|
Service /
|
Primary Health Care |
Secondary Health Care |
Tertiary Health Care |
|
|
PHC I |
PHC II
CHC I |
CHC II |
CH
(50 beds) |
CH (100 beds) DH /ZH |
Medical Colleges |
GENERAL SURGICAL SERVICES
|
|
EMERGENCY SERVICES:
TRAUMA AND LIFE
SUPPORT |
First Aid
Dressing |
Resuscitate
Stabilise
Refer |
As in CHC I |
As in CHC II
|
As in CHC +
Specialized Ortho care
|
Severe Head and spinal
injuries |
|
SHOCK
|
Refer |
Supportive treatment
Refer |
Initiate treatment
Refer |
Initiate treatment
Refer |
Investigate
Treat |
|
|
HEAD INJURIES |
First aid, refer
|
First aid, refer
|
First aid, observe,
refer |
Stabilise, manage,
refer |
Treatment |
Complicated and
referred cases |
|
FRACTURES |
First Aid, Refer |
First Aid, Refer |
Stabilise |
Stabilise
Reduce |
Stabilise
Reduce
Surgical management of
compound fractures |
Complicated and
referred cases |
|
SURGICAL PROCEDURES
MINOR: |
Removal of FB
Stitching of wounds |
Basic techniques:
Drainage of abscess;
Removal of cyst, lymph
nodes, lipoma;
Others as in PHCI
|
As in CHC I
+
Lymph node biopsy and
other biopsies
|
As in CHC II +
Debridement |
As in CH +
Split thin graft
Biopsy of the skin |
|
|
MAJOR : |
Refer |
Vasectomy, tubectomy,
circumcision |
Appendicectomy,
Herniotomy, hydrocele, large abscesses, |
Rectal prolapse,
prostectomy, haemmoroidectomy, cystotomy, Hystectomy and other
gynaecological operations. |
Cholecystectomy
Surgical management of
intestinal obstruction, pyelolithotomy, intussusceptions, volvulus |
|
|
SNAKE AND DOG BITE
CASES |
First Aid |
Manage |
Manage |
Manage |
Manage complications |
Referred cases |
|
ACUTE POISONINIG |
Refer |
Symptomatic &
Refer |
Symptomatic &
Refer |
Investigate
Manage |
Investigate
Manage and refer the
complicated cases for example patients needing ventilatory support. |
|
|
|
ANAESTHESIA
|
|
|
BASIC TECHNIQUE |
Local anasthesia |
Local Anesthesia |
Care of airway
Intubation
Equipment handling |
Care of airway
Intubation
Equipment handling |
Management of Spinal
and general anasthesia |
Management of Spinal
and general anesthesia |
|
|
BLOCK ANAESTHESIA |
|
|
Yes |
Yes |
Yes |
Yes |
|
|
SPINAL ANAESTHESIA |
|
|
Yes |
Yes |
Yes |
Yes |
|
|
GENERAL ANAESTHESIA
|
|
|
|
Yes |
Yes |
Yes |
|
|
OBSTETRICS AND GYAENOCOLOGY, INCLUDING REPRODUCTIVE HEALTH
|
|
|
HIGH RISK PREGNANCY,
INCL APH, PPH, ECLAMPSIA ETC. |
Early diagnosis and
refer |
Early diagnosis and
refer |
Early diagnosis and
refer |
Investigate and
management |
Investigate and
management |
Referred cases
|
|
|
NORMAL AND
COMPLICATED DELIVERY ** |
Antenatal care
Domiciliary normal
delivery |
Ante natal care Normal
institutional delivery, |
Ante natal care
Institutional delivery, episiotomy
Forceps |
Forceps
Vacuum extraction,
breach delivery, manual removal of placenta, |
Lower Segment Caesarean
Section |
Complicated and
referred case
|
|
|
ECTOPIC PREGNANCY /
ABNORMAL PRESENTATION |
Refer |
Refer |
Stabilize and refer |
Exploratory laparotomy |
Exploratory laparotomy
for ruptured ectopic pregnancy |
Complicated and
referred cases |
|
|
ABORTION (THREATENED
/ INCOMPLETE ) |
Refer |
MTP in first trimester |
Conservative D&C
MTP in second trimester
|
MTP in second trimester |
MTP in second trimester
|
Complicated and
referred case |
|
|
PID |
Refer |
Refer |
Diagnose and manage |
Diagnose and manage |
Diagnose and manage |
Referred cases |
|
MENSTRUAL
IRREGULARITIES |
Refer |
Refer |
Refer |
Diagnose and manage |
Diagnose and manage |
Referred cases |
|
INFERTILITY |
Refer |
Refer |
Refer |
Diagnose and manage |
Diagnose and manage |
Referred cases |
|
CERVICAL EROSION |
Refer |
Refer |
Refer |
Manage |
PAP Smear
Biopsy
Manage |
Complicated and
referred cases |
|
FAMILY PLANNING ** |
Counseling
Contraceptives
(Spacing methods)
|
Counseling
Vasectomy
Tubectomy
|
Laparoscopic tubectomy,
NSV |
Laparoscopic tubectomy,
NSV |
Laparoscopic tubectomy,
NSV |
Recanalisation
|
|
DISEASES OF CENTRAL NERVOUS SYSTEM |
|
INFECTIONS:
ENCEPHALITIS,
MENINGITIS |
Symptomatic and Refer |
Symptomatic and Refer |
Symptomatic and Refer |
Investigate and manage
|
Investigate and manage
|
CT Scan, EEG
Treatment |
|
SEIZURE DISORDERS:
(CONVULSIONS
EPILEPSY)
|
Symptomatic and Refer |
Symptomatic and Refer |
Symptomatic and Refer |
Investigate
Manage |
Investigation, LP,
Manage |
CT Scan, EEG
Treatment |
|
COMA/ LOSS OF
CONSCIOUSNESS, CVA |
Symptomatic Refer |
Symptomatic Refer |
Maintain airway
Investigate manage |
Investigate
Medical decompression
Manage |
Investigate
Surgical decompression
Manage |
CT Scan, EEG
Treatment |
|
MUSCLE AND NERVE
DISORDERS |
Symptomatic Refer |
Symptomatic Refer |
Symptomatic and Refer |
Investigate and manage
|
Investigate and manage
|
CT Scan, EEG ,EMG,NCV,
Muscle biopsy;
Treatment |
| |
|
|
|
|
|
|
|
|
DISEASES OF RESPIRATORY SYSTEM
|
|
RESPIRATORY TRACT
INFECTIONS (UPPER AND LOWER) |
Initiate management
Refer |
Initiate management
Refer |
Initiate management
Refer |
PH change
Manage severe cases
|
PH change
Severe distress |
|
|
BRONCHIAL ASTHMA |
Refer |
Symptomatic and refer |
Symptomatic and refer |
Investigate Manage
|
Investigate severe
cases
Manage |
Referred cases |
|
COPD (CHRONIC
BRONCHITIS AND EMPHYSEMA) |
Refer |
Symptomatic and refer |
Symptomatic and refer |
Investigate
Manage |
Severe cases |
|
|
TUBERCULOSIS **
|
Suspect, refer |
Microscopy
Treatment |
Microscopy
Treatment |
Microscopy
Treatment |
District TB Centre |
Resistant cases |
|
PLEF
|
Refer |
Refer |
Investigate
Treatment |
Investigate
Treatment |
Confirm diagnosis |
Treat malignant cases
|
|
LUNG CANCER |
Refer |
Refer |
Symptomatic and
supportive treatment
Refer |
Symptomatic and
supportive treatment
Refer |
Symptomatic and
supportive treatment
Refer |
Treatment |
|
OCCUPATIONAL LUNG
DISEASES |
Suspect, refer |
Suspect, refer |
Investigate and
supportive treatment |
Investigate, confirm
diagnosis, treat |
Investigate and manage |
|
CARDIO VASCULAR DISEASES
|
|
HYPERTENSION
|
Manage mild cases |
Manage moderate cases |
Investigate and Manage
moderate cases |
Investigate and Manage
moderate cases |
Investigate and manage
serious cases, ICU |
Investigate and manage
serious cases, ICU |
|
CORONARY ARTERY
DISEASE
(ANGINA, MI) |
Refer |
Initiate treatment and
refer |
Initiate treatment and
refer |
Investigate manage and
refer |
Investigate
TMT, Doppler
Treat |
Angiography
Angioplasty
By-pass surgery |
|
RHEUMATIC FEVER AND
VALVULAR DISEASES. |
Screen
Refer |
Screen
Symptomatic Refer |
Screen
Symptomatic Refer |
Screen
Symptomatic Refer |
Investigate
Confrim diagnosis,
manage |
Complicated cases |
|
PERICARDIAL DISEASES |
Refer |
Refer |
Refer |
Screen, symptomatic and
refer. |
|
|
|
DISORDERS OF CARDIAC
RHYTHM |
Refer |
Refer |
Investigate and manage |
Investigate and manage |
Investigate and manage |
Treat |
|
CONGESTIVE HEART
FAILURE
|
Refer |
Refer |
Initiate treatment
Refer |
Initiate treatment
Refer |
Investigate
Treat |
|
|
|
GASTRO
INTESTINAL DISEASES |
|
|
ACUTE DIARRHOEAL
DISEASES:
Gastro enteritis,
Cholera,
Amebiasis Diarrhoea
** |
ORT
HAF
IEC |
Management of mild,
moderate cases |
ORT
Management of severe
cases |
Management of severe
cases |
Investigate
Management of severe
cases |
|
|
|
GIT DISORDERS e.g.
Dyspepsia, Upper GI bleed, PU. |
Symptomatic management |
Symptomatic management |
Symptomatic
Supportive management |
Symptomatic
Supportive management,
Sigmoidoscopy
|
Investigate
Endoscopy
Colnoscopy
Treatment |
Complicated cases |
|
|
LIVER DISORDERS:
Hepatitis,
Cirrhosis, malignancy. |
Symptomatic Refer
|
