Report on Emergency Medical Care
New Delhi, 7 April 2004
The group of experts headed by Dr. P.K. Dave, former Director, All India Institute of Medical Sciences constituted by NHRC to study the existing system for emergency medical care submitted its report to the Chairperson, Dr. Justice A.S. Anand in New Delhi today.
While pointing out a number of deficiencies in the existing Emergency Medical Care System (EMS) of the country, it has suggested a number of short-term and long-term measures to address the lacunae.
The recommendations that have to be implemented immediately include
(i) Enunciation of a National Accident Policy.
(ii) Establishment of a central coordinating, facilitating, monitoring and controlling committee for Emergency Medical Services (EMS) under the aegis of Ministry of Health and Family Welfare as advocated in the National Accident Policy.
(iii) Designating 3-4 districts to Medical colleges, which will act as referral centers to their respective earmarked districts in each state and UT.
(iv) Establishment of Centralized Accident and Trauma Services in all districts of all States and various union territories along with strengthening infrastructure, pre-hospital care at all government and private hospitals.
(v) Development of computerized information base at all levels of health care to help in perspective policy planning and networking.
(vi) Need to establish a National Trauma Registry for data collection and analysis.
(vii) Information dissemination to all of the existing facilities, legislations, referral system, existing networking to facilitate EMS health care utilization.
(viii) States to develop proposals for up-gradation of EMS with organizational infrastructure and financial details for appraisal by Ministry of Health and Family Welfare and Planning Commission.
(ix) Training in EMS to be organized in the Medical Colleges and other regional areas.
(x) The existing expert group constituted by the NHRC will further recommend the infrastructure facilities, equipment, staffing and training at various levels of healthcare delivery viz. primary health centers, sub-district/taluka hospitals, district hospitals, medical colleges and teaching institutions.
The measures that need to be taken up in the long-term (5 years) are
(i) Implementation of the proposed recommendations of the National Accident Policy.
(ii) The speed and efficiency are the two most vital considerations for any trauma care services. It would be ideal to set-up a well-equipped and adequately trained staffed trauma center at Regional and National level. All District Hospitals to have specialized multidisciplinary trauma care facilities.
(iii) Establishment of Emergency Medicine as a speciality.
(iv) Dedicated communication toll free number to respond for emergency. The access code of such a dedicated number should be such that it is easily remembered by all e.g. 4444 or 9999 and should be common for the entire nation. The interface system should be able to receive multiple calls at any one time and also coordinate a speedy response.
(v) The Golden Quadrangular road project presently under progress should have a communication call center, Ambulance equipped and staffed as recommended in the National Accident Policy every 30 Kms. Emergency care centers manned by paramedical staff should be established every 50 kms. All the National Highways should also have the same facilities.
(vi) Constitution of a committee by the NHRC to monitor the progress of implementation of recommendations at National and State level.
The expert group to study the existing system for emergency medical care was constituted by NHRC on 23 April 2003 in the light of the inadequacies highlighted in the Uphar Cinema Tragedy and the ever increasing number of accidents especially on the road. The Members of the expert group were Dr. P.K. Dave, former Director, AIIMS; Dr. A.N. Laud, Breach Candy Hospital, Mumbai; Prof. I.K. Dhawan, Retd. Professor AIIMS and presently with Sita Ram Bharatiya Institute of Medical Sciences, Delhi; Dr. Shakti Kumar Gupta, Additional Professor, Department of Hospital Administration, AIIMS; Dr. Salunke, Director of Health Services, Government of Maharashtra; Dr. B.M. Das, Director (EMR), Directorate General of Health Services, Delhi; Dr. Rajendran, Senior Civil Surgeon, Madras Medical College, Chennai; Dr. Surinder Katyal, Senior Medical Officer, Trauma Centre, Karnal; Dr. G. Gururaj, Additional Professor, NIMHANS.
The group was asked to look into the following:
1. To study the existing system for emergency medical care in India.
2. To study the existing system for emergency medical care (Centralized Accidents & Trauma Services) set up by the Ministry of Health and Family Welfare in the National Capital Territory of Delhi.
3. To suggest appropriate models of emergency medical care which should be developed by different States/Union Territories and their essential components.
The report will now be sent to the Government.
******
The group of experts headed by Dr. P.K. Dave, former Director, All India Institute of Medical Sciences constituted by NHRC to study the existing system for emergency medical care submitted its report to the Chairperson, Dr. Justice A.S. Anand in New Delhi today.
While pointing out a number of deficiencies in the existing Emergency Medical Care System (EMS) of the country, it has suggested a number of short-term and long-term measures to address the lacunae.
The recommendations that have to be implemented immediately include
(i) Enunciation of a National Accident Policy.
(ii) Establishment of a central coordinating, facilitating, monitoring and controlling committee for Emergency Medical Services (EMS) under the aegis of Ministry of Health and Family Welfare as advocated in the National Accident Policy.
(iii) Designating 3-4 districts to Medical colleges, which will act as referral centers to their respective earmarked districts in each state and UT.
(iv) Establishment of Centralized Accident and Trauma Services in all districts of all States and various union territories along with strengthening infrastructure, pre-hospital care at all government and private hospitals.
(v) Development of computerized information base at all levels of health care to help in perspective policy planning and networking.
(vi) Need to establish a National Trauma Registry for data collection and analysis.
(vii) Information dissemination to all of the existing facilities, legislations, referral system, existing networking to facilitate EMS health care utilization.
(viii) States to develop proposals for up-gradation of EMS with organizational infrastructure and financial details for appraisal by Ministry of Health and Family Welfare and Planning Commission.
(ix) Training in EMS to be organized in the Medical Colleges and other regional areas.
(x) The existing expert group constituted by the NHRC will further recommend the infrastructure facilities, equipment, staffing and training at various levels of healthcare delivery viz. primary health centers, sub-district/taluka hospitals, district hospitals, medical colleges and teaching institutions.
The measures that need to be taken up in the long-term (5 years) are
(i) Implementation of the proposed recommendations of the National Accident Policy.
(ii) The speed and efficiency are the two most vital considerations for any trauma care services. It would be ideal to set-up a well-equipped and adequately trained staffed trauma center at Regional and National level. All District Hospitals to have specialized multidisciplinary trauma care facilities.
(iii) Establishment of Emergency Medicine as a speciality.
(iv) Dedicated communication toll free number to respond for emergency. The access code of such a dedicated number should be such that it is easily remembered by all e.g. 4444 or 9999 and should be common for the entire nation. The interface system should be able to receive multiple calls at any one time and also coordinate a speedy response.
(v) The Golden Quadrangular road project presently under progress should have a communication call center, Ambulance equipped and staffed as recommended in the National Accident Policy every 30 Kms. Emergency care centers manned by paramedical staff should be established every 50 kms. All the National Highways should also have the same facilities.
(vi) Constitution of a committee by the NHRC to monitor the progress of implementation of recommendations at National and State level.
The expert group to study the existing system for emergency medical care was constituted by NHRC on 23 April 2003 in the light of the inadequacies highlighted in the Uphar Cinema Tragedy and the ever increasing number of accidents especially on the road. The Members of the expert group were Dr. P.K. Dave, former Director, AIIMS; Dr. A.N. Laud, Breach Candy Hospital, Mumbai; Prof. I.K. Dhawan, Retd. Professor AIIMS and presently with Sita Ram Bharatiya Institute of Medical Sciences, Delhi; Dr. Shakti Kumar Gupta, Additional Professor, Department of Hospital Administration, AIIMS; Dr. Salunke, Director of Health Services, Government of Maharashtra; Dr. B.M. Das, Director (EMR), Directorate General of Health Services, Delhi; Dr. Rajendran, Senior Civil Surgeon, Madras Medical College, Chennai; Dr. Surinder Katyal, Senior Medical Officer, Trauma Centre, Karnal; Dr. G. Gururaj, Additional Professor, NIMHANS.
The group was asked to look into the following:
1. To study the existing system for emergency medical care in India.
2. To study the existing system for emergency medical care (Centralized Accidents & Trauma Services) set up by the Ministry of Health and Family Welfare in the National Capital Territory of Delhi.
3. To suggest appropriate models of emergency medical care which should be developed by different States/Union Territories and their essential components.
The report will now be sent to the Government.
******