Emergency medicine
A turning point for the region
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Preparations are now in place in the event there is major disaster in the UAE, or the wider region for that matter, with the development of a new, state-of-the-art trauma center in Dubai. Callan Emery toured the facility and filed this report.



An airplane crashes on landing at Dubai International, an inferno roars through a tower block, a violent earthquake destroys a community of villas or a big passenger liner collides with an oil tanker in the Gulf – these are all scenarios you wouldn’t wish on your worst enemy, but they could happen and when they do they strike without warning.

Having an emergency response plan to deal with such an event is essential. If emergency services are not prepared, hundreds, even thousands, of lives can be lost.

Conversely, if emergency services are ready, an emergency response programme is in place and adequate trauma recovery facilities are available, then the number of lives lost will be kept to a minimum. It is with this in mind that Dubai has developed and will soon open (an announcement to this effect is expected in September) a state-of-the-art, 140-bed trauma center, capable of handling major medical emergencies not only in Dubai, but throughout the UAE and across the region if need be.

Dr Moin Fikree, the clinical director of the Accident and Emergency Trauma Center gave me a tour of this masterpiece of modern medical design while a few workers bustled here and there putting the final touches in place.

Dr Fikree is also the head of the chairman of the Department of Health and Medical Services (DoHMS) Disaster Management Committee and explained that, as well as having such an outstanding trauma facility, the UAE has also devised a multi-level, dynamic disaster response programme that will be activated in the event of a largescale disaster or emergency.

“Via the Disaster Plan we can co-ordinate various government agencies – the newly established Dubai Unified Ambulance Service, civil defence, police, hospitals, DoHMS and Dubai Healthcare City,” Dr Fikree explained. “There are five levels of response depending on the scale of the disaster, ranging from, on the one hand, putting emergency services on standby, to the other extreme, activating a major response involving all hospitals regionally and internationally if need be.”

The medical aspect of the disaster response will be directed from a purposebuilt, highly sophisticated command and control centre at the new trauma center. “From the control room we have hotlines to all emergency services in the UAE and all the key hospitals,” Dr Fikree said “This facility marks a turning point for medicine in the region,” Dr Fikree told me casually as we entered the facility.

“It is the largest free-standing trauma centre of its kind in the region and perhaps Asia as well.” But more than its size – 140 beds of which 100 are critical beds – is its advanced design using the latest principles in medical architecture and the most advanced technology available.

“The entire building is wirelessly networked,” he added. It seems no expense has been spared and throughout the facility the newest, most advanced equipment was in place in the Operating Rooms (OR), recovery rooms, Intensive Care Units (ICU) and so on, waiting to have their plastic wrappings removed, in anticipation of the arrival of the first patients.

We entered through the walk-in entrance which leads into a spacious reception area and triage and then made our way to the other main entrance – the ambulance entry point which leads directly into a large, hitech resuscitation zone.

The ambulance entry can accommodate up to 14 ambulances at any one time. There are also two helicopter pads at this entry to enable an uninterrupted rotation of air ambulance service. From this it is apparent how the trauma centre is built to handle a large volume of patients in a short space of time.

And this is reflected throughout the building – the wide corridors and the easy flow from one zone to the next. Basically, the double-storey Accident and Emergency Trauma Center can be separated into six zones: on the ground floor there is the triage and resuscitation area; the acute treatment area – medical and surgical; and the low acute treatment area or short-stay wards (medical and surgical) along with a fully equipped, PACS enabled diagnostic radiology department and biomedical laboratories.

On the second level are six operating theatres; the ICU with isolated burns ICU; and the recovery wards. The trauma center is linked to Rashid Hospital via a corridor on both levels. “However,” Dr Fikree said,

“The ageing Rashid Hospital was not designed to handle the volume of patients it now treats and there are plans to develop, in the next few years, a new, larger Rashid Hospital, which will also be connected to the trauma center,”.

The resuscitation area has six beds each in a separate room, one of which houses the newly developed Lodox Statscan which can X-ray the entire body in 13 seconds. The resuscitation area leads into the acute treatment zone which is separated into medical and surgical zones, each of which has it own specialised areas to treat patients with specific lifethreatening conditions, such as burns. Beyond this zone are the short-stay wards and radiology and labs.

“There is also one small OR on this level for emergency surgery,” Dr Fikree pointed out. Each of the six advanced ORs on the upper lever has an anaesthesia room as part of the OR, accelerating the process of moving the patient from the ward to the operating table. Each OR has an attached scrubs room.

All the OR tables have video cameras enabling the surgery to be monitored by physicians in the OR, in the hospital and around the world. Also on the upper level are the recovery rooms, ICU and high dependency area.

All beds are constantly monitored and the ICU beds have ceiling-mounted webcams positioned over them for remote video monitoring of patients. When the center does open its doors it won’t be starting cold. “Nurses have been in training for the past four or five months,” Dr Fikree noted. “And we have taken on leading physicians from Canada and Germany. Two trauma specialist professors from Germany are working here already.

“We have hired InterHealth Canada to provide staff training and operations management for the initial three years. They will also prepare the trauma centre for JCI accreditation.” People in Dubai, the UAE and wider region can now feel confident they will receive the best emergency care available from one of the world’s most sophisticated trauma centers. It will be comforting knowledge in the face of a distressing major medical emergency.  

                                  
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