Junior Consultant

Job Title 2. Department 3. Reporting Structure

• Reports to: Head of Emergency Medicine / Senior Consultant - Emergency Medicine / Medical Superintendent.
• Supervises: Emergency Medical Officers, Junior Residents, Emergency Nurses and other emergency department staff, as per hospital policy.
• Coordinates with: ICU, Anaesthesia, General Medicine, General Surgery, Orthopaedics, Neurosurgery, Cardiology, Neurology, Radiology, Laboratory and other clinical departments.

4. Job Purpose 5. Key Roles and Responsibilities A. Emergency Patient Assessment and Management

1. Assess patients presenting to the Emergency Department, including medical, surgical, trauma and paediatric emergencies within the assigned scope of practice.
2. Perform rapid clinical assessment and identify life-threatening conditions.
3. Obtain detailed medical history and conduct appropriate physical examinations.
4. Initiate timely investigations based on clinical presentation.
5. Establish provisional diagnosis and formulate an appropriate management plan.
6. Initiate immediate treatment for acute and critical conditions.
7. Reassess patients regularly and monitor response to treatment.
8. Identify patients requiring admission, observation, referral, transfer or discharge.
9. Ensure appropriate documentation of clinical findings, diagnosis and treatment.

B. Management of Medical Emergencies

• Acute myocardial infarction and acute coronary syndromes.
• Cardiac arrhythmias.
• Cardiac arrest.
• Acute respiratory distress and respiratory failure.
• Acute asthma and COPD exacerbations.
• Stroke and transient ischaemic attacks.
• Seizures and status epilepticus.
• Diabetic emergencies, including DKA and hypoglycaemia.
• Sepsis and septic shock.
• Acute poisoning and drug overdose.
• Anaphylaxis.
• Gastrointestinal bleeding.
• Acute renal failure and electrolyte disturbances.
• Hypertensive emergencies.
• Altered sensorium and unconsciousness.
• Acute abdominal pain and other medical emergencies.

C. Trauma and Surgical Emergency Management

1. Conduct primary and secondary trauma surveys.
2. Follow ATLS principles and hospital trauma protocols.
3. Assess and stabilize patients with polytrauma.
4. Manage initial resuscitation of patients with haemorrhagic shock.
5. Identify life-threatening thoracic, abdominal and head injuries.
6. Coordinate with surgical, orthopaedic and neurosurgical teams.
7. Manage initial wound assessment and appropriate wound care.
8. Perform emergency procedures within the scope of competence and hospital privileges.
9. Ensure timely referral and transfer of patients requiring specialist intervention.
10. Monitor trauma patients for deterioration and complications.

D. Resuscitation and Critical Care

• Performing Basic Life Support (BLS) and Advanced Cardiovascular Life Support (ACLS).
• Leading or participating in cardiac arrest resuscitation as per hospital policy.
• Airway assessment and management.
• Bag-mask ventilation.
• Endotracheal intubation, where trained and credentialed.
• Defibrillation and synchronized cardioversion, where indicated.
• Establishing intravenous and intraosseous access.
• Initiating fluid resuscitation.
• Administering emergency medications.
• Managing shock and haemodynamic instability.
• Initiating ventilatory support in coordination with the critical care team.
• Recognizing patients requiring ICU admission.

E. Emergency Procedures

1. Endotracheal intubation.
2. Bag-mask ventilation.
3. Central venous catheterization.
4. Arterial blood sampling.
5. Peripheral intravenous cannulation.
6. Intraosseous access.
7. Lumbar puncture.
8. Pleural decompression and chest tube insertion.
9. Cardioversion and defibrillation.
10. Suturing and wound management.
11. Fracture and dislocation stabilization.
12. Nasogastric tube insertion.
13. Urinary catheterization.
14. Emergency ultrasound/POCUS.
15. FAST/eFAST examination, where trained and credentialed.

F. Triage and Emergency Department Operations

1. Ensure timely clinical assessment of patients according to triage priority.
2. Identify and prioritize critically ill patients.
3. Ensure appropriate utilization of emergency beds and resuscitation areas.
4. Coordinate patient flow from triage to consultation, investigation and disposition.
5. Monitor waiting patients for clinical deterioration.
6. Escalate delays in investigations, consultations and transfers.
7. Ensure smooth handover between shifts.
8. Coordinate with nursing and support staff for efficient ED functioning.
9. Ensure timely escalation of high-risk patients to senior consultants.

G. Coordination with Other Departments

1. Coordinate with specialty consultants for patients requiring multidisciplinary management.
2. Communicate clinical findings and treatment plans clearly.
3. Arrange timely consultations and specialist referrals.
4. Coordinate with ICU for critically ill patients.
5. Coordinate with the operation theatre for emergency surgical cases.
6. Liaise with radiology and laboratory services for urgent investigations.
7. Facilitate interdepartmental and interhospital transfers.
8. Ensure proper clinical handover during admission and transfer.

H. Patient Admission, Referral and Discharge

1. Make appropriate decisions regarding admission, observation, discharge or referral in accordance with hospital protocols and clinical circumstances.
2. Ensure that admission requests contain adequate clinical information.
3. Communicate the patients condition and management plan to the receiving team.
4. Ensure appropriate stabilization before transfer.
5. Provide clear discharge instructions and warning signs.
6. Explain follow-up requirements and medication instructions.
7. Document patient or attendant counselling.
8. Ensure safe discharge practices and appropriate documentation.

I. Documentation and Medical Records

1. Maintain accurate, complete and timely medical records.
2. Document history, examination findings, provisional diagnosis and treatment.
3. Record vital signs and clinical reassessments.
4. Document emergency procedures and informed consent, wherever applicable.
5. Maintain proper documentation of resuscitation events.
6. Record referrals and consultant communication.
7. Document reasons for admission, transfer or discharge.
8. Complete medico-legal case documentation as per hospital policy.
9. Maintain confidentiality of patient information.

J. Medico-Legal Responsibilities

1. Identify medico-legal cases (MLCs) according to applicable regulations and hospital policy.
2. Ensure appropriate MLC registration and documentation.
3. Inform the appropriate authorities as required by law and hospital policy.
4. Maintain accurate records of injuries, examination findings and treatment.
5. Ensure proper preservation and handling of relevant medico-legal evidence.
6. Follow protocols for cases involving road traffic accidents, assault, poisoning, burns, sexual violence and other reportable incidents.
7. Maintain professional communication with police and legal authorities.
8. Ensure patient confidentiality and ethical conduct.

K. Infection Prevention and Patient Safety

1. Follow hospital infection prevention and control policies.
2. Ensure appropriate hand hygiene and use of personal protective equipment.
3. Follow biomedical waste management guidelines.
4. Ensure safe handling of sharps and contaminated materials.
5. Follow isolation precautions for infectious patients.
6. Participate in patient safety initiatives.
7. Identify and report adverse events and near misses.
8. Follow medication safety protocols.
9. Ensure compliance with patient identification and procedural safety standards.

L. Quality Assurance and Clinical Goverce

1. Participate in departmental quality improvement activities.
2. Follow hospital clinical protocols and standard operating procedures.
3. Participate in clinical audits and mortality and morbidity reviews.
4. Review emergency department performance indicators.
5. Participate in root cause analysis when required.
6. Identify opportunities to improve patient waiting time and treatment turnaround time.
7. Support NABH accreditation requirements and other applicable quality standards.
8. Participate in incident reporting and corrective and preventive action (CAPA).

M. Training and Academic Responsibilities

1. Participate in departmental academic activities.
2. Attend clinical meetings, case discussions and morbidity and mortality meetings.
3. Support the training of residents, interns and emergency medical officers.
4. Participate in mock drills for cardiac arrest, mass casualty incidents and other emergencies.
5. Maintain continuing medical education (CME) and professional development.
6. Keep updated with current emergency medicine guidelines and protocols.
7. Participate in clinical research and audit activities, where applicable.

N. Disaster and Mass Casualty Management

1. Participate in hospital disas
   
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