AMBULANCES – SHOULD IT RUN AMOK?

Outrunning Death

Sirens wailing, lights flashing, ambulances zip through traffic as if nothing else exists in their way. Mortals admire his ability to turn traffic chaotic and even negotiate through it. It seems that his heroics alone, in carting the afflicted to hospitals at lighting speeds, is enough to prevent ‘the end’ and ensure survival of the patient. To us the public, he our saviour can outrun death.

What happens in the hospital at the emergency room or casualty is something different. Lightning speeds and driver’s daredevilry notwithstanding, the patient becomes one amongst many medical emergencies and receives a very informed and calibrated response, often mistaken by the near and dear ones as heartless apathy and callous complacency.  

Hailing Ambulances

Ambulances are used to evacuate accident victims or patients in emergency. It is common belief that, if a patient is ‘somehow’ ferried to the intended hospital fastest, survival and recovery stand better chances.  Thus, it has become a norm for drivers to fly ambulances over omnipresent potholes, ricocheting over unmarked humps on a ‘surface’ called road, chock-a-block with unyielding traffic and unruly people poised to strike at the slightest provocation. Knowing how emergencies are managed in hospitals, it is time to consider the need for ambulances needlessly rocketing all over.

Evacuation Woes

The maximum damage inflicted upon a victim after an accident happens during extrication from the wreckage. Unfortunately, the first respondents are inevitably people who have no clue of handling trauma. While many happily film the event, others shamelessly slip away. The few who dare, in their exuberance to extricate, drag the victim out holding whichever limb or part thereof they can first reach. In most cases rescuers, ignorant of the injury already suffered by the victim, unintentionally aggravate the condition. The victim’s ordeal doesn’t end there. Whatever damage is left to be inflicted or can be inflicted occurs during the reckless ride to the hospital.

Other medical emergencies are no different.

Imagine the state of a patient being evacuated in a medical emergency involving heart attack or asphyxia.  The speed with which an ambulance covers crowded and winding roads negotiating heavy traffic worsens the patient’s condition.

Mistakenly, speed seems to be the ultimate response.

Speed or Care?

Speed seems to be necessitated because it is important to provide medical attention without loss of time. Ambulances without requisite medical expertise on board resort to speed. If the requisite quality of medical care can be provided on board the ambulance, speed becomes inconsequential. An ambulance should ideally be moving the fastest to reach a victim or patient. Having reached the patient, its movement to hospital must be deliberate and with medical attention on board. Ambulance must have trained doctor or paramedics, adequately equipped to manage such emergencies. Ambulances should transform from merely being carriages to mobile intensive care units capable of providing medical support to stabilise the patient so that required medical interventions can happen immediately on arrival.

Timely medical support is of essence, not speed.

Role of First Respondents

Modern automobiles provide high degree of survivability and protection to occupants if safety instructions, like fastened seat belts or well secured helmet, are adhered to. With most of the impact absorbed by inbuilt crumble zones, many occupants escape from crashes with minor injuries. However, with the scant regard we have for safety norms, most individuals involved in accidents sustain grievous injuries. In such cases people who arrive first at the site become rescuers. Unaware of how crash victims should be rescued and prepared for evacuation, first respondents in their eagerness unwittingly aggravate injuries causing irrevocable damage to the victims. This can be avoided.

Enablers

NGOs, governmental bodies and organisations involved in social work must launch awareness programs to educate people on how to respond to medical emergencies and accidents. Various audio visual and print mediums of mass communication, including social media tools and street meetings must be employed to prepare the society to handle emergencies individually and collectively.  Simultaneously, ambulance services be mandated to upgrade on-board capabilities. Government must create a medical emergency response grid and all hospitals must be mandated to be part of the grid.