1993-2018 ,u ,p vkj lh % iPphl o’kZ&vla[; vk’kk,a Nhrc : Twenty Five Years-billion Hopes 30. What are the essential practices while referring a patient from prison hospital to higher centre? Formalities at the referring prison hospital 1. The medical of icer who is treating the patient is to take initiative for referral and sign in the referral card. 2. A patient should be referred only if there is a de inite and convincing indication felt by the referring doctor for referral. The indication should be clearly mentioned. Referral should be documented in referral out register maintained at prison. 3. The reasons for referral should be clearly indicated in the referring letter. Brief summary of vital signs at the time of sending the patient and medications given should be clearly mentioned. It should be accompanied with suf icient documents like referral letter and supporting materials like X-ray, ECG or other similar investigation reports. 4. Basic patient work up at the level of referring centre should as far as possible be completed depending on the availability of facilities for investigation as well as time. Efforts should be taken from the referring end to provide investigation results pending if any to be later collected and sent to the referred institution through the accompanying policeman. 5. Writing in any communication and correspondence should be legible and easily readable. 6. The diagnosis to be recorded is the most likely working diagnosis felt by the referring doctor at the time of referral. 7. Necessary information should be passed on to the patient along with counselling about the need of referral and necessary supportive information and guidance. In most of the situations of con lict lack of communication or misgivings of matters to patients end up in hostile situations. Proper care must be taken to avoid such situations. 8. In the case of emergency referrals transport should be arranged from the referring prison based on the clinical condition of the patient as decided by the referring doctor. Prison administration may arrange the transport on request of the doctor. 9. In the case of emergency referral if the patient's condition is critically dangerous warranting continuing medical support, or if there is a chance to worsen, demanding emergency resuscitation, an appropriately functional medical ambulance should be made FORENSIC INVESTIGATION | 21