DUBAI // The young man is grimacing and screaming with pain, and convulsions rack his body.
Seconds after paramedics rush him to hospital, nurses and doctors stand over him and begin emergency treatment for a diabetic seizure. The medical team work like clockwork to control the situation. Their quick and effective treatment saves his life.
"The golden hour is the first hour when things have to be done right or the outcome will be very different," says Dr Moin Fikree, clinical director of the Emergency and Trauma Centre at Rashid Hospital, the largest of its kind in the GCC.
"A trauma centre is very different from a regular hospital — it requires a very high level of readiness. How do you save that life immediately? How do you save that limb?"
The trauma centre in Oud Metha, established in 2006, houses the main emergency department for the city. It treated about 142,000 patients last year, and Dr Fikree estimates that the number will rise to about 145,000 this year.
Among the unique features of the trauma centre is a Stat scanner — a digital X-ray scanning machine. It can scan the whole body in 14 seconds, and does so with less than half the radiation of a chest X-ray.
The centre has been built not only for trauma, but also for mass casualty and disaster response from the ground up, in case of a large fire, earthquake or large-scale accident.
Its five-level activation sequence and codes are set up to handle such emergencies, with more staff and — ultimately — other hospitals added to the effort as the emergency level rises.
"One of the things that makes us unique is that disaster management is incorporated within our core component," says Dr Fikree, who has 25 years' experience in the field of emergency medicine. "God forbid, if we were to have a major casualty incident, this would be the primary place where all the serious patients would come."
The unit has 140 beds, and can increase its capacity to a maximum of 200. The disaster management component means each bed has the capability of ICU (intensive care unit)-level monitoring, and there is a disaster command centre within the trauma centre. The machines attached to these ICU beds can monitor the heart beat, blood pressure and breathing of critically ill patients.
"Any emergency case that arrives at the hospital, whether it is a medical emergency or trauma, is stabilised immediately before the patient is transferred to the area that can best address his or her needs," Dr Fikree says.
A medical case would be a diabetic seizure or heart attack, while a trauma would be described as a stabbing or burn victim, for example.
The trauma centre treats patients based on five priority levels: triage level 1 is a life-threatening case such as a heart attack, triage level 5 is a non-emergency case in which the patient may be treated after two hours.
The centre houses a surgical and neurosurgical ICU for traumas, a paediatric trauma area and an acute physiotherapy area. It also has its own blood bank, laboratory and radiology department and an observation unit to monitor patients for 24 hours to reduce the number of those who are admitted to the hospital for more extensive treatment.
"If you have 142,000 patients coming into the emergency department they have to be filtered. Our admission rate to Rashid Hospital is approximately 16,500 patients admitted every year, so roughly about 11 to 12 per cent are admitted," Dr Fikree says.
There is a highly refined mechanism to treat the rest of the patients, care for them, observe them, and then discharge them. According to Dr Fikree, the emergency room treats an average of about 12,500 patients each month.
"Some months it drops down to about 10,500 and other months it climbs to 13,000. Ramadan is our slow period, especially this year because it looks like all the holidays have fallen in Ramadan," he says.
In one of the resuscitation rooms at the trauma centre, a woman with an acute allergic reaction is being treated.
"She was prescribed a medication for a chest infection and developed an acute allergic reaction with rash and difficulty breathing. It is life threatening," said Dr Mohammed Shaji, a specialist senior registrar at the hospital.
Doctors are quickly able to stabilise her and save her life.
Dr Obaid Khan, a specialist registrar who works in the surgical ICU at the trauma centre, said: "We get a lot of patients who are involved in trauma accidents. Most of the patients we see come in a very critical state, but when they leave the hospital, we feel a sense of achievement. It is a high area of responsibility."