The Green Zone of Emergency Department Hospital Universiti Sains Malaysia (EDHUSM) which provides treatment for
non-critical cases contributes partly to the hustle and bustle in the emergency department. The imbalance of doctors
and nurses with the patient ratio which forms the resources’ bottleneck further results to the long patients’ waiting time
especially after the office hours and during weekends and public holidays. Collectively, this disproportion and bottlenecks
roots up the current problem faced by Green Zone EDHUSM which constantly fails to achieve the KPIs set by the hospital.
Henceforth, this study focuses on the best resource allocation of doctors and nurses for shifts during the weekdays and
for shifts during weekends and public holidays. The hybrid method of Discrete Event Simulation, and Data Envelopment
Analysis models such as BCC-input oriented and Super-Efficiency, were deployed to obtain the best resource allocation
for the two groups of shift. The method produced a series of resources allocation alternatives for doctors and nurses
with a total of 64 alternatives for weekdays and 729 alternatives for weekends and public holidays. The results show that
the best allocation for doctors and nurses during weekdays are three doctors and three nurses serving for every shift,
while during weekends and public holidays, a combination of four doctors and four nurses for every shift are the best.
The proposed combinations have reduced the average waiting time, optimized the utilization of doctors and nurses, and
managed to increase the number of patients served during weekdays, weekends and public holidays.
Background: Diving related illness has become a public health concern, as there isan increasing number of diversworldwide. However, the incidence of Decompression Illness (DCI), a medical disorder as a result of sudden reduction of ambient pressure, remainsgenerallylow. This paper describes the patternsof decompression illness treated in a military hospital-based recompression chamber facility in Peninsular Malaysiafrom year 2000 until 2010.Objective:The objective ofthis study is to determine the patternsof decompression illnesspatientstreated withHyperbaric Oxygen Therapy(HBOT)in a military hospital-based recompression chamber facility inPeninsular Malaysia.
Methodology:A retrospective descriptive study was carried out to utilizesecondary data from Hospital Angkatan Tentera Lumut, Perakfrom 1stJanuary 2000 to 31stDecember 2010. A total of 96 caseswere included in thisstudy.
Results:Most of the patients were male (94.8%), recreational divers (43.0%), non-smokers (56.3%),with no previous medical illness(85.4%), who had dived with compressed air (78.0%), had lessthan 5years divingexperience (56.3%), were non-instructors(75.0%),and had body mass index between 18.5 to 24.9kg/m2(59.4%). Interestingly,25% of the patients developing DCI dived to less than 10 meters depth, 35.4% of them went for a single dive and 71.9% performed safety stops.The majority of the patients had symptoms startingwithin 12 hours after surfacing (85.4%),mainly within the first 3 hours and many had neurological manifestation (61.5%).Only 16.7% of the patients treated withHBOThad therapycommenced within 6 hours from the onset of symptomsand 93.8% from this group had complete recovery. Overall,76.0% of patients had fullrecovery after HBOT.
Conclusion:Diving activities must be closely monitored. Medical surveillance as well as legislations related to diving activities in Malaysia areessential to improve SCUBA discipline and to reduce mortality and morbidity ofDCI in the future.
Ring removal is indicated in a number of clinical circumstances to manage or prevent tourniquet effect of the digit. A ring made from hardened metal may defy commonly known methods of removal. We reported a case of unusual difficulty in removing a ring of hardened metal composition using a dental drill. We believed the unusual circumstances of this case is likely to be repeated in some other clinical practice and this instrument is an appropriate option to consider in such cases.