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By Dr. Zulfikar Bux Assistant Professor of Emergency MedicineIts 3:45 in the morning and I can’t sleep. My staff in the overcrowded emergency room are overworked and tired and have just informed me of an influx of many patients who are seriously injured from accidents and other early morning lapses.Everyone is frustrated and wants immediate care. As tired as they are, most of my staff skip their breaks and motor on doing what they do best; fighting to save the lives of those that need it the most.2015 was mostly sleepless nights for me and I wish for better sleep in 2016. For my wish to come true we need to further develop the emergency medical response system,Jerseys From China, so I don’t have to worry about tired and overworked staff, and of course, the sick patients awaiting emergency care. I will share with you some cost effective interventions which are achievable in 2016 and can advance emergency medical care for us all.HAVING MORE TRAINED EMERGENCY MEDICAL PROFESSIONALSThe staff that work in emergency rooms have to make multiple, fast-paced and safe decisions with little to no room for error.Their decisions can literally make or break one’s life. The evidence has shown that the more specialized the staff training, the more effective the medical care delivered.We have a robust training programme for doctors, which is beginning to deliver specialist emergency doctors who are delivering the expected level of care for patients who urgently require it. In 2016 we need to move one step further and train emergency nurses and technicians. This will create a full team of emergency medical professionals that will deliver more efficient and effective medical care.HAVING A NATIONAL AMBULANCE SERVICEThis is such a vital need for patients involved in accidents or those that are critically ill and in need of urgent and safe transport to a hospital. For the past few years we have trialed a mini pilot ambulance unit, and many mothers, babies, accident victims etc. were saved. We need to expand this service to all Guyanese and coordinate it through a central dispatch unit. Once this is fully instituted, patients that are in accidents and those that are very sick will be safely and efficiently transported to a Hospital and more lives will be saved.UPGRADING OF EMERGENCY ROOMSWe cannot train specialist staff and not have the appropriate environment for them to work in. Emergency rooms countrywide should be upgraded so that staffers have the appropriate equipment and space to effectively carry out their vital work.It should be started centrally at the GPHC,where there is the highest patient load, and then dispersed to other emergency rooms. This can be coordinated through a central office designated as the National Emergency Medical Service. Such an office will ensure standards for emergency patient care are initiated and upheld at all medical care points in Guyana.IMPROVED LIFESTYLESThe reckless driving, eating and alcohol/drug use by Guyanese are contributing to a substantial proportion of patients that present to emergency rooms for care. We need to reflect on ourselves as individuals and as a society. Instead of complaining, we need to comply and contribute to the solution. Living reckless is not good for you, not good for the other patients that have to await care because of your transgression, not good for the medical staff who are given additional work, and not good for your country which is losing out on a valued contributor towards its development. It’s also not good for my sleep.It’s now 4:50 am and I still can’t sleep. My staff is still going at it and getting more tired. The fresh staff that will be coming in will be greeted with an overcrowded emergency room. We are all tired, but we keep doing it because we are a bunch of adrenaline-driven cohorts who chose a field that suited our personality. But its 2016 and I wish to sleep better. If you are reading this article, I ask that you contribute to the solution of making me sleep better this year.