Calling an ambulance in an emergency? You may face a bumpy road

Imagine calling an ambulance in a moment of distress. The ambulance arrives but the driver is untrained, there is no paramedic to assist, and there is no mobile stroke unit on board. Also, an untrained junior doctor attends to the patient instead of a specialist when you reach the hospital. This situation is shockingly common in India.

Sample these:

• 95 per cent of ambulances don’t have trained personnel

• 90 per cent of ambulances don’t have equipment or oxygen

• 80 per cent of ambulances don’t have mobile stroke units

• 30 per cent of mortalities happen due to delays in emergency care

• Most emergency department doctors don’t have formal training in Emergency Medical Services

Not quantity, quality is the issue

The problem lies in the quality of emergency services, not mainly with the quantity. The World Health Organization recommends at least one ambulance per lakh population, and India is barely in line with the recommendation. “There are a total of 2,423 Advanced Life Support (ALS) ambulances, 17,135 Basic Life Support (BLS) ambulances, 3,676 Patient Transport Vehicles, 17 boats, and 131 bikes presently supported by the National Health Mission in the country,” Bharati Pravin Pawar, Junior Minister in the health ministry apprised the Parliament on February 3, 2023.

ALS is supported for an average population of five lakh and a BLS ambulance is supported for over one lakh population. India has 0.88 ALS ambulances per five lakh people and 1.25 BLS ambulances per lakh population.

Statewise ambulances per lakh population

Insufficient equipment and beds

Nearly 1.5 lakh people die in the four lakh road accidents that take place every year. That’s almost the entire population of the Buxar district in Bihar. Such a large number of road accidents and fatalities demand a robust emergency medical service. However, the situation indicates mismatches.

Emergency cases account for up to 30 per cent of all OPD patients on a given day. In terms of admissions, they account for up to 24 per cent of government hospital patients and up to 39 per cent in private hospitals, according to Niti Aayog. To address this flow of emergency patients, it is essential to have a complete list of all recommended emergency medicines at all times. The Niti Aayog assessment revealed that only nine per cent of all hospitals fulfilled this criterion.

Even emergency beds are scarce across hospitals. In large government hospitals with more than 300 beds, 11 per cent of all cases are emergencies. But they allocate only four per cent of all beds to these cases. In small private hospitals with less than 300 beds, this figure is about 30 per cent of all cases are emergencies but they allocate only five per cent of all beds to these.

Meanwhile, a few countries have taken their ambulance services to the next level. For instance, Dubai has a Lotus Evora ambulance, which is the fastest ambulance in the world as it is a supercar and can touch speeds of around 300 kmph.

Tokyo has a super ambulance, which is a big bus. Germany has a Mercedes-Benz Citaro ambulance, which is the largest ambulance in the world and has a capacity for transporting and treating 123 patients at a time. Many countries have separate emergency lanes on roads.