Table 3

The hospital readiness requirements for Essential Emergency and Critical Care

Identification of critical illness
The following items are required for a hospital to be ready for the identification of critically ill patients
CategoryItem
 1.1. Equipment
  • 1.1.1 Clock with secondhand

  • 1.1.2 Pulse oximeter and probe

  • 1.1.3 Blood pressure measuring equipment (eg, sphygmomanometer with a stethoscope)

  • 1.1.4 Blood pressure cuffs of different paediatric and adult sizes

  • 1.1.5 Light source (lamp or flashlight)

  • 1.1.6 Thermometer

 1.2 Consumables
  • 1.2.1 Soap or hand disinfectant

  • 1.2.2 Examination gloves

 1.3 Drugs  None
 1.4 Human resources
  • 1.4.1 Health workers with the ability to identify critical illness 24 hours/day

 1.5 Training
  • 1.5.1 The health workers are trained in the identification of critical illness

 1.6 Routines
  • 1.6.1 Routines for the identification of critical illness

 1.7 Guidelines
  • 1.7.1 Guidelines for the identification of critical illness

 1.8 Infrastructure
  • 1.8.1 Designated triage area (area for the identification of critical illness) in the Out-Patient Department or Emergency Unit (area of the hospital where patients arrive)

  • 1.8.2 Running water

Care of critical illness
The following items are required for a hospital to be ready to provide the care of critically ill patients
 2.1 Equipment
  • 2.1.1 Suction machine (electric or manual)

  • 2.1.3 Oxygen supply 24 hours/day (cylinder, concentrator (with electricity supply) or piped oxygen)

  • 2.1.4 Flow meter (if using cylinder or piped oxygen)

  • 2.1.5 Leak-free connectors from oxygen source to tubing

  • 2.1.6 Bag valve mask (resuscitator)—neonatal, paediatric and adult sizes

  • 2.1.7 Sharps disposal container

  • 2.1.8 External heat source

 2.2 Consumables
  • 2.2.1 Suction catheters of paediatric and adult sizes

  • 2.2.2 Guedel airways of paediatric and adult sizes

  • 2.2.3 Pillows

  • 2.2.4 Oxygen tubing

  • 2.2.5 Oxygen nasal prongs

  • 2.2.6 Oxygen face masks of paediatric and adult sizes

  • 2.2.7 Oxygen face masks with reservoir bags of paediatric and adult sizes

  • 2.2.8 Masks for bag valve mask (resuscitator)—neonatal, paediatric and adult sizes

  • 2.2.9 Compression bandages

  • 2.2.10 Plasters or tape

  • 2.2.11 Gauze

  • 2.2.12 Intravenous cannulas of paediatric and adult sizes

  • 2.2.13 Intravenous giving sets

  • 2.2.14 Skin disinfectant for cannulation

  • 2.2.15 Syringes

  • 2.2.16 Nutrition

  • 2.2.17 Nasogastric tubes

  • 2.2.18 Lubricant for nasogastric tube insertion

  • 2.2.19 Intramuscular needles

  • 2.2.20 Intraosseous cannulas of different sizes

  • 2.2.21 Blankets

  • 2.2.22 Facemasks for infection prevention and control

  • 2.2.23 Aprons or gowns

  • 2.2.24 Charts/notes for documentation

  • 2.2.25 Pens

 2.3 Drugs
  • 2.3.1 Oral rehydration solution

  • 2.3.2 Intravenous crystalloid fluids (eg, normal saline or Ringer’s Lactate)

  • 2.3.3 Intravenous dextrose fluid (eg, 5%, 10% or 50%)

  • 2.3.4 Oxytocin

  • 2.3.5 Epinephrine

  • 2.3.6 Appropriate antibiotics

  • 2.3.7 Diazepam

  • 2.3.8 Magnesium sulphate

  • 2.3.9 Paracetamol

  • 2.3.10 Local anaesthetic (eg, 2% lignocaine) (eg, for intraosseous cannulation)

 2.4 Human resources
  • 2.4.1 Health workers with the ability to care for critically ill patients 24 hours/day

  • 2.4.2 Senior health worker who can be called to assist with the care of critically ill patients 24 hour/day

 2.5 Training
  • 2.5.1 The health workers are trained in the care of critically ill patients

 2.6 Routines
  • 2.6.1 Routines for managing critically ill patients

  • 2.6.2 Routine for the provision of EECC without taking into account patients’ ability to pay

  • 2.6.3 Routines for who and how to call to seek senior help 24 hours/day, 7 days/week

  • 2.6.4 Routines for integrating EECC with other care including the definitive care of the underlying condition (eg, use of condition-specific guidelines)

 2.7 Guidelines
  • 2.7.1 Guidelines for the essential care of critically ill patients

 2.8 Infrastructure
  • 2.8.1 Designated space for the care of critically ill patients (eg, a bay, ward, high dependency unit)

  • 2.8.2 Areas for separating and managing patients with a suspected or confirmed contagious disease from those without