Emergency in ECHS Means

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 Para 16. *Treatment in Emergency.*

(a) If in 'emergency', patients can go directly to any empanelled / non 
empanelled hosp. 'Emergency' in ECHS is defined as life threatening conditions 
to include the following :- 
(i) Acute Cardiac Conditions/ Syndromes including Myocardial 
Infarction, Unstable Angina, Ventricular Arrhythmias, Paroxysmal 
Superventricular Tachyccardia, Cardiac Tamponade, Acute Left Ventricular 
Failure/ Severe Congestive Cardiac Failure, Accelerated Hypertension, 
Complete dissection. 
(ii) Vascular Catastrophies including medical and surgical shock and 
peripheral circulatory failure, Acute limb ischaemia, Rupture of aneurysms.
(iii) Cerebro-Vascular Accidents including Strokes; Neurological 
Emergencies including coma, cerebro meningeal infections, convulsions, 
acute paralysis, acute visual loss. 
(iv) Acute Respiratory Emergencies including respiratory failure and 
decompensated lung diseases. 
(v) Acute abdomen including acute obstertrical and gynaecological 
(vi) Life threatening injuries including road traffic accidents, Head 
injuries, Multiple injuries, Crush injuries and thermal injuries. 
(vii) Acute poisonings and snake bite. 
(viii) Heat stroke and cold injuries of life threatening nature. 
(ix) Acute endocrine emergencies like Diabetic Ketoacidosis. 
(x) Acute Renal Failure. 
(xi) Severe infections leading to life threatening sequelae including 
Septicaemia disseminated/ miliary tuberculosis. 
(xii) Any other condition in which delay could result in loss of life or limb. 
(b) 'Emergency' provision should not be misused. It is related to medical 
condition of the patient and not with closing hour of PC/ holidays. 
(c) This provision should not be used as a 'short cut' to avoid going 
through PC. 
 (d) In life threatening conditions, moving to one of the closest hospital is 
the natural response and therefore all emergency admissions will be viewed 
from this perspective as well. Hospital should also be careful while treating 
such cases. Intimation within 24 hr by empanelled hospital for ER and 
within 48 hr from non empanelled hosp by individual (EIR) is mandatory. 
 (e) All empanelled hospitals must allow treatment/ admissions in case of 
genuine emergencies only. 'Benefit of doubt' should be given to the patient. After 
stabilisation, patient should be discharged viz a patient may come to empanelled 
hosp feeling chest pain but on examination, he/she may be suffering from gastric 
problem and all tests done don't indicate heart problem, such patients after 
stabilisation and basic medication, should be discharged and charges raised on 
day care basis to ECHS. Empanelled hospital will indicate date and time of 
reporting and discharge on discharge summary/ bills (Auth: Para 4(b)(iv) of GoI 
(MoD) letter No 24(8)/03/US(WE)/D(Res) dt 19 Dec 2003) to the nearest as well as parent PC. The bills under emergency clause will be raised with specified 
documents as under:- 
 (i) Copy of ECHS Card. 
 (ii) Emergency room case sheet/ discharge summary indicating time of 
reporting / discharge. 
 (iii) Copy of ER. 
 (iv) The applicable charges will be as under :- 
 (aa) Consultation Charges (max two) as per CGHS rates. Second 
consultation is allowed if a specialist attends in addition to MO. 
 (ab) Emergency investigation charges. 
 (ac) Medicines & consumables used for stabilisation including 
 POP charges etc. 
 (ad) No room rent will be paid. 
 (f) Those misutilising the provision be it ECHS beneficiaries/empanelled 
hospitals will be strongly penalised. 
 (g) Emergency Treatment in Non Empanelled Hosp and Reimbursement. 
All beneficiaries are allowed to get themselves treated in any hospital in case of 
emergency, though empanelled hospitals will submit their bills online, patients 
who have treated themselves in non empanelled hosp to process their 
reimbursement bills through parent PC. Mandatory documents are as under :- 
 (i) Copy of ECHS Card. 
 (ii) Emergency certificate issued by the hosp. 
 (iii) Discharge summary (must include admission date & discharge 
 date correctly with details of disease & treatment provided). 
 (iv) Emergency room case sheet. 
 (v) Copy of EIR. 
 (vi) Bill in detail with summary. 
 (vii) All images, pouches, barcode, invoices etc.

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