing room etc

Ø Trolley bay

Ø Doctors work station

Ø Counselling room

Ø pharmacy

Ø Utility room for laundries ,CSSD etc

Ø Machine storage area

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ZONE

• There are 5 types of zones in the hospital on the basis of preparations of architectural
brief.

• Outermost zone

Ø Immediately accessible to public

Ø Aspects related to community orientation

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LOCATION

Ø Easy access to public and separate access to ambulance

Ø Easily visible

Ø Ground level location is best

Ø Easy transportation

Ø Access to clinical, diagnostic, therapeutic and utility services

PRINCIPLES / CODES

Ø Control the movements in each area

Ø Safety and security

Ø Sterile and unsterile environment

Ø Adequate temperature, humidity, ventilation etc

Ø Periodic maintenance of equipments

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 TECHNOLOGY

Ø Centralised piped oxygen, pressure , suction etc

Ø mechanical CPR devices

Ø Portable X ray, USG facility

Ø Portable lighting

Ø Fire safety : fire detection alarms, fire hydrant, way findings etc.
TYPES OF DESIGN

CORE DESIGN
ARENA DESIGN
CORRIDOR PLAN
CORE DESIGN

Ø Treatment spaces are situated around a central point in which ED personnel works.

Ø There should be a corridor outside the treatment area through which patients enter the
cubicle

Ø Support rooms are along the periphery of corridor

Ø This plan offers greatest freedom of movement for ED personnel

ARENA DESIGN

Ø This is essentially a core plan without corridor and best suited for ED that are smaller in
size.

Ø The design provides good view of all cubicles from nursing and physician work areas
CORRIDOR PLAN

Ø Many variants are possible, depending on the size of the department.

Ø It is a desirable plan for the large ED

Ø Separate space is provided for each speciality

LAYOUT