The significance of promoting trauma awareness in India

Dr Sandeep B. Gore, Director of Emergency Medicine at Fortis Hospital and Vice President of the Society for Emergency Medicine in India, notes that raising awareness of Golden Hour is crucial in view of the alarmingly high incidence of trimodal mortality. When performed during the first several hours after an accident, resuscitation and other life-saving measures have the potential to achieve this.
The National Crime Records Bureau reports that the number of road accidents in 2021 increased by 14.6% to 4,22,659. More than 1,556,000 persons lost their lives in traffic accidents in 2012, and another 3,71,884 were seriously or moderately injured. This mortality rate was also the highest in the past five years.
When traffic laws and regulations are strictly adhered to and victims get quick medical attention following an accident, many lives may be saved on India's roads. Since most individuals are unprepared to deal with trauma, there is a pressing need to educate the public on how to improve trauma treatment throughout the nation.
Trauma deaths: avoidable? How significant is the "Golden Hour"?
Trimodal mortality is common in traffic accidents and trauma injuries. The first is when an accident victim dies at the scene owing to brain damage or cardiac artery rupture, leaving little prospect of survival. The second case happens minutes after the accident due to bleeding, the patient may be rescued if hurried to the hospital. Third, organ failure occurs days or months after the event owing to trauma-related problems in ICU or outdoors.
Golden Hour knowledge is crucial given the high risk of trimodal mortality. This may happen with vigorous resuscitation and life-saving measures. Most second-peak trimodal cycle deaths are avoidable if Golden Hour measures are made. Compressing external bleeding, preserving the airway, administering oxygen and early resuscitation of fluids and blood, and emptying trapped air in the chest owing to severe lung damage are all lifesaving procedures. Golden Hour treatment may save trauma patients' lives via thorough resuscitation.
Trauma/accident victims must be cared for during the Golden Hour, and India's trauma treatment systems must be improved. Our nation lacks pre-hospital medical services, trauma centres, level-one trauma care facilities, and a qualified workforce (particularly emergency medicine-trained physicians) to care for accident victims. Trauma centres on routes at particular distances are needed. Level 1 trauma facilities with the right infrastructure and staff should be accessible around the nation.
These trauma centres need the following:

  • Always have on-call emergency doctors.
  • Surgeons, anaesthetists, surgical assistants, and nursing teams should be available 24/7.
  • Always provide CT scans and angiography.
  • The centre must treat all trauma victims definitively.
  • Focus on trauma research, injury prevention, and education
  • The government and healthcare system must prioritise trained medical and paramedical workers.
  • Doctors and nurses need trauma resuscitation training.
  • Emergency Medicine's fundamental expertise and subspecialty is trauma resuscitations.
  • Schools and workplaces should raise trauma awareness.
  • Implementing traffic restrictions like helmets for motorcycles, seatbelts for all automobile occupants, and speed limits
  • Ensure no drinking and driving.
  • After worldwide criteria are met for airbags and other safety measures, vehicles should be permitted on the road.
  • Any level-one trauma centre needs ER-trained physicians.
Any level-one trauma centre must have emergency medicine-trained physicians. We don't meet 5% of emergency medicine-trained physicians' needs compared to the US, Singapore, Canada, Australia, and the UK. We should take steps to close this gap. Because trauma and accident victim mortality is growing, the government must expand the number of EM-trained physicians. We must establish an emergency care system infrastructure and provide a skilled team to manage them effectively.

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