New Delhi: The cold room is a vital part of any hospital’s emergency response and should be used sparingly, according to a group of experts who have recommended that it should be utilised sparingly.
Dr Ashish Sharma, an emeritus professor of emergency medicine at Columbia University, wrote in a letter to the National Institute of Medical Sciences that the “matrix has been used sparingfully” in the past, even as it became “more commonly” used for routine tests in the ICU.
He wrote that the use of the matrix is “the most commonly used technique for cold room diagnosis in the emergency department” and should not be overused.
“The current usage is a major contributor to poor outcome and increased mortality in cold-related emergencies,” Sharma wrote.
“It is time to rethink the use and usage of the matrices.”
Sharma noted that it is “a difficult and time-consuming process” to identify and treat a cold, and that in the absence of a specific test, “there is no assurance that the patient is in the correct body position to receive a proper diagnosis”.
He said a patient should be instructed on what to do when the temperature is below -15C, but that patients should also be given instructions on how to interpret the results.
“Patients should be given a specific protocol for their cold room testing, based on the patient’s clinical and physical condition,” Sharma said.
“This protocol should include instructions for the use or refusal of the machine, the temperature measurement and/or the use/rejection of the patient.”
In a letter submitted to the government on January 20, the National Council of Medical Research (NCMR) said that the matrix should be removed from all tests and administered “to ensure proper diagnosis and therapeutic response”.
“If there is no specific test or test-specific protocol, the machine should be stopped immediately,” the NCMR said.
The letter also said that cold room units should be kept in a “cold room”, with “cold rooms” defined as a room where temperatures are above -15 degrees Celsius.
“There should be no machines in the room, and the patient should remain on his or her own.
Machines should be monitored during the time of cold room assessment.
If there is a test or a test-related protocol, it should include the patient as well as the machine,” the letter said.
Sharma’s letter also warned that the availability of free “cold” devices, including the Matrix, should be restricted.
The use of a machine in the “cold bed” of the ICUs has come under fire from advocates of free, open testing.
The government recently scrapped the requirement that all patients have to be checked for influenza by an “outside” laboratory before they can receive a “free” flu shot.
Shaharma said that free machines “can be problematic because of the cost and the fact that there is often a waiting period” for them to be used.
“A patient might feel pressured to go to a hospital without testing and test the machines before leaving.
There is a huge delay in testing, which is a problem in ICUs,” he said.
According to Sharma, the use “is not a good idea” because it “is expensive to get a machine, and in the case of a patient with poor immune function, it may be difficult to identify”.
“It is also not clear that the machine is the best way to determine the correct diagnosis.”
In the past week, several other experts have issued similar recommendations to the ICUC.
Dr Sridhar Dhar, a consultant cardiologist and senior consultant in emergency medicine and emergency medicine, wrote that a patient can be found to be in the right body position at any given moment, and is in a good position to have the correct results if he or she is given a cold room test.
“Patients may not know the temperature in the bed and/ or whether the bed is cold or warm.
So the patient can not be able to make the appropriate assessment.”
Dhar’s letter urged that all cold room tests be done within 24 hours.
The recommendations were not welcomed by the National Medical Council (NMCA).
In a statement, NMCA chairman Dr Rishi Rana said that, while some tests are “important for a proper cold room”, they should be performed “by experienced, experienced physicians who have been trained and certified in the field”.
“The NMCA believes that this is not the case and will continue to strongly advocate against the use, use and misuse of cold rooms in the medical arena,” he added.
“For example, it is highly inappropriate for a patient to have a test for influenza, which results in a diagnosis, to be done in the operating theatre, without any training and without the knowledge of the appropriate health professionals, while a cold test is being done in a hospital, and a patient is lying in the hospital, without being in the proper body position.”
Sharmarma’s suggestion that