On May 26 this year, the Supreme Court directed states and Union Territories to put in place a unified emergency trauma care architecture to reduce deaths from road crashes and other accidents.
Key among the nine measures it had directed states to implement were these: A common emergency phone number, GPS-equipped ambulances, a Good Samaritan law, a trauma registry and a rescue protocol. These five measures form a crucial framework to prepare for the “Golden Hour” — the first 60 minutes after an accident critical to saving lives.
The Indian Express has found that not a single state has a complete trauma care architecture for saving lives, according to data submitted to the Supreme Court by 34 states and Union Territories over the last nine months. We explain what’s behind this:
Many agencies, poor coordination
Poor coordination among agencies, multiplicity of departments and missing standard operating procedures (SOPs) are some of the key reasons why states have not built a trauma response system as directed by the Supreme Court.
A road fatality involves at least six departments viz., police, health, road agency, district magistrate office, insurance company and the death registration office, which makes a quick response in emergency cases difficult.
The first challenge whenever an accident happens is which number to call. There are many emergency numbers — police (100), fire (101), medical (102), ambulance (108), highway (1033), women (181), cyber crime (1930), etc. A single number 112 has been conceived, but this will work only when there is a command centre at the district or state level to deploy required resources from all concerned agencies promptly during an accident.
“The integration to 112 is not just an integration of two computers. It is an integration of two different ecosystems. Currently, the API level integration of 1033 (highway helpline number) has been done in around 20 states. So when a call related to the national highway is received on 112, it issues a ticket on our system with the location of the accident. For instance, we get around 40 tickets from Uttar Pradesh daily. However, the integration of resources like ambulances etc. and automatic deployment through the system will take time. Recently, we migrated to a software solution developed by C-DAC, which also runs the 112 national emergency response system. So now the integration will be done much faster,” said a senior official of Indian Highways Management Company Limited (IHMCL), which runs 1033 highway helpline number.
States lag on integration with 112 emergency system
According to the data submitted in the Supreme Court, five states/UTs — Delhi, Kerala, Gujarat, Haryana and Lakshadweep — have reported complete integration to 112 NERS. In its June 22 Budget, the West Bengal government announced the Dial 112 helpline with an allocation of Rs 100 crore. One dedicated vehicle will be placed in each thana for quick response during the emergency.
Apart from this, Uttar Pradesh is close to achieving full API level integration, with only 102 emergency medical services remaining to be integrated. UP is also among few states who have SOP for 112, which provides a clearing mechanism for its working and a command centre in Lucknow.
States have to also establish grievance redressal systems for good Samaritans at district level, compliance of National Ambulance Code (NAC), paramedic training and accreditation, GPS in ambulances and different levels of trauma centres.
In its judgement, the Supreme Court has directed the chief secretaries for the compliance with the directions relating to the different departments within the states.
“Our opinion is that the government should enact a right to trauma care law, where they can include all these nine kinds of infrastructure which the supreme court has directed. The law will help in developing a comprehensive system and it provides for a nodal authority to implement it,” said Piyush Tewari of SaveLIFE Foundation, the petitioner in the case.
