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AMBULANCES and Emergencies

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As we Indians refuse to really believe that emergencies could strike our homes and us, we are caught horribly off-guard and unprepared when a sudden crisis does strike. Most of us, for instance, may not know what number to call in case of a fire or a medical emergency. One might argue that there is no point remembering numbers that we are convinced would work, and we rely on our skills of “jugaar” as the best way out.
Efficient ambulance services, by quickly bringing people who have suddenly taken critically ill, to medical attention, have indeed saved many lives. The London Ambulance Service, started since 1897, is one of the most efficient with 400 ambulances and 4500 strong staff parked in different parts of the city, poised to rush in. A telephone call to a central command and control center evokes a quick response. The service is not merely of transportation of sick person to a hospital but also provides resuscitaion, preliminary care, oxygen, life support and so on.
The quickness of response may make all the difference between life and death especially in the case of a sudden heart attack. The Emergency Medical Services of Seattle serves as a world model. A single phone call makes fire-fighters (yes, firefighters!) rush to the spot in less than 7 minutes. This time is critical as brain death occurs if blood circulation to the brain has stopped for 5 minutes or more. The fire fighters, who are trained and equipped, can resuscitate patients, provide cardiac massage, defibrillate a stopped heart, give oxygen, start intravenous drugs, and transport the patient to the nearest equipped hospital. With this strategy, 40% of their patients with cardiac arrest survive compared to 20% in other American cities that have longer response times.
What about our Indian cities? A web search shows around 15 hospitals in Lucknow to offer ambulance services. Most however is only on paper (or net). Few private diagnostic centres arrange ambulance pick-up and drop for patients who undertake expensive tests such as CT or MRI scans with them.
One trust (Dr Akhilesh Das Gupta Charitable Trust) provides a semblance of a true ambulance service in the city. They have a central control room (numbers 0522-3911222, 0522-6560000) that responds promptly, have 7 ambulances parked in 6 parts of the city to respond quickly ( 20-30 minutes), offer transportation to any hospital of the patient’s choice, and is free of charge (you need not worry about money in the middle of the night). The ambulance however has only a driver, and does not have any additional staff or facilities for resuscitation or cardiac revival.
As they say, “A wise man knows his neighbours”, a wise citizen should know how best to seek help in his city in an emergency. 
As published in HT City( Hindustan Times) dated 23 January, 2011.
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