Hospital Training Report Part-I

For partial fulfillment of B.Pharm 5TH Semester

Session 2017-18

Dr. A.P.J Abdul Kalam Technical University

Lucknow

Ashoka Institute Of Technology And Management

Varanasi

Submitted By:
Name: HARISH SHARMA

Roll no: 1564150022

 CERTIFICATE

This is to certify that Mr/ Ms HARISH SHARMA has submitted the report on Hospital

training for partial fulfilment of B. Pharm V Semester, session 2017-18. The contents of the

report do not form the basis for the award of any other degree to the candidate or to anybody

else from this or any other University/Institution.

Dr. BRIJESH SINGH

(Hospital Training Incharge)

AITM Varanasi

HEAD OF DEPARTMENT......................................................................................

EXTERNAL EXAMINER........................................................................................

DIRECTOR OF PHARMACY.................................................................
 ACKNOWLEDGEMENT

The training opportunity I had with District Hospital, chandauli was a great chance for

learning and professional development. Therefore, I consider myself as a very lucky

individual as I was provided with an opportunity to be a part of it. I am also grateful for

having a chance to meet so many wonderful people and professionals who led me though this

training period.

I am using this opportunity to express my deepest gratitude and special thanks to Ashoka

Institute of Technology and Management varanasi who in spite of being extraordinarily

busy with their duties gave us an opportunity so that we could learn something so important.

I express my deepest thanks to DR. UMAPATI DVIVEDI CMS of District Hospital,

Chandauli and Dr. ASHOK KUMAR (Blood Bank Incharge) for taking part in useful

decision & giving necessary advices and guidance and arranged all facilities to make life

easier. I choose this moment to acknowledge his contribution gratefully.

It is my radiant sentiment to place on record my best regards, deepest sense of gratitude to

Mr. AJIT SINGH (Chief Pharmacist) for their careful and precious guidance which were

extremely valuable for my study both theoretically and practically.

I perceive as this opportunity as a big milestone in my career development. I will strive to use

gained skills and knowledge in the best possible way, and I will continue to work on their

improvement.

Thanking You HARISH SHARMA

B.PHARM 3RD YEAR

ROLLNO. 1564150022
 VISION

The vision of the Hospital training is to study the organisation of various departments, the

working and development of the organisation, the present status of the hospital & future

prospects of the organisation. To promote civic sense and shoulder the responsibilities with

full potential by being a ultimate healthcare Professional and a Responsible Pharmacist.

The overall objectives of the study:-

 To study the Hospital structure.

 To know about its products and service activities.

 To know the different functions of all the departments.

 To know the responsibilities of top management and how to execute responsibility.

 To analyse the working of Hospital using by analysis of various departments.

 CONTENTS

1. Introduction 4

2. Different departments of hospital 4-5

3. Dispensary 6-7

4. Surgical ward 7

5. Parentral routes of administration 8-11

6. Blood bank 12-13

7. Waste management 14

8. Trauma and emergency 15

9. Summary 16

10. Observation 16

11. Conclusion 17
 About Hospital

Hospitals are centres of treatment. People from all corners of the society and all walks of life

converge here to cure themselves of their diseases.

I did my training in District Hospital, chandauli [232104]

This is also known as “Pt Kamalapati Combind District hospital’’ chandauli

It is a centre for all types of medical facilities especially for the poor people.

This training also made me realize the importance of hospitals for people and how it affects

even the day-to-day lives of them.

Not only the patients but also the people working in the hospital are truly dependent on it.

This training report comprises of the whole summary of my training in this hospital and what

I learned from that.

 Different Departments in Hospital

There are a number of parts in a hospital. This large number of departments is responsible for

treating the patients of their diseases.

The various departments of hospitals covered in the hospital training are:-

1. Dispensary

2. In-Patient Department

a. Children Ward

b. TB and Surgical Ward

3. Emergency (Trauma center)

4. Record Room

5. Injection Room

6. Waste Management

7. Rabies Vaccination

8. Ortho wards

9. Trauma Centre

10. Blood bank

11. Pathology
 FIRST AID

FIRST AID TREATMENT

First aid is the assistance given to any person suffering a sudden illness or injury, with care
provided to preserve life, prevent the condition from worsening, and/or promote recovery. It
includes initial intervention in a serious condition prior to professional medical help being
available, such as performing CPR while awaiting an ambulance, as well as the complete
treatment of minor conditions, such as applying a plaster to a cut. First aid is generally
performed by the layperson, with many people trained in providing basic levels of first aid,
and others willing to do so from acquired knowledge. Mental health first aid is an extension
of the concept of first aid to cover mental health.

Aim

The key aims of first aid can be summarised in three key points, sometimes known as 'the
three P's':-

Preserve life:
the overriding aim of all medical care, including first aid, is to save lives and minimize the
threat of death.

Prevent further harm:

also sometimes called prevent the condition from worsening, or danger of further injury, this
covers both external factors, such as moving a patient away from any cause of harm, and
applying first aid techniques to prevent worsening of the condition, such as applying pressure
to stop a bleed becoming dangerous.
Promote recovery:

first aid also involves trying to start the recovery process from the illness or injury, and in
some cases might involve completing a treatment, such as in the case of applying a plaster to
a small wound.

Specific disciplines
There are several types of first aid (and first aider) which require specific additional training.
These are usually undertaken to fulfill the demands of the work or activity undertaken.

Aquatic/Marine first aid

It is usually practiced by professionals such as lifeguards, professional mariners or in diver
rescue, and covers the specific problems which may be faced after water-based rescue and/or
delayed MedEvac.
Battlefield first aid
takes into account the specific needs of treating wounded combatants and non-combatants
during armed conflict.

Hyperbaric first aid

may be practiced by SCUBA diving professionals, who need to treat conditions such as the
bends.

Oxygen first aid

is the providing of oxygen to casualties who suffer from conditions resulting in hypoxia.

Wilderness first aid

is the provision of first aid under conditions where the arrival of emergency responders or the
evacuation of an injured person may be delayed due to constraints of terrain, weather, and
available persons or equipment. It may be necessary to care for an injured person for several
hours or days.

Mental health first aid

is taught independently of physical first aid. How to support someone experiencing a mental
health problem or in a crisis situation. Also how to identify the first signs of someone
developing mental ill health and guide people towards appropriate help.

Conditions that often require first aid

 Altitude sickness, which can begin in susceptible people at altitudes as low as 5,000
feet, can cause potentially fatal swelling of the brain or lungs.
 Anaphylaxis, a life-threatening condition in which the airway can become constricted
and the patient may go into shock. The reaction can be caused by a systemic allergic
reaction to allergens such as insect bites or peanuts. Anaphylaxis is initia lly treated
with injection of epinephrine
 Battlefield first aid—This protocol refers to treating shrapnel, gunshot wounds, burns,
bone fractures, etc. as seen either in the ‘traditional’ battlefield setting or in an area
subject to damage by large-scale weaponry, such as a bomb blast
 Bone fracture, a break in a bone initially treated by stabilizing the fracture with a
splint.
 Burns, which can result in damage to tissues and loss of body fluids through the burn
site.
 Cardiac Arrest, which will lead to death unless CPR preferably combined with an
AED is started within minutes. There is often no time to wait for the emergency
services to arrive as 92 percent of people suffering a sudden cardiac arrest die before
reaching hospital according to the American Heart Association.
 Heart attack, or inadequate blood flow to the blood vessels supplying the heart
muscle.
 Heat stroke, also known as sunstroke or hyperthermia, which tends to occur during
heavy exercise in high humidity, or with inadequate water, though it may occur
spontaneously in some chronically ill persons. Sunstroke, especially when the victim
has been unconscious, often causes major damage to body systems such as brain,
kidney, liver, gastric tract. Unconsciousness for more than two hours usually leads to
permanent disability. Emergency treatment involves rapid cooling of the patient.
  Heavy bleeding, treated by applying pressure (manually and later with a pressure
bandage) to the wound site and elevating the limb if possible.
 Hyperglycemia (diabetic coma) and Hypoglycemia (insulin shock).
 Insect and animal bites and stings.
 Poisoning, which can occur by injection, inhalation, absorption, or ingestion.
 Muscle strains and Sprains, a temporary dislocation of a joint that immediately
reduces automatically but may result in ligament damage.
 Wounds and bleeding,including lacerations, incisions and abrasions, Gastrointestinal
bleeding, avulsions and Sucking chest wounds, treated with an occlusive dressing to
let air out but not in.

.
.

PATHOLOGY

Pathology is a branch of medical science primarily concerning the cause, origin and nature of
disease. It involves the examination of tissues, organs, bodily fluids and autopsies in order to
study and diagnose disease.

Here are some common tests performed during the hospital training in hospital.

1. Widal test
2. Pregnancy test
3. Glucose test
4. Blood group test
5. Urine test
1:Widal Test

Salmonella typhi and Salmonella paratyphi A, B and C cause enteric fever (typhoid and paratyphoid) in

human. Laboratory diagnosis of enteric fever includes Blood culture, Stool Culture and Serological test.

Widal test is a common agglutination test employed in the serological diagnosis of enteric fever. This test

was developed by Georges Ferdinand Widal in 1896 and helps to detect presence of salmonella antibodies

in a patient’s serum.

2: Pregnancy test
3:Glucose test

Both low blood sugar (hypoglycemia) and high blood sugar (hyperglycemia) are of concern
for patients who take insulin. It is important, therefore, to carefully monitor blood glucose
levels. In general, patients with type 1 diabetes need to take readings four or more times a
day. Patients should aim for the following measurements:

 Pre-meal glucose levels of 70 - 130 mg/dL

 Post-meal glucose levels of less than 180 mg/dL

Different goals may be required for specific individuals, including pregnant women, very old
and very young people, and those with accompanying serious medical conditions.

Finger-Prick Test. A typical blood sugar test includes the following:

 A drop of blood is obtained by pricking the finger.

 The blood is then applied to a chemically treated strip.

 Monitors read and provide results.

Home monitors are less accurate than laboratory monitors and many do not meet the
standards of the American Diabetes Association. However, they are usually accurate enough
to indicate when blood sugar is too low.

To monitor the amount of glucose within the blood a person with diabetes should test their
blood regularly. The procedure is quite simple and can often be done at home.

Some simple procedures may improve accuracy:

 Testing the meter once a month.

 Recalibrating it whenever a new packet of strips is used.

 Using fresh strips; outdated strips may not provide accurate results.

 Keeping the meter clean.

 Periodically comparing the meter results with the results from a laboratory
4: Blood group test

A test kit can be used to test blood type. It involves pricking finger and placing a drop of
blood on a card that will react to a serum on the card that contains antibodies. Now we will be
given the opportunity to test blood type using this technique.

Dispensary

A dispensary can be defined as the main area where the dispensing of the drugs takes place. It

is mainly present for the OPD patients. The various drugs are being distributed to the patients

here on the basis of their prescription written by the doctors. The dispensary in the district

hospital consists of various pharmacists who are present to hand out the medicines to the

patients. The distribution of the drugs in the district hospital is for free.
The various drugs which are being distributed are:-

1. Alusil-C – Antacid chewable tablets

2. Paracetamol tablets and suspension

3. Calcium tablets

4. Chlorpheniramine Maleate tablets

5. B-Complex tablets

6. Walamycin suspension for children

7. Ciprofloxacin Capsules

8. Flamar gel – analgesic

9. Doxycyclin capsules

10. Diclofenac sodium

11. Tramadol

12. Perinorm

13. Metronidazole ointment

14. Atenolol
The drug distribution in the dispensary takes place through several windows. These windows

are of:-

 Women

 Men

 Elderly i.e. above age 60

 Staff members

The people are required to stand according to these lines only in order to get the prescribed

medicines. The pharmacist also has the job to ex plain the time of administration and the

amount of dose to be given to the patient.

Surgical Ward

The surgical ward is an in-patient department which consists of those patients who are:-

 Severely injured

 Undergoing a surgery

 Wounded

 The surgical ward is divided into two parts:-

 Male Surgical ward – It consists of all the male patients

 Female Surgical Ward – it consists of all the female patients

 Routes of administration

1:Parental routes of administration

An injection is an infusion method of putting fluid into the body, usually with a syringe and a

hollow needle which is pierced through the skin to a sufficient depth for the material to be

administered into the body.

2:Intradermal injection

Intradermal injection injection of small amounts of material into the corium or substance of

the skin, done in diagnostic procedures and in administration of regional anesthetics, as well

as in treatment procedures. In certain allergy tests, the allergen is injected intracutaneously.

3:Intramuscular injection

Intramuscular injection injection into the substance of a muscle, usually the muscle of the

upper arm, thigh, or buttock. Intramuscular injections are given when the substance is to be

absorbed quickly. They should be given with extreme care, especially in the buttock, because

the sciatic nerve may be injured or a large blood vessel may be entered if the injection is not

made correctly into the upper, outer quadrant of the buttock.

4:Subcutaneous injection

Subcutaneous injection injection made into the subcutaneous tissues. Although usually fluid

medications are injected, occasionally solid materials such as steroid hormones may be

injected in small, slowly absorbed pellets to prolong their effect. Subcutaneous injections

may be given wherever there is subcutaneous tissue, usually in the upper outer arm or thigh.
5:Intravenous injection

Intravenous is a term that means “into the vein”. Intravenous medication administration

occurs when a needle is inserted into a vein and medication is administered through that

needle. The needle is usually placed in a vein near the elbow, the wrist, or on the back of the

hand. Different sites can be used if necessary.

List of Injections

Various injections and vaccines are used in department of pharmacy, some of them are:-

Vaccines

Tetanus

Anti-rabies vaccines (ARV)

Anti-snake venom (ASV

Hepatitis

Injections-

Antibiotics ( Gentamycin 80mg, Ampicillin 500mg, Monoceff 500mg, Ciprofloxacin 500mg,

Metrogyl 400mg, Tetracycline 500mg, etc)

Steroids (Dexamethasone Sodium Phosphate Injection 4mg, Betamethasone injection)

Hydrocortisone Sodium Succinate injection 100mg

Antiemetic (Metoclopramide HCL Injection 10mg, Ondem 10mg)

Gastritis (Ranitidine HCL Injection 150mg, Omeprazole 20 mg, Pan tab 20mg, Homotidine

20mg)

Anti-allergic ( Phenaramine maleate 25mg)

Blood Bank

A blood bank is a center where blood gathered as a result of blood donation is stored and

preserved for later use in blood transfusion.

The term "blood bank" typically refers to a division of a hospital where the storage of blood

product occurs and where proper testing is performed (to reduce the risk of transfusion

related adverse events). However, it sometimes refers to a collection center, and indeed some

hospitals also perform collection.

For blood donation agencies in various countries, see List of blood donation

agencies and List of blood donation agencies in the United States.

 BLOOD DONATION

"Blood donation refers to the process of collecting, testing, preparing and storing blood and

blood components. Donors are most commonly unpaid volunteers, but they may also be paid

by commercial enterprises. Blood registry refers to the collection and sharing of data about

donated blood and ineligible donors."

Purpose Of Blood Donation

 The purpose of the blood collection and distribution system is to help ensure an

adequate supply of blood for accident victims, people needing surgery, and people

suffering from certain diseases, as well as for medical research.

 Sometimes, donors give blood specifically to benefit a particular person. People

preparing for elective surgery may donate their own blood to be held and then

returned to them during surgery. This is known as autologous blood donation.

Directed donor blood has been donated by someone known to the intended recipient,

such as a family member or friend.

TYPES OF BLOOD BANK SERVICE

 Government blood bank

 Non- government blood bank

 Commercial blood bank

Process of blood donation

ENTRY

BLOOD FORM
DONATION FILLING

SECONDARY INITIAL
SCREENING SCREENING
 Rabies
Vaccine
Vaccination against rabies is used in two distinct situations:
 to protect those who are at risk of exposure to rabies, i.e. preexposure vaccination;
 to prevent the development of clinical rabies after exposure has occurred, usually
following the bite of an animal suspected of having rabies, i.e. post-exposure prophylaxis.
The vaccines used for pre-exposure and post-exposure vaccination are the same, but the
immunization schedule differs. Rabies immunoglobulin is used only for post-exposure
prophylaxis. Modern vaccines of cell-culture or embryonated-egg origin are safer and
more effective than the older vaccines, which were produced in brain tissue. These
modern rabies vaccines are now available in major urban centres of most countries of the
developing world. Rabies immunoglobulin, on the other hand, is in short supply
worldwide and may not be available, even in major urban centres, in many dog rabies-
infected countries.

Precautions and contraindications

Modern rabies vaccines are well tolerated. The frequency of minor adverse reactions
(local pain, erythema, swelling and pruritus) varies widely from one report to another.
Occasional systemic reactions (malaise, generalized aches and headaches) have been
noted after intramuscular or intradermal injections.

Type of vaccine: Modern cell-culture or embryonated-egg vaccine

Number of doses: Three, one on each of days 0, 7 and 21 or 28, given i.m. (1 or 0.5 ml/dose
depending on the vaccine) or i.d. (0.1 ml/inoculation site)a
Booster: Not routinely needed for general travellers b
Adverse reactions: Minor local or systemic reactions

Before departure: Pre-exposure prophylaxis for those planning a visit to a country or area at
risk, especially if the area to be visited is far from major urban centres and appropriate care,
including the availability of post-exposure rabies prophylaxis, cannot be assured.
 Waste Management

Biohazard waste must have a way to dispose of it in a safe manner.During the period of

hospital training I have observed the Bins of various colours that contain the biohazard waste.

The disposing off waste carelessly may lead to DEATH.

So, the waste should be dumped in a systematic way.

Procedure :

THERE ARE 5 BINS -

1. Black Bin : General Waste (Dust, Paper, Kitchen waste)

2. Blue Bin : Broken Glass

3. Red Bin : Syringes, Plastic tubes, Urine Bag, Plastic Bottles \

4. Yellow Bin : Animal Tissue, Gloves, Expired Drugs

5. White Bin : Needle, Blade, Scaples

 Practice should be Right

 Handwashing& Cleaning Should be there at the Hospitals

 Trauma Center and Emergency

AIM

They aimed to treat injured patients as well as emergency cases.

PROCEDURE

Firstly the doctor check the patient, weather to admit the person or not according to the injury

or disease.

Bed head ticket (BHT) formed and then medicines are prescribed by the doctor. Now the

patient is shifted in the ward according to the disease.

Responsibility of this department was taken by team including EMO, Pharmacist, and Ward

boy. Open 24*7 hrs.

Problems encounter during the training

There are different problem which I had faced during training period:-‘

1- It’s tough to handle children, as they are not cooperative throughout the treatment.

2- Most of the patients are illiterate, so were unable to understand the medicine use and

forgot there doses.

3- If medicines were finished in the stock, So, immediate supply of the drug in the dispensary

was not there.

4- In emergency, patients were allowed to wear oxygen mask, So, sometimes they didn’t

wear that mask, so difficulty in the treatment was there.

5- Patient thought that, the staff was giving wrong drugs and the wrong treatment
 Summary

After 1 month of hospital training I came to learn about how to dispense medicines to the

patient, how to inject injections to them, how to handle trauma and emergency cases. I also

learn about dealing with hospital conditions like diseases of the patients, wards, staff

members, different departments, etc. Almost 2000 of prescriptions were received by the

dispensary and we have to treat them with full hospitality services.

Future plan

As I had completed my hospital training from District Hospital, So, I can use my knowledge

in medical field. For ex- if I will be posted in rural area, and if there is no doctor at the time

of emergency, So, I’ll be able to handle the situation by giving proper treatment to the patient

at the time. Another thing that I had learn in my training period about the whole procedure of

the hospital, starting from admitting the patient upto there treatment.

Observation

Thus I observed that the hospital is a place where people of all kinds come with their

problems which they believe to be solved by the medical staff. The working in the hospital

takes place by maintaining proper cleanliness in the environment. The staff and the doctors

are all hostile and good-natured towards the patients and listen to their problems. Each and

every department has its own way of working and at the end of the day; all of the work is

finished by it. There is no carelessness towards the patients for their drugs or injections and

they are treated on time. The nursing staffs are present at all times for their care. This type of

methodology should really be applicable in all hospitals so that the public may get treated

once and for all to maintain a healthy country.

 Conclusion

The training in a hospital gives us a conclusion that the training in the hospital was really

necessary as it not only helped us to see how a hospital operates, but it also helped me to

learn basic functions of it like first aid care, how to give injections and dispensing of drugs

etc. The conclusion drawn out can be that I have finally learned as to how important role a

hospital plays in peoples’ lives and that the hospital staff can go to any means to save them

since its their duty. Since District Hospital receives only 1 rupees per patient, so it also shows

us their good deed towards mankind and to their service.

THANK YOU