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Operations and Casualty

Operations

Clinical > Operations lists the operations; New Operation records one.

The list of operations

An operation

  1. The Operation:
    • Date, From and To (HH:MM), Theatre and Status (planned, done, cancelled);
    • the Patient (C.R. No.) and the Admission (I.P. No.);
    • Operation and its I.C.D.-10 code, Anaesthesia, Surgeon, Assistant and Anaesthetist.
  2. The Note: the diagnosis before and after, the Findings, What Was Done, the Specimen Sent, Blood Loss, Complications and the Advice after the Operation.
  3. 1 Implants, Consumables and Charges, one line at a time:
    • What Kind: an implant, a consumable or a charge;
    • an item From the Pharmacy Stock (it leaves the stock when the operation is charged), or Or Write It;
    • Qty, Rate and Remark, then Add.
  4. 2 Total shows the Value of the Items and the bill they were charged on.
  5. Click Save Operation.
  6. 3 Charge to the Bill puts the items on a credit bill of the admission and takes the pharmacy items out of the stock. Do this once the list is complete.
  7. Print prints the operation note; Forms prints the consent for the operation (Consents and Forms).

Casualty

Clinical > Casualty Register lists every emergency case; New Casualty Case records one.

The casualty register

A casualty case with its M.L.C.

  1. Who Came In:
    • Arrived On and At (empty is now);
    • 1 Triage: red at once, yellow urgent, green can wait;
    • How They Came: walking, ambulance, police ...
    • a Registered Patient (C.R. No.), or, for someone not registered, the Name, Age, Sex, Mobile No. and Address;
    • Brought By: a relative, the police, a passer-by.
  2. 2 What Was Found and Done:
    • the Complaint, On Examination, Treatment Given, the Diagnosis Code and who saw the patient;
    • Outcome: treated and sent home, admitted, referred, died. If admitted, give the I.P. No.; if referred, Referred To.
  3. 3 Medico-Legal Case (M.L.C.). For an injury, poisoning, burn, assault, accident, or anything the police must know of, set Is It an M.L.C.? to Yes and fill in:
    • M.L.C. No.: leave it empty for the next number of the year;
    • Police Station Informed, F.I.R. No., Informed On / At and Informed To (the constable or officer told);
    • Injuries and Marks of Identification.
  4. Click Save Case. Print prints the casualty sheet; Forms prints the M.L.C. intimation to the police (Consents and Forms).

The M.L.C. cases also appear in Reports > M.L.C. Register.