Valley hospitals’ ambulances lack basic life support

Mir’s father is writhing in pain as he bleeds profusely and there are little chances that he may survive in absence of the emergency medical aid.

Written by Bashaarat Masood | Srinagar | Published:February 28, 2009 9:21 am

Bashir Ahmad Mir is holding a drip set in his hand as the ambulance negotiates the traffic jams to reach Sheri Kashmir Institute of Medical Sciences (SKIMS). Mir’s father is writhing in pain as he bleeds profusely and there are little chances that he may survive in absence of the emergency medical aid.

In valley,a couch and occasional oxygen unit is the only difference between the valley ambulances and the load carriers. And most of the times,the patients die even before reaching a hospital.

In violation to the guidelines set up the Ministry of Health and Family Welfare for the ambulances,the J-K’s Health directorate is using ambulances even without the Basic Life Support (BLS) system.

“The Ambulance services must carry equipment and medications as per requirement of treatment protocols,” a guideline issued by the Ministry of Health and Family Welfare says. “It must meet any international standard for Ambulance Supplies specifications”.

A white Mazda vehicle or a pickup van fitted with a couch is termed as Ambulance in the conflict ridden valley. The ambulance lacks even the Basic Life Support system – installed Oxygen System,Portable Suction Unit,Traction Splints,Padded Board Splints,Ring Cutter,Adult Sphygmomanometer (Blood Pressure Apparatus),Defibrillator cum Monitor.

In fact,the couch too doesn’t meet the required specification. The international standards seek a ‘roll in,roll out type’ cot that meets the safety specifications and is fitted with the patient restraining devices to prevent displacement.

“These ambulances are no better than the passenger vehicles,” says Dr Niyaz Jan. “The ambulances of the Health department don’t meet even the basic requirements. This increases the mortality rate as no emergency medical aid is available to the patients”.

The ambulances are not accompanied by any trained paramedic and the responsibility is taken by the attendants. In fact,there is little a paramedic could have done as the ambulance vehicle is without any life saving equipment.

The international standards make it mandatory for the ambulance to have all the necessary equipments for the Basic,Advanced and Cardiac Life Support system. As per international standards,an ambulance van should be accompanied by a first responder,an ambulance care assistant and a paramedic trained in Advanced Life Support system. The van should be air conditioned and have crash-resistant cots,Airway,ventilation,oxygen and suction equipment that consist of portable oxygen with a minimum 350 liter capacity,an in-ambulance oxygen system with a minimum 1200 liter capacity and other emergency equipment.

The Director Health,Kashmir,Dr Muzzaffar Ahmad admits that the ambulance system in valley is primitive and results in increased mortality rate. “There are normal ambulances and critical care ambulances,” he says. “We don’t have any critical care ambulances. They are costly. Our ambulances are better than the passenger vehicles as they gave stretchers”.

Director Ahmad says that they are working on the critical care ambulance services but they don’t have trained manpower for ambulance services. “We are going to issue two critical care ambulances to each district. But it would take time to reflect the change on ground,” he says. “In health planning,the change is reflected only after 10 -20 years on ground”.

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