India Healthcare
Delhi hospitals lacking in emergency protocols
Sep 14, 2011 - 4:06:39 PM

Last week's Delhi High Court blast, which left 13 dead and around 90 injured, once again exposed one of the most glaring shortcomings of the capital's hospitals -- lack of a robust emergency response system, medical experts say.

'Emergency protocols are needed to receive mass casualties or victims of disaster in public hospitals. There are no dedicated trauma surgeons and very few designated trauma centres in India. Other than this, speedy redistribution of patients from the accident site to nearest hospitals strategically can save more lives,' Sanjeev Bhoi, head of emergency at the Jai Prakash Narayan Apex Trauma Centre, -, told IANS.

A redistribution system helps give proper medical attention to all the patients without burdening any specific hospital. The lack of a proper redistribution mechanism can seriously hamper response to emergencies.

For example, the Ram Manohar Lohia - Hospital, where most of the Sep 7 Delhi blast victims have been admitted, had to evacuate its surgery wards to accommodate the blast victims. The hospital received around 60 victims in the first hour of the blast after 10.15 a.m. The number swelled later, doctors said.

'Workload is tremendous at government hospitals. We had to discharge some of our routine patients that day to accommodate blast victims,' a senior doctor at the RML Hospital told IANS on condition of anonymity.

'It is important for other hospitals to respond quickly to the crisis. Private hospitals that have had land on concessional rates could also contribute in such situations,' the doctor added.

The JPNATC at the All India Institute of Medical Sciences - is the second exclusive trauma management centre in the capital, after the Sushruta Trauma Centre in north Delhi.

The JPNATC has 30 trollies in the emergency room, apart from a 280-bedded trauma centre, say doctors.

In case of any emergency, a hospital is alerted to press its orthopaedic department, general surgery department, and neurosurgery department into action.

According to a statement on emergency medicine in India co-authored by Bhoi, orthopaedic surgeons lead the trauma response in 50 percent of facilities in the country. In the absence of defined roles amongst specialists at hospitals, multi-system injury patients are at a greatest risk.

Experts say a lot of victims can be saved if a specialist attends to them within the first 20 minutes after the accident.

'It is mostly the casualty doctor who attends patients in cases of mass casualties. These causality/accident room physicians lack any specific training in emergency medicine,' Bhoi said.

The picture presented by a hospital's equipment and facilities may be hunky-dory, but their acid test is how they respond to real-life situations.

'A hospital may boast of equipment and facilities, but where we lack is directional referral process. All ambulances rush to the same hospital from one spot, leading to overburdening. They can be directed to different hospitals to give equal and focussed attention to one patient,' public health expert and physician S. Sunder Raman told IANS.


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