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Monday, May 15, 2017

Saving Service comes in 10 minutes ~ Hail 108

In life, there are so many important things – the most important thing is LIFE itself. 

We know that it takes days and months for accomplishing feats ~ ‘Metro train comes into being only after years’ – yet, we come across ‘just a second / just a minute’  ~ though second is a miniscule part of minute, these are used almost interchangeably !!  - the  hard truth is that there just aren't quick fixes for most things in life. It takes time to gain experience and build up an expertise in most fields.  Yet lot could happen or be done in shortest span of time !!

Safety is everybody’s concern ~ accidents unfortunately do occur – lot many of them could be  avoided by observing safety and many lives saved by immediately attending to them.   All  users of a road including pedestrians, cyclists, motorists, passengers in vehicles, its drivers and others face risk on road.  Best-practice road safety strategies focus upon the prevention of serious injury and death. Safe road design is now about providing a road environment which ensures vehicle speeds will be within the human tolerances for serious injury and death wherever conflict points exist. Unfortunately, in our country, some roads are bad and when roads are good, people tend to drive fast and end up with more accidents.

Nearer home, we have Kasturba Gandhi hospital [popularly Gosha hospital] which dates back to 1890s. The Madras government took over the management of this hospital in 1921.  Inside this century old institution, a wonderful service functioned – tens of thousands of calls made everyday seeking emergency aid lands here,  it was the  Office and call centre of 108 Ambulance services – that has since moved to more spacious premises at Teynampet.   In what could be described as fine blend of  Govt Private joint entrepreneurship. GVK Emergency Management and Research Institute (GVK EMRI), the major corporate social responsibility arm of GVK, was established in April, 2005. It provides integrated Emergency Response services promptly responding  to millions of emergencies and save lives nationally.   This service is spread across 15 states (Andhra Pradesh, Telangana, Gujarat, Uttarakhand, Goa, Tamil Nadu, Karnataka, Assam, Meghalaya, Madhya Pradesh, Himachal Pradesh, Chhattisgarh, Uttar Pradesh, Rajasthan and Kerala) and two Union Territories (Diu Daman and Dadra Nagar Haveli);  equipped with more than 11,000 ambulances, over 45 million cases have been attended to and over 1.5 million lives have been saved.

For accident victims, it was earlier – ‘Golden hour’ – 108 service redefined and made us aware of ‘Platinum minutes’ too. Any tragedy can be taken to either success or failure within the first 10 minutes of medical attention, they say.  In this crucial period, quick and  timely help would ensure that the victim is  saved so that appropriate treatment can be made available from the nearby hospital. Golden Hour according to is  defined as the period during which all efforts are made to save a life before irreversible pathological changes can occur thereby reducing or preventing death in the second and third phase. This period may range from the time of injury to definitive treatment in a hospital. The first platinum 10 minutes becomes important to make this golden hour effective and should be distributed as follows to make it fruitful.

Aimed at serving accident victims timely, Tamil Nadu Govt on 8th Feb 2016  launched two-wheeler ambulance service that would be positioned in vital junctions in the city. Chief Minister Ms. Jayalalithaa flagged off 41 two-wheeler ambulances, worth about Rs. 70 lakh, at a function in the Secretariat.Whenever you see an accident or somebody in dire need of medical attention, do not panic..try and assist the victim in some possible manner.. the simplest is to call the Emergency Service (108) and inform them clearly of the need, probable requirement and  the place where their attendance is required.

I am attracted to anything on 108 service and was so happy to read today’s Chennai Express Supplement of The New Indian Express titled ‘Help within 10 minutes’ by Abinaya Kalyanasundaram~ more so for the nice graphic depiction and the reference to friend Sri B Prabhudoss.  Here is the article reproduced as it is :

Mr B Prabhudoss addressing SYMA Growth students & Parents

CHENNAI: A deafening crash cuts through the cacophony of horns on the busy highway — the speeding car is reduced to scrap metal by the tanker lorry in no time. Shattered glass shards sparkle on the black tar, mingled with specks of bright red. The man behind the wheel is severely injured. Some hands reach inside the vehicle to pull him out, while others look for a phone to dial 108.

Strategic distribution :Ambulances are distributed and strategically located closer to the hotspots where accidents occur frequently based on research data and also information gathered from the police. Places like Poonamallee-Bangalore highway and Chengalpattu-Tiruchy highway are a few of those.

The ‘Sense’ team :At the Emergency Response Centre in Chennai, the call is answered and a 3-minute countdown begins. “Vanakkam 108, Sollunga enna emergency”, answers an Emergency Response Officer (ERO). Deciphering all the details of the accident — where, when, how, and who, is the victim conscious, etc — the ERO has to handle the situation calmly by  gathering all vital information from the sometimes panicking  caller.

The type of emergency is categorised — accident trauma.The ambulance closest to the location is identified and dispatched. If the ambulance is busy, then the next available ambulance is alerted.The call is disconnected after reassuring the caller of prompt service, to be free for the next call. The counter clock reads 2.30 minutes. The ERO has done their job well. 

“We need to be careful when we note down details. Phonetic sounds are tricky to decipher; for instance, Kancheepuram and Gandhipuram may sound the same, so clarification is required. Also, if they say Gemini Bridge, there is one each in Nungambakkam as well as in Coimbatore; so a thorough geographical familiarity and alertness while on call is mandatory,” says an ERO.Average handling time should not cross three minutes. EROs work in six-hour shifts, so that 40 EROs are available to attend calls at any given time.

The ‘Reach and Care’ team :The ambulance pilot receives the call, notes down the location and immediately starts the engine to reach the spot within 10 minutes (Average Response Time).Once at the spot, the on-board Emergency Medical Technician (EMT) scans the situation — heavy blood loss, an airway compromise etc is analysed, and responds immediately.

In the first ‘Platinum 10’ minutes, three things have to be done — assessing the emergency, immobilising the patient (in case of a fracture) and then in case of no response, immediately reviving the patient using cardiopulmonary resuscitation.This is the protocol —despite the urgency to rush to the hospital. If done successfully, the survival rate increases substantially.The EMT and the ambulance pilot transfer the immobilised patient into the ambulance carefully to avoid worsening injury.Once inside, the EMT works on bleeding control, starts an IV line and gives additional pre-hospital care.

A conference call is made to the Emergency Response Centre physician, and all vital details of patient — BP, sugar levels, saturation levels, pulse rate etc are conveyed. The doctor provides guidance.Once the ambulance transfers the patient to the closest hospital, it returns to its original stand-by location, ready for the next call. Ambulance pilots work in 12-hour shifts.

~ they are ready for the next call – not caring to know, whether the common man appreciates or not – the warriors, nay Saviours.

With regards – S. Sampathkumar

15th Ma 2017.

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