Emergency medical care in the country needs to be upgraded according to a report of NITI Aayog released on December 10, 2021. The report is a study by All India Institute of Medical Sciences, New Delhi of secondary and tertiary level care in emergency, injury and trauma.
NITI Aayog Member Dr V K Paul highlights the extraordinary importance for India to embark towards creating a world-class, efficient, professional, integrated emergency-care system, that is enabled by technology for the care of accident victim, emergency or trauma in any part of the country. He has pointed out that the assessment conducted in this pan-India study would be a starting point to deliberate changes.
The study noted that there is a need to develop a robust emergency care as 1,50,000 road traffic related deaths and 30 percent mortality is due to delay in emergency care.
To overcome these challenges emergency medicine must be a part of medical curriculum is one of the important recommendations.
It has been noted that 98.5 percent ambulances are transporting dead bodies, 95 percent are managed by untrained personnel and 90 percent do not have oxygen support. Ambulance services need to be upgraded and made available 24 by 7. Information technology must be used to integrate the services of emergency care.
Dr Randeep Guleria, director of AIIMS, New Delhi says, “Systems need to be created to deal with emergency care in road accident, injuries, heart attack, brain stroke, maternal and paediatric emergencies. There is a need to standardize emergency care by recommending proportion of beds, infrastructure, equipment, drugs and human resources. Best practices in the emergency care system outside and inside hospitals will help to create a seamless system of care.”
The study was carried out in 100 emergency and injury care centres in government and private hospital settings in 28 States and 2 Union Territories of India, in addition to 34 District Hospitals. Live observations of care, assessment of personnel and organizations was carried out.
The gaps in the system need to be addressed and medical colleges must attain self-sufficiency in providing definitive emergency care. Most of the hospitals across the spectrum lacked trauma registry and systems for surveillance of trauma and Emergency Care.
Upgrading the systems is most important in government hospitals where the standard protocols of care are missing.
The hospitals which have structured academic programs in emergency care are found to tackle these cases better. They have effective communication including critical and definitive care, tackling imminent disasters and continuous quality improvements.
The systems were found in National Accreditation Board for Hospitals and Healthcare providers where there is effective communication among care givers and timely delivery of care.
1. Establish Academic Emergency Medicine departments to ensure continuous ongoing medical education and development of skills for doctors, nurses and paramedics.
2. Expand Blood Bank services to smaller hospitals for timely availability.
3. Upgrade all emergency services by standardizing norms.
4. Create efficient funding in hospitals for emergency care and delivery of services.
5. Regular audits of medical services must be carried out in Government Hospitals as they were found lacking in comparison to Private Hospitals