The 2014 Academic College of Emergency Experts in India′s INDO-US Joint Working Group (JWG) White Paper on "Developing Trauma Sciences and Injury Care in India"

Abstract

It is encouraging to see the much needed shift in the understanding and recognition of the concept of “burden of disease” in the context of traumatic injury. Equally important is understanding that the impact of trauma burden rivals that of nontraumatic morbidities.Subsequently, this paradigm shift reinstates the appeal for timely interventions as the standard for management of traumatic emergencies. Emergency trauma care in India has been disorganized due to inadequate sensitivity toward patients affected by trauma as well as the haphazard, nonuniform acceptance of standardization as the norm. Some of the major hospitals across various regions in the country do have trauma care units, but even those lack protocols to ensure that all trauma cases are handled by those units, largely owing to lack of structured referral system.As a first step to reform the state of trauma care in the country, a detailed overview is needed to gain insight into the prevailing reality. The objectives of this paper are to thus weave a foundation based on the statistical and qualitative burden of trauma in the country; the available infrastructure of trauma care centers equipped to deal with trauma; the need and scope of standardized protocols for intervention; and most importantly, the application of these in shaping educational initiatives in advancing emergency trauma care in the country.

The 2017 International Joint Working Group white paper by INDUSEM, The Emergency Medicine Association and The Academic College of Emergency Experts on establishing standardized regulations, operational mechanisms, and accreditation pathways for education and care provided by the prehospital emergency medical service systems in India

“…Taking into account official and unofficial sources, nearly 30,000 ambulances would exceed the minimum recommended number of emergency transport vehicles for the Indian population, as outlined by the WHO experts. [ 2 ] In terms of absolute numbers, these figures are more consistent with ambulance volumes servicing mid-size European economies. [ 6 ] Yet, in the case of an emergency, the quality of the patient experience in India is not comparable to that in Europe.…”

“…[ 1 ] The opportunity exists to successfully achieve this goal through an enabling legislative framework, with the help of suitable organizations and experts available. [ 2 ] To that end, we must ask the question, “Why is a legislative framework necessary to oversee and regulate prehospital service providers?”…”

What′s new in emergencies, trauma and shock? Traumatic Brain Injury Research in India: Getting shape, taking momentum

“…It is extremely encouraging that “trauma related injuries research” including “traumatic brain injury (TBI) research” has become a priority for researchers and has been recognized as a major public health problem by many with growing efforts to address TBI on priority basis. [ 1 2 3 4 ] Good enough data have been published on TBI from different parts of the country (from urban as well as rural institutions) those address issues related to TBI demographics, prehospital care, management and outcome characteristics. [ 1 2 4 5 6 ]…”

“…[ 7 ] Other very important fact which have been pointed out was that private vehicles were the most common mode to transport patients, up to 40% cases general public/policeman provided first aid and they did not have any formal training to do so. [ 7 ] Many other studies from India document the demographic, clinical, management and outcome characteristics[ 1 2 3 4 5 6 8 9 10 ] and try to identify and explore the similar issues as the authors have raised in their work (i.e., TBI in India “requires appropriate attention from researchers and policymakers,” “need to develop effective evidence — based interventions” with “better reporting and documentation of cases”). [ 7 ]…”

“…As Pal et al [ 3 ] have raised issues in the context of emergency trauma care “no uniform acceptance of standardization as the norm” largely holds true for TBI care. In spite of the fact that these study address the common public health issue that is, “TBI;” it is apparent that in India still the approach to TBI research is confined to few institutes and individuals and largely remains fragmented.…”