DELHI MATTERS: A New Lecture Series

First in the Series: How Prepared are you to Tackle a Medical Emergency?

The India International Centre (IIC) launched a series of lectures on matters that concern the well-being of citizens of Delhi and NCR. Entitled “Delhi Matters”, the series began on 18 December, 2017. The first discussion in the series focused on medical emergencies and trauma. The series will be taken forward for the next 12 months. The discussion on the 18th was aimed at providing a holistic view of different kinds of medical emergencies, the available operational structure to respond to a wide variety of situations, and precautionary measures to prevent and deal with emergencies at home, at the workplace and while commuting.

Ms. Shailaja Chandra as Chair gave the genesis of the series and the choice of subjects which were all topical and citizen-centric. The talks and discussions were aimed at making people aware of important concerns and what citizens can do to be better equipped.

Shailaja Chandra as Chair: Introduction to Medical Emergencies of the Delhi Matters Series

The discussion was led by a panel of distinguished professionals which included Dr. M. C. Misra, former Director of AIIMS and a trauma expert; Dr. Tamorish Kole, Chairman of Institute of Emergency Medicine at Rockland Hospital covering the NCR; Ms. Monika Bhardwaj, IPS, who heads the operations of PCR vans and 100 helpline; Mr. Rana, in-charge of the Centralized Accidence Trauma Services (CATS); and Mr. Suhaan Mukherjee, a lawyer who had assisted in drafting the new Motor Vehicle Act (MVA) for the government (now awaiting Parliament’s approval).

Accident data
Source: National Crime Records Bureau (2015)

Dr. Tamorish Kole began the discussion by narrating specific events involving different kinds of patients who suffered trauma, and the preventive steps that the families could have taken to avoid the emergency. Dr. Kole described the case of a 76- year-old man who had had a fall in the washroom and was rushed to emergency. It was later diagnosed that the reason for his fall was low lighting and cataract - something that could have been easily prevented. He suggested that elderly people should be encouraged to do physical exercises and families should avoid using carpets and slippery mats when there are elderly people in the house.

While emphasizing the importance of mental health, Dr. Tamorish cited the case of a patient who complained of discomfort and high blood pressure and assumed it was gas . But later it was found to be a minor heart attack. Likewise, an 82-year-old patient visited the hospital thrice, each time with three different problems, and was subsequently discharged the same day each time. After a detailed conversation with the patient, he was diagnosed with severe depression. Dr. Kole thus advised that no symptom should be ignored and must be examined for better survival and to follow five simple rules.

““People must be encouraged to CONNECT with each other, BE ACTIVE, TAKE NOTICE and KEEP LEARNING about minute changes in one’s body and GIVE time to oneself to avoid mental health problems. Because, mental health is as important as physical health” Dr. Tamorish Kole

Dr Tamorish Kole: Panelist on Doing Your Part :Lessons Learnt from 5 Case Studies

In confronting acute medical conditions and providing urgent attention and care, Dr. M. C. Misra narrated several experiences he had encountered. He highlighted some of the emergency cases that he had seen first hand and emphasized that no bodily symptoms can be termed minor, unless proved otherwise. No symptoms should be ignored and should be treated immediately. Irrespective of the time of day, including late at night.

It is important to be aware of medical specialties available in the hospitals in your vicinity.For instance, in the case of head injury one should be taken where neurology facilities are available. While discussing acute diseases irrespective of the age and trauma caused in road accidents, he applauded the efficiency shown by over 800 PCR vans whose personnel had helped in the evacuation of individual emergencies as well as mass causalities. But, he hoped for significant improvements to be made to upgrade to international standards.

“Nowadays, among the leading causes of injury among adolescents and adults are road accidents: 40% of the injuries are due to vehicle crashes, and drunken and unskilled drivers are major contributors of road accidents.” Dr. M C Misra

Dr M C Misra Panelist on : Warning Signals, Preventive Strategies-What People at Risk Need to Know

Mr. Suhaan Mukerji, who helped draft the legislation and policy for the new Motor Vehicle’s Act, spoke about the amendments being made in the law and how it would impact citizens. He highlighted that the focus of the new law is on safety and creating a systemic response by adopting a 360-degree approach. As part of the changes proposed, action to protect the citizen who helps road accident victims is a big change; the new law also recognizes the use of statistics and systematic data collection to generate data-driven decision making. Increased fines for violating road or traffic rules will also be introduced. He believes that there is a major structural shift in how the government views the need for smoother transportation, swift mobility and safety of citizens.

“Road accidents are also like a national emergency in a sense. We need a 360-degree approach to tackle this by looking at the design of the car, its inbuilt safety features, different types of offences being committed, and the adoption of a systematic approach to respond to emergencies.” Suhaan Mukerji

Mr Suhaan Mukherji Panelist on Improving Mobility/ Access Issues in Traffic and Transport

Accident data
Ms. Monica Bhardwaj spoke of her personal as well as official mission to save lives. Ms Bhardwaj was proud to lead the PCR Department, whose mandate was to provide quick police assistance and help people in distress. In her talk, she explained the objective of the Police Control Room (PCR) and details of its coordinated functioning.

“PCR vans are equipped with ‘Phablets’ i.e. Phone and Tablets with internet connectivity, first aid kits, stretchers and trained staff. When the victim calls 100, the location of the victim is tracked and sent to the PCR vans to immediately provide assistance. Now, more than 20 Green Corridors have been created to increase efficiency in evacuation and to avoid traffic and other road barriers,” Ms. Bhardwaj said.

“ We are duty bound to help anybody who is in distress or in medical emergencies in Delhi. But, PCR cannot be used to transport sick people or dead bodies which are among its limitations.” Monika Bhardwaj, DCP (PCR)

Ms Monika Bhardwaj (IPS) Panelist on : Management of Medical Emergencies -Lessons Learnt from 100

The talk continued with Mr. Laxman Singh Rana from the CATS ambulance services informing the audience about responding to accidents, particularly when a person is injured or badly hurt. Firstly, one should never touch broken limbs or try to remove any object that has penetrated the victim’s body as it may aggravate the injury.

Every citizen should enroll themselves in an emergency training course. Speaking about CATS, he mentioned that the helpline numbers 102 and 1099 are two key lines through which the ambulance system operates.

Mr L S Rana Administrative Officer (Operations) Centralised Accident Trauma Services

Each ambulance is equipped with paramedics who take the patient to the desired hospital or any public hospital by default. The role of CATS is critical in times of emergencies and it has established a large network across the capital.

Several questions and answers ended the evening with guests asking the speakers about specific problems they had faced.

Written by Dr. M. Shahid Siddiqui for IIC