Table 2 Authors’ recommendations to address identified gaps in emergency care at tertiary facilities in the Kathmandu region are listed in this table

Recommendation 1

Triage system and time metrics

-Ensure all facilities have an adequate triage system in the ER

-Ensure time targets in triage

-Ensure labeled resuscitation and high acuity areas within the ER

Recommendation 2

Training and education

-Ensure universal emergency staff training and competency with a focus on following procedures: establishment of surgical airway, pelvic binding, cardiac pacing, pericardiocentesis, burn fluid resuscitation, neonatal resuscitation

-Consider cross-institutional collaboration in training programs

Recommendation 3

Written protocols for emergency care

-Ensure availability of written protocols for condition-specific care, transfer, and discharge

-Ensure cross-institutional collaboration in sharing written protocols

Recommendation 4

Infrastructure

-Ensure minimal standards are met in emergency room infrastructures with a focus on the following: adequate isolation area, waiting area, hand-washing stations, and toilet facilities

-Hospital administration must ensure the availability of essential emergency care materials: point-of-care testing, 24/7 radiology, point-of-care ultrasound, etc.