Article by : Dr. Sree Sowjanya Patibandla MD, MBA; ATLS Faculty India; Consultant and Head; Continental Institute of Trauma and Emergency Medicine ; Continental Hospitals
· More than 1 million die and 20 million hospitalized every year due to injuries
· Trauma related death reported one every 8 minutes in India!!
· India accounts for 10% of world wide accidents
Trauma has evolved as a global epidemic that affected the young and middle aged victims. India accounts for more than 10% of the world wide accidents and one-fifth of the global deaths due to road accidents. It is estimated that more than one million die and 20 million hospitalized every year due to injuries. It is very alarming to realize that a vehicular accident is reported every 2 minutes and a death related to trauma every 8 minutes on Indian roads.
WHAT TO DO IN EMERGENCY:
Whenever we witness an accident, most of the time we are clueless of what to do next? We are not aware
- What first-aid to be given to the trauma victim?
- How to transfer the victim?
- Which hospital to choose to shift the victim?
- What are the legal implications to be faced for helping the trauma victim?
With all these questions lingering in the mind, we either silently swift away from the site of accident or we become the silent spectators of the event. Remember, when trauma strikes, the first few minutes are called platinum minutes and the first one hour is labelled as Golden Hour. Any appropriate action taken during this time can multiply the chances of survival for the trauma victims. Your swift action can save a trauma victim and the entire family. Let’s see what to do to become a “Trauma Hero”
- What first aid to be given to the Trauma Victim?
Evidence suggests that any life-saving measures performed before the arrival tot he hospital, the chances of survival improves and have a greater chance of reduction in the adverse consequences in their injuries. So follow these steps to help a trauma victim. - if any trauma patient is with decreased level of consciousness or unconscious, keep the patient in supine position with spine in a straight line. Immobilise the cervical spine by applying 2 hard or wooden blocks on either side of the neck and tie with a cloth so that head doesn’t move independently. Remember not to shake the head to check repsonse of the victim. Mobilising the head and neck of the patient causes damage to the spinal cord and makes the victim paralysed for the rest of the life.
- Any victim with loss of consciousness or decreased consciousness or altered mental status or brething difficulty or seizures should be transported to the nearest trauma facility with utmost care in an advanced
- Don’t attempt to remove the helmet until they reach the hospital as these maneuvers can injure the cervical spine.
- If you notice any limb injury, try to immobilize the limb, either using 2 sticks or card boards on either side and immobilize the victim on the spine board and shift the patient to the nearest hospital.
How to transfer the Victim to the Hospital?
India being a developing country, does not have a reasonable rescue mechanisms and bystanders play a major role in saving lives by taking appropriate measures after the accident, during the transfer and choosing a best hospital. It is important to remember that the victim should be kept flat on a spine board and transferred to the nearest trauma centre in an ambulance. Though Time is precious, it is important not to cause secondary fatal injuries by lifting the victim or transferring these patients in own vehicles or autorickshaws.
Which hospital to choose to shift the trauma victim?
Evidence has proved that transferring the trauma victim to a facility which lacks specific treatment for the trauma victims,delays appropriate treatmetn and endangers the life of the victim.
Trauma care is a complex treatment and requires timely interventions by advanced trauma life support certified Emergency Physicians in preventing hypoxia, control of bleeding and provide adequate ventilation and airway mangement. Once stabilised in the emergency department, a proper Radiological imaging including CT scan is required to see what kind of internal injuries are there and then a specialized team consisting of intensivists, neurosurgeons, general surgeons, orthopedics, anaesthesiologists together as a team provide timely interventions to prevent secondary injuries and save the life of the trauma victim. Along with the availability of the specialists, trauma victims need prompt laboratory back up, blood bank, sophisticated intensive care unit and a operation theatre. A facility with all the above resources is labelled as Level 1 Trauma center. Apart from the resources and availability of the specaialists, they follow international trauma guidelines which help in taking swift appropriate actions and timely interventions. Hence shifting a trauma victim to the nearest level 1 Trauma centre at the earliest helps in multiplying the chances of survival of these victims says Dr. Sree Sowjanya Patibandla Consultant and Head; Continental Hospitals
What are the legal implications to be faced for helping the trauma victim?
Many Bystanders of the trauma victims remain mere spectators by the trauma victim with the fear of legal implications, harassment by the police or to bear the financial cost of the treatment provided tot he trauma victim.
As per the good samaritan law of India, there are no legal responsibilities to aid a trauma victim. There is no need to reveal your identity, or to find the identity of the victim, file an FIR or stay in the hospital to bear the expenses incurred. There is no need to attend the court proceedings or give statement to the police. Good samaritan law has been introduced to mitigate the dalays associated in shifting the trauma victims to the nearby trauma centre and there by benefitting the needy in the most crucial golden hour.
After realizing what to do in Emergency, it is important not to forget the preventive measures of trauma.
A. don’t give vehicles to youngsters below 18 years of age to drive
B. Follow traffic rules
C. Wear helmet and seat belt
D. don’t drink and drive
E. don’t get distracted by using mobile while driving
F. Don’t allow kids to stand in the rear seat or seated in the front seat
G. don’t over speed or overtake speeding vehicles.
