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Siren song: Bengaluru’s paramedical problem

Posted May 16th, 2017, 11:27 AM IST

Siren song: Bengaluru’s paramedical problem

Calling for an ambulance in Bengaluru and navigating the city's roads in a moment of crisis is a harrowing affair, what with the traffic jams and commuters who refuse to get out of the way. Experts say that well-equipped vehicles and highly-trained paramedics can overcome the more obvious logistical challenges and help provide treatment during the crucial Golden Hour. The technological leaps the Indian healthcare system has made over the years will amount to very little if ambulances don’t have paramedics who know how to use the equipment.

VIP vehicles may have lost their beacons, but it doesn’t seem to be making much of a difference in the city as only a couple of weeks ago, on May 2, an ambulance was shockingly stopped on JC Road to make way for the convoy of the Chief Minister.

While this has expectedly created a furore, Additional Commissioner (Traffic), R. Hitendra, blames lower rank officials for the incident, which could have cost someone his life, saying they need to be sensitised to medical emergencies and the role of ambulances. But a traffic police official claims they only do as told by their seniors.

While the game of passing the buck continues, it seems obvious that not all officials seem to quite understand the golden hour theory. Going by the WHO if a road mishap victim or a heart patient is rushed to a hospital within an hour, his or her chances of survival go up by 70 to 80 percent.

The fact that the latest NIMHANS and UL report says 13, 028 people died in road accidents in the state in 2015 makes this all the more relevant for Karnataka particularly as 10 per cent of such deaths reportedly take place while the accident victim is being transferred to a hospital. Doctors point out that getting them help within the golden hour could make all the difference.

"Unfortunately a lot of people still don’t get help within the golden hour in the city as it is not being taken seriously enough," regrets Dr N K Venkataramana, founder and Chief Neurosurgeon, Bangalore Regenerative Advanced Institute of Neurosciences (Brains) Neuro Spine Centre, also stressing that proper training is essential for the paramedics in an ambulance to give those who in a critical condition the care they need even before they reach a hospital.

Pointing out that some ambulances do not have a spine board or a cervical collar, he deplores that they still operate without such basic facility. "Paramedics should realise that the manner in which a patient is shifted to a hospital can make a huge difference to his or her life. Mere transportation is not the answer," he underlines.

Agreeing, Dr Firozahmad H Torgal, consultant emergency medicine, Columbia Asia Referral Hospital, Yeshwanthpur says if a patient has suffered a stroke then he needs an advanced cardiac life support ambulance with proper paramedics, who can pick up any red flags and begin treatment in the vehicle itself even before the patient reaches the hospital.

“A basic life support ambulance service serves no purpose in such cases," he explains. Ask State Health Commissioner, Subodh Yadav and he says the state has some 711, 108 ambulances along with over 800 government ambulances with trained paramedics on board for both basic life support and advanced life support ambulances. "People should at least try and give up their mindset of trusting only private ambulances," he adds.

Also pointing out that the private ambulance service providers, which only carry patients to hospitals, come under the transport department, he says his department can do little about them even if they are not equipped as well as they should be.

How many people actually make way for ambulances?
Receiving flak for the police stopping an ambulance to make way for the Chief Minister‘s convoy, city police commissioner, Praveen Sood made it clear in a memo to senior traffic officials on May 5 that an ambulance or emergency vehicle should be given priority “even at the cost of slowing down VVIP movement.”

But while the police may now be careful in following his diktat and make sure ambulances get right of way even over a VIP convoy, it's hard to take the message to the many ordinary commuters, who continue to show grave insensitivity on the roads to these vehicles deployed in medical emergencies.

Sometimes commuters can do little as they are hemmed in by the heavy traffic on the roads , which forces them and the ambulances to move at a snail’s pace.

While many cities abroad have separate lanes for ambulances to avoid just such a situation, can Bengaluru hope for a similar solution?

Former traffic advisor to the government, Prof. M N Sreehari says a firm no. "It is not possible to have separate lanes for ambulances in Bengaluru as its roads are too narrow,” he says, explaining that 60 per cent of the 15,000 kms of road in the city is narrow and not even fit for two-lane traffic. “With 68 lakh vehicles plying on the roads and 48,000 junctions, the vehicles move very slowly even now and this inevitably impedes the movement of ambulances,” he adds.

However, emphasising that movement of ambulances should always be a priority, he suggests that the Chief Minister should take stern action against the cops who stopped the ambulance for his convoy.

He also believes ambulances should have control over the traffic signals like in some Western countries and besides being fitted with GPS, should be equipped with software, which can tell them where the nearest hospital is. “It should be made mandatory for ambulances to approach the nearest hospitals from the accident spot rather than any specific one. Most of the time with the roads choked with traffic, precious time is wasted as the ambulance driver heads to a specific hospital,” he regrets.

A transport expert, for his part, believes that having separate lanes for ambulances will serve no purpose unless the people’s attitude changes. “In the west people make way for emergency vehicles the moment they hear a siren. And here we drive faster to ensure the ambulance does not overtake us,” he rues.

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