Need to enhance medical competence to handle crisis

24 Mar
2009

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Rishabh Srivastava - Profile
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Ever since Mumbai was hit by terrorists on November 26 last year, there have been many steps taken to improve the security and to counter similar situation in the future in a better way. There has been no denying that there was security lapse due to which terrorists were able to create mayhem in the city. But, it is the time to introspect the weaknesses in our system and try to plug the same to avoid such occurrence again in any part of the country.

This post is basically to attract the attention of readers and administrators on the incapability of our medical staff during such hour of crisis. There is a report that 70 people died in the carnage at Chhatrapati Shivaji Terminus (CST). Out of these 70 people, 30 who were hit on hands or legs lost their lives due to non-availability of treatment at the right time. So, we should learn some lessons and try to step up the emergency handling capability of the administration.

It is thus very essential that our administration tries to ponder on the following points which I and few of my doctor friends felt should be implemented:

  • We need to have concept of ‘triage’ in this country. This concept needs to start from the place of disaster itself. Triage is a process of prioritising patients based on the severity of their condition. This rations patient treatment efficiently when resources are insufficient for all to be treated immediately. The term comes from the French verb trier, meaning to separate, sort, sift or select.
  • Then we need to place ambulances at the strategic locations throughout the city. The staff with the ambulance should be well trained in cardiopulmonary resuscitation (CPR). CPR is an emergency medical procedure for a victim of cardiac arrest or, in some circumstances, respiratory arrest. These are the two commonest complications which person injured in such strike undergoes. There should be training of civilians as well in CPR. The situation in our country is such that even medical professionals don’t have any experience in this. Right now, staff in ambulance is just not capable to do this simplest procedure which is taught in school in many of the Western countries.
  • The infrastructure in hospitals in current scenario is not up to the standards. There are very less number of beds in casualty and operation theatre. A hospital was just a few metres away from CST station and if it was better equipped, then few more lives probably could have been saved. Hence, it is very important to have separate wards/beds to handle any emergency situation.
  • The biggest problem then faced is shortage of blood. The blood bank and hospital coordination is also poor in our country. It takes much time for a relative of injured or a hospital staff to collect blood and then give it to the wounded. Therefore, it is essential that our blood-banks and hospitals work in tandem.
  • According to a few medical students, there should be especial training given to doctors as well. It is just because under normal circumstances, a doctor hardly treats the bullet injury.Few of them were of view that this training should be done by the army doctors, who are quite familiar with the treatment during bullet injury. There can also be the proposal of setting a separate unit of trained doctors like we have National Security Guard (NSG) or something. These doctors can be flown in the minimum time period to the place of casualty. They can work in aggregation with the regular staff of hospitals and also this can overcome the shortage of and burden on regular doctors. There is a fact that the doctors are overburdened in regular days and during emergency situation the condition gets even worse.
If there is proper team of trained medical and paramedical staff to handle any crisis then the number of deaths can be brought down. Whether the points mentioned above are feasible or not is to be decided by decision making bodies. But, I have felt that the current medical facilities are just not enough. It is thus of utmost importance that the administration thinks over this aspect as well.

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