Dr. Ashim's Emergency and General Practice

11/05/2026

What is the cost of this medication???

Where do we use it??

11/05/2026

Ecg what say

11/05/2026

47 yrs male with central chest pain for 3 days, aggravated since last 14 hours.

ECG diagnosis please????

11/05/2026

11/05/2026

47 years male with central chest pain for 3 days and more aggravated since this morning..

Your probable ECG diagnosis please

???

09/05/2026

Anyone who can recognize the equipment..

06/05/2026

🚑 Why Triage Is Important
Saves Lives: By rapidly identifying patients with life-threatening conditions (airway obstruction, cardiac arrest, severe bleeding), triage ensures they receive immediate intervention.

Optimizes Resources: Emergency departments often face overcrowding. Triage prevents bottlenecks by prioritizing care based on urgency rather than arrival order.

Reduces Mortality in Disasters: In mass casualty incidents, triage systems (like WHO or START) help responders quickly separate critical from non-critical patients, maximizing survival rates.

Improves Patient Flow: Structured triage prevents delays, reduces waiting times, and ensures stable patients are managed efficiently.

Supports Fairness & Transparency: Patients and families understand why some cases are treated first, reducing frustration and conflict in high-stress settings.

Guides Documentation & Communication: Clear triage categories help nurses, doctors, and paramedics coordinate care seamlessly.

🩺 Practical Example
Imagine a busy tertiary hospital emergency department with 50 patients arriving in 24 hours:

A patient with chest pain and low blood pressure is triaged as high priority (Red/ESI 2) → immediate physician evaluation.

A patient with a minor wound is triaged as low priority (Green/ESI 5) → safe to wait.

This structured approach prevents critical patients from being lost in the crowd.

✅ Bottom Line:
Triage is not just about sorting patients—it’s about saving lives, maintaining order, and ensuring fairness in the chaos of emergencies. It’s the backbone of every efficient emergency department and disaster response system.

06/05/2026

We are trying to develop a culture of Academic Excellence in our Emergency

Thanks to our BSc Nursing students
Coming for their training in Emergency

With their artful masterpiece of Knowledge on
9Ps of RSI...

They had an opportunity to observe and also help in some extent in a case of intubation yesterday..

We share the knowledge and grow.

Hope this takes our experiences, knowledge and learning to contribute the health system in our country

I saw a clip of our people threatening our nurses yesterday
They learn and work for you

Respect our nurses, protect our nurses..

06/05/2026

Know your equipments

06/05/2026

Checked today and intact to save life

Its easy to check

Hope this video helps you know your equipment
Hope you know how to use it in your emergencies

Our nurses check it everyday
3 times in 3 shifts

We used this on a crashing patient yesterday for VT which reverted on one go

And guess what, the shock was delivered by our nurse
They have been trained for it

Its the safest and easiest treatment that can be delivered for a unstable patient in Arrythmia..

Hope this will help build confidence and eagerness to use this lifesaving machine

Targeted for our young and new doctors working in emergencies in different parts of Nepal..

05/05/2026

👉 Patient’s case:

Presentation:

Palpitation, chest discomfort, anxious but stable vitals except for rapid heart rate (160–180).

Diagnosis:
Supraventricular tachycardia (SVT).

Intervention: Adenosine administered → immediate conversion to sinus rhythm.

Learning Point: With proper diagnosis, Adenosine is safe, effective, and life-saving.

💡 For your students and colleagues, here are some confidence-building takeaways you can share alongside the video:

Defibrillator vs. Adenosine:

Defibrillator (synchronized cardioversion) is for unstable tachyarrhythmias or when drugs fail.

Adenosine is first-line for stable SVT — it works by transiently blocking AV nodal conduction.

Safety pearls:

Always confirm it’s SVT (narrow complex tachycardia, regular rhythm).

Have resuscitation equipment ready, but expect transient flushing, chest pressure, or brief asystole — these are normal.

The dramatic conversion to sinus rhythm is both diagnostic and therapeutic.

Confidence message for peripheries:

“Time is rhythm.” Early recognition and intervention prevent deterioration.

Adenosine is safe when used correctly — don’t hesitate if the diagnosis is clear.

Defibrillator is not the first step in stable SVT; drugs like Adenosine are.

“Save Life with Ashim” series — showing the ECG before and after Adenosine, with a bold message: “SVT can be reverted in seconds — diagnose, act, save life.”