emergency medical services 2020 ;issues and challenges
DESCRIPTION
EMS Asia ppt 19th October 2014TRANSCRIPT
Dr.Venugopalan P PDA,DNB,MNAMS,MEM[GWU]Director, Emergency Medicine , Aster DM Healthcare LtdDeputy Director ,MIMS Academy Founder and Executive Director –ANGELS PG Teacher ,DNB Program in Emergency Medicine
Emergency Medical Services - Indian Scenario @ 2020
EMS Asia 2014 ;Goa ; October17,18&19
Focus
EMS Asia 2014 ;Goa ; October17,18&19
Why EMS What is the current status in IndiaWhat are the issue and Challenges? What should be our EMS system in 2020?How to make a hassle free road map ?
Ground reality
Total 3.57 lakhs (0.35 million) accidental deaths were reported during the year 2009 with the Male-Female victim ratio of 77 : 23.
J Emerg Trauma Shock. 2012 Jan-Mar; 5(1): 49–54. doi: 10.4103/0974-2700.93113PMCID: PMC3299154
EMS Asia 2014 ;Goa ; October17,18&19
Road accidents (37.9%), railway accidents, and rail-road accidents (7.8%), poisoning (8.0%), drowning (7.7%), sudden deaths (7.4%), and fire accidents (7.0%).
Most of the victims of accidents were aged between 15 to 44 years. This group of people has accounted for nearly two-third (60.7%) of all persons killed in accidents in the country
EMS Asia 2014 ;Goa ; October17,18&19
• Many of them die for want of timely EMS.• Thousands of these accident victims could
have been saved if timely medical intervention were available to them.
• Need of quality EMS in India is an unmet need of the masses.
J Emerg Trauma Shock. 2012 Jan-Mar; 5(1): 49–54. doi: 10.4103/0974-2700.93113PMCID: PMC3299154
EMS Asia 2014 ;Goa ; October17,18&19
Mumbai Study
• The injured victim in Mumbai usually is rescued by a good Samaritan passer-by (43.5%)
• Helped by the police (89.7%)• Almost immediately after rescue, the victim
begins transport to the hospital• No one waits for the EMS ambulance to arrive, as
there is none• A taxi cab is the most popular substitute for the
ambulance (39.3%).Prehosp Disaster Med. 2010 Mar-Apr;25(2):145-51.Where there are no emergency medical services-prehospital care for the injured in Mumbai, India.Roy N1, Murlidhar V, Chowdhury R, Patil SB, Supe PA, Vaishnav PD, Vatkar A.
Healthcare delivery system
CHCCommunity Health center
PHCPrimary Health Center
SCSub Centers 1 ,46 ,036
23, 458
4, 276
District hospital , Medical colleges ,Specialty centers
AS
REFERING
units
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• National Family Health Survey – III, • Private medical sector remains the primary source of healthcare for the majority of households in both urban areas (70%) and rural areas (63%). • Even the quality of private sector is also questionable.
: http://www.ncrb.nic.in/CD-ADSI2009/ADSI2009-full-report.pdf
EMS Asia 2014 ;Goa ; October17,18&19
Emergency Medical Services
• EMS is thus provided in two forms Pre-hospital services Treatment to inpatients. • EMS is an essential part of the overall
healthcare system as it saves lives by providing care immediately.
Potluri P. Emergency services in India- Counting on betterment. A transition in progress. Editorial Section. [Last assessed on 2011 Jan 25];Asian Hospital and health care Management magazine. 2009 18 Available from: http://www.asianhhm.com/healthcare_management/emergency_services_india.htm
EMS Asia 2014 ;Goa ; October17,18&19
Intra Hospital Transfer facility
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India
• Life and death are equally importance
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Pre-Hospital Care networks
• National Network of Emergency Services at Ahmedabad, Delhi, Pune, Hyderabad, Chennai, Raipur, Ranchi, and Kolkata
• Emergency Management and Research Institute (EMRI) at Haryana, Chandigarh, Uttarakhand, Rajasthan, Gujarat, Madhya Pradesh, Andhra Pradesh, Goa, Karnataka, Tamil Nadu, Meghalaya, and Assam
Subhan I, Jain A. Emergency care in India: The building blocks. Int J Emerg Med. 2010;3:207–11EMS Asia 2014 ;Goa ; October17,18&19
Pre-hospital care
• Centralized Accidents and Trauma Services (CATS)
• Life line foundation –Ahmadabad
• 1298 ambulances • IIEMS – international
Courses
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NRHM -108
• Adopted from EMRI• National single Number• Fully Funded by NRHM • Free to victims • Fully equipped
ambulance
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Active Network Group of Emergency Life saves- ANGELS
• Community based Ambulance network
• 300 ambulances • PPP model • Bagged three
International /National awards
• Massive first responder awareness
• EMCT EMS Asia 2014 ;Goa ; October17,18&19
Angels awards • First EMS Asia award 2013 • AIIMS entrepreneurship
award 2013 • AAEMI and Lifeline
foundation award 2013
Best community based EMS
Angels take out Emergency Medicine from the hospital boundaries
Kerala is highly motivated for EMS and EM
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EMS - Issues and challenges
• Big country with diversities
• Rudimentary emergency medicine specialty
• Uniformity and lack of standardization
• National Ambulance cord• Paramedic council • Vehicle for India roads • Courses and Trainings
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Indian diversities influence EMS
Regional
Geographical
EmotionalFinancial
Cultural
Political
Individual
People EMS Asia 2014 ;Goa ; October17,18&19
Implementation of Rules
• Mr.Rishi Raj Singh IPS-Transport commissioner of Kerala implemented traffic rules strictly
• 40 percent reduction in RTA
Net result – He has been Removed from the post !!!!!!!
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108 challenges
• Scams – Prevalent in all states
• Vehicle conditions and its issues
• Availability of Paramedics• Equipments and related
issue • Fabricated call list • Unauthorized usage for
non emergency purposes
Equipment given in 108 are not available in hospital OT
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Scams
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Angels Challenges
• Funding• Drivers attitude • People attitude • Ambulance Mafia • Non Standardized
charging patterns
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Angels innovations
• Emergency Medical Care Technicians Training
• First response provider course
• Rural emergency medical care initiatives
• Emergency Medicine Crash course
• App based networking
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Angels Bike Emergency Rescue Team
• First batch launched with 25 volunteers
• Second batch training started 150 volunteers
• Target to train 20000 volunteer by 2nd October 2016
• 12 modules to complete in 3 months
• Act as first responders • Networks through mobile
apps EMS Asia 2014 ;Goa ; October17,18&19
ABERT vision
• No matter whether an ABERT volunteer saved somebody …
• If 20000 ABERT volunteers follow proper road culture and safe driving principle will bring down accident rate to 30 to 40 percent
• ABERT focus on college students and youth
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National Ambulance Code
Design
Equipment
Classification
Standardization process
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National Skill development corporation
• EMT B training program aiming to train plus two holders
• Wrongly utilized – Nation wide agencies focused on nurses
• Easy money like NRHM• Program Hold
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EMT B Training proposal
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Last Decade Changes in Emergency Medicine India
• MCI recognition 21st June 2009
• GWU program 2007 • MD programs in Medical
colleges 2011• Upstate and other abroad
university programs• Popularity on MCEM and
its liberalization • DNB emergency Medicine
EMS Asia 2014 ;Goa ; October17,18&19
EMS 2020 Road map• Implementation of National
ambulance code • One Nation – One emergency
access number • Paramedic council• EMS BSc and MSc Courses• Standardization of EMS
protocols • National EMS society /
Foundation • Integration of various EMS
systems WAR Water –Air - Road
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Our style
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Create what we want …which is suitable for us!!!
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Thank you so much …..
www.drvenu.net , www.emergencymedicinemims.com
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