Pre hospital care and outcome of road traffic accident victims at a Level-I, urban, trauma centre in Mumbai

In a populous city like Mumbai, which lacks an organized pre-hospital emergency medical services (EMS) system, there exists an informal network through which traffic accident victims arrive at the trauma centre. The study... [ view full abstract ]

In a populous city like Mumbai, which lacks an organized pre-hospital emergency medical services (EMS) system, there exists an informal network through which traffic accident victims arrive at the trauma centre. The study describes the pre-hospital care received by the accident victim. This was a prospective hospital based study of road traffic crash victims carried out at a Level-I, urban, trauma centre in Mumbai between December 2012 and May 2013. After informed consent to participate in the study, patients/ attendants were interviewed for the study. Patients brought dead were excluded from the study. The injured road traffic accident victim in Mumbai usually is rescued by the police contrary to popular belief. Almost immediately after rescue, the victim begins transport to the hospital. No one waits for the EMS ambulance to arrive, as there is none. Almost two thirds of the patients were transferred from other medical health facilities. A taxi followed by auto rickshaw is the most popular substitute for the ambulance. The accident victims were transported to Level- 1 trauma centre with and without EMS. EMS is not uniformly distributed to all the injured patients, and many get transported directly without field triage or stabilization. In Mumbai basic life support consists of basic life support, oxygen support and advanced life support for few patients. Currently, as a result of not having an EMS system, pre-hospital care is a citizen responsibility using societal networks. It is easy to eliminate this system and shift the responsibility to the state.