Dangerously ill list patient

BMJ 2008; 337 doi: (Published 09 July 2008) Cite this as: BMJ 2008;337:a229
  1. Ajit Singh Kashyap, consultant, Command Hospital (Central Command), Lucknow, India ,
  2. Kuldip Parkash Anand, deputy director of medical services, Uttar Bharat Area, Bareilly, India
  1. kashyapajits{at}

    After completing my medical studies 27 years ago, I was posted to a government hospital as a medical officer. On my first day on duty as the emergency medical officer I was told by a senior matron that I had to conduct rounds of all the wards and write progress notes for all the patients on the dangerously ill list.

    I started the ward rounds in earnest. In a remote corner of the sprawling, colonial era hospital, I entered a high ceilinged ward that was deserted except for a steel bed in the centre of the room. Placed in centre of the bed was a table, on top of which was a stool. Standing on the stool was a young man, and perched on his shoulders was another young man, who was cleaning the ceiling fan as part of the preparations for a forthcoming hospital inspection. It was pointed out to me by the nursing officer in charge of the ward that the young man cleaning the fan was on the dangerously ill list.

    When I asked the patient about his diagnosis and progress, he confirmed being on the dangerously ill list for anaemia—his haemoglobin concentration was 90 g/l. The nursing officer informed me that, according to the existing medical services rules (framed in the era of British rule), all patients with haemoglobin levels below 100 g/l had to be placed on the dangerously ill list.


    Cite this as: BMJ 2008;337:a229

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