Comprehensive trauma consortium: vaulting human lives

Abstract

Road accidents in India have become a common sight, and in most cases the accident victims' situation gets aggravated due to poor handling, causing irreparable damage. Realizing this, Dr. Venkataramana, neurosurgeon and Head of Department of Neurosurgery at Manipal Hospital in Bangalore embarked on a project for implementing a 'pre-hospital care' or 'trauma care' system in Bangalore in the year 1998. According to available statistics, 22 per cent of accident deaths in the country were on-the-spot deaths, 10 percent were deaths during transportation of victims to hospitals, while 68 per cent of accident deaths were delayed deaths (deaths occurring within three days of the victim being admitted to a hospital). Delayed deaths have a scope of being prevented if the victim is provided with proper medical attention within the 'Golden Hour' (the first hour after the injury). Dr. Venkataramana successfully established the Comprehensive Trauma Consortium (CTC), a well coordinated centralized system of emergency medical care protocol equipped with high technology systems to provide quick medical care to accident victims. Some of the services provided by CTC are free ambulance, air ambulance, highway trauma care, training, etc. The challenges for CTC to expand its services today are raising funds, availability of human resources, persuading hospitals to join the consortium, lack of awareness among people about the existence of the helpline number 1062, and the need for a cost-effective communication network. Due to the services being free of charge, rising input costs and continuous expansion of services, the operational costs continue to rise. One way of reducing these costs is to make optimum use of the services provided by CTC. However, this can only happen if people are aware of CTC and make more use of its services. One of the key goals of Dr Venkataramana is to make CTC a standardized system throughout the country with common emergency call numbers and protocol. But all these would cost money. The air hung heavy in Bangalore. Heavy rains were pounding the city and as an omen of more down pour to come, thick black clouds hovered in the sky. Dr. N K Venkataramana, who was pursuing his ppst graduation training in Neurosurgery at the National Institute of Medical Health and Neuro Sciences (NIMHANS), Bangalore grabbed a quick bite at a nearby restaurant before making it to his night shift duty at the Accident & Emergency (A&E) Casualty ward. The A&E ward largely received patients involved in serious accidents. Venkataramana's experiences on each of the nights spent here were dreadful. That night, while still signing in his name on the night-shift duty roster, Venkataramana saw an accident victim being rushed into the A&E ward. The victim had succumbed to heavy head injuries and had breathed his last well before being brought to the hospital. With a heavy heart, Venkataramana initiated the necessary paper work and wrote a report in relation to the dead victim. Just when the formalities were completed, another victim was brought into the ward in a similar state. On this single rainy night in July 1981, towards the end of his shift, eventually five dead victims ended up at the A&E ward, all of who had been involved in independent road accidents. The ghastly sight of these deaths left Venkataramana completely shaken and devastated. "What is the purpose of my medical education if it cannot help save lives at the right time? Is all this education and specialization meant to only certify deaths and issue death certifications? What am I doing here?" he asked himself. On looking at the condition of the injures and the manner in which the victims had been transported, it was glaring to Venkataramana that several hours had elapsed from the time the accident had taken place to the time the victims had been wheeled into the hospital's casualty ward. Had the victims been brought in much earlier to the hospital, their chances of survival would have been far greater.