Emergency Medical Services in India

By - Dr Purushottam Kumar Garg

Wish I see that happening in every place in India . A system which works. Remember government does not pay of none of the following. Government just pays certain ( not everybody's) people's medical bill on there own rates , which is often very little. An hour ago we ( Emergency department in a rural, in USA were I am the doctor tonight) were alerted by emergency medical services (ambulance) and police; that they are bringing a child ( keeping age for confidentiality) who is victim of a motor vehicle accident. We were told child is unresponsive, pupils are dilated and fixed, EMS arrived at scene in 3-5 min, bady was handed over from the arms of a police officer to the arms of EMS.

Prior to arrival there appropriate people were notified . About 10 people came from various areas of the hospital. Operation suites were opened for access of medicine or equipment. Baby , respiratory therapist ( from his home) , police arrived at the same time. Resuscitation , evaluation started. Monitors were attached, Vitals were shown constantly on the screen. 4 people were looking for IV access and we found IV access at all 4 limbs. Co-ordination was amazing. Look for pediatric ET tube, said the person who was ambu-bagging ( by pediatric ambu bag) A person started arranging and reporting , what number? Answer "5/0" . All were laid organised. Anesthetist arrived . Started prep for intubation. Started asking for "drugs." Propofol ! One person ran and got a vial from Operation Room. Draw 10 cc . need flush lines. People were taking orders and doing it. More people came . ( Later I was introduced by a nurse practitioner, not emplyee or affiliate of this hospital , who happen to become aware , drive to hospital and joined our efforts) , Chaplin came , indicated to me about that he is praying , jesture that we are doing good. Vitals were checked by monitors . Some body informed the helicopter which arrived .

They started set up. Baby was intubated. Placement was checked. Establization of neck and tubes were done . Things which were needed immediately appeared from all over without any delay or shout or commotion. Transfer process from ER trauma room to helicopter was very carefully done. Team work was spontaneous and calm. When I went with patient toward helicopter I see that local police has cordoned the area , fire truck , fire marshal were there. We were securing the patient in helicopter while I saw the pilot was doing a safety check of copter. It will take about 22 min for this baby to reach to a tertiary pediatric trauma center. Her mother ( driver) and grand mother were killed in the accident , we were told. There car was hit by another person who was driving fast in a wrong lane while he was chased by the police . Sadly he died too in the wreck. The aim of this story is to highlight that there should be a working system suitable to our needs and means that people are able to help in that system if they can. And that the system should work every single time.