The document discusses the current state of emergency medical services (EMS) in India and a proposed roadmap for EMS in India by 2020. It notes that over 350,000 accidental deaths occur annually in India, many due to lack of timely EMS. Current EMS is provided by various regional networks but faces issues like lack of standardization, equipment and funding challenges. The proposed 2020 roadmap calls for a national ambulance code, single emergency number, EMS education programs and integrating existing EMS systems to provide standardized emergency response across India.

1. Emergency Medical Services - Indian
Scenario @ 2020
EMS Asia 2014 ;Goa ; October17,18&19

2. Focus
Why EMS
What is the current status in India
What are the issue and Challenges?
What should be our EMS system in
2020?
How to make a hassle free road map ?
EMS Asia 2014 ;Goa ; October17,18&19

3. Ground reality
Total 3.57 lakhs (0.35 million)
accidental deaths were
reported during the year 2009
with the Male-Female victim
ratio of 77 : 23.
J Emerg Trauma Shock. 2012 Jan-Mar; 5(1):
49–54.
doi: 10.4103/0974-2700.93113
PMCID: PMC3299154
EMS Asia 2014 ;Goa ; October17,18&19

4. Road accidents (37.9%), railway
accidents, and rail-road accidents
(7.8%), poisoning (8.0%), drowning
(7.7%), sudden deaths (7.4%), and
fire accidents (7.0%).
Most of the victims of accidents
were aged between 15 to 44 years.
This group of people has
accounted for nearly two-third
(60.7%) of all persons killed in
accidents in the country
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5. • Many of them die for want of timely EMS.
• Thousands of these accident victims could
have been saved if timely medical intervention
were available to them.
• Need of quality EMS in India is an unmet need
of the masses.
J Emerg Trauma Shock. 2012 Jan-Mar; 5(1):
49–54.
doi: 10.4103/0974-2700.93113
PMCID: PMC3299154
EMS Asia 2014 ;Goa ; October17,18&19

6. Mumbai Study
• The injured victim in Mumbai usually is rescued
by a good Samaritan passer-by (43.5%)
• Helped by the police (89.7%)
• Almost immediately after rescue, the victim
begins transport to the hospital
• No one waits for the EMS ambulance to arrive, as
there is none
• A taxi cab is the most popular substitute for the
ambulance (39.3%).
Prehosp Disaster Med. 2010 Mar-Apr;25(2):145-51.
Where there are no emergency medical services-prehospital care for the injured in Mumbai,
India.
Roy N1, Murlidhar V, Chowdhury R, Patil SB, Supe PA, Vaishnav PD, Vatkar A.

7. Healthcare delivery system
District hospital , Medical colleges ,
Specialty centers
Community Health center CHC
Primary Health Center PHC
SC
4, 276
23, 458
Sub Centers 1 ,46 ,036
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8. • National Family Health Survey – III,
• Private medical sector remains the primary source
of healthcare for the majority of households in
both urban areas (70%) and rural areas (63%).
• Even the quality of private sector is also questionable.
: http://www.ncrb.nic.in/CD-ADSI2009/ADSI2009-full-report.pdf
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9. Emergency Medical Services
• EMS is thus provided in two forms
Pre-hospital services
Treatment to inpatients.
• EMS is an essential part of the overall
healthcare system as it saves lives by providing
care immediately.
Potluri P. Emergency services in India- Counting on betterment.
A transition in progress. Editorial Section. [Last assessed on 2011 Jan 25];
Asian Hospital and health care Management magazine.
2009 18 Available from:
http://www.asianhhm.com/healthcare_management/emergency_services_india.htm
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10. Intra Hospital Transfer facility
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11. India
• Life and death are equally importance
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12. Pre-Hospital Care networks
• National Network of Emergency Services at
Ahmedabad, Delhi, Pune, Hyderabad,
Chennai, Raipur, Ranchi, and Kolkata
• Emergency Management and Research
Institute (EMRI) at Haryana, Chandigarh,
Uttarakhand, Rajasthan, Gujarat, Madhya
Pradesh, Andhra Pradesh, Goa, Karnataka,
Tamil Nadu, Meghalaya, and Assam
Subhan I, Jain A. Emergency care in India: The building blocks. Int J Emerg Med. 2010;3:207–11
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13. Pre-hospital care
• Centralized Accidents
and Trauma Services
(CATS)
• Life line foundation –
Ahmadabad
• 1298 ambulances
• IIEMS – international
Courses
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14. NRHM -108
• Adopted from EMRI
• National single Number
• Fully Funded by NRHM
• Free to victims
• Fully equipped
ambulance
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15. Active Network Group of Emergency
Life saves- ANGELS
• Community based
Ambulance network
• 300 ambulances
• PPP model
• Bagged three
International /National
awards
• Massive first responder
awareness
• EMCT
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16. Angels awards
• First EMS Asia award 2013
• AIIMS entrepreneurship
award 2013
• AAEMI and Lifeline
foundation award 2013
Best community based EMS
Kerala is highly motivated for EMS and EM
Angels take out Emergency Medicine
from the hospital boundaries
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17. EMS - Issues and challenges
• Big country with
diversities
• Rudimentary emergency
medicine specialty
• Uniformity and lack of
standardization
• National Ambulance cord
• Paramedic council
• Vehicle for India roads
• Courses and Trainings
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18. Indian diversities influence EMS
Regional
Geographical
Emotional
Financial
Cultural
Political
Individual
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19. Implementation of Rules
• Mr.Rishi Raj Singh IPS-Transport
commissioner
of Kerala implemented
traffic rules strictly
• 40 percent reduction in
RTA
Net result –
He has been
Removed from the post !!!!!!!
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20. 108 challenges
• Scams – Prevalent in all
states
• Vehicle conditions and its
issues
• Availability of Paramedics
• Equipments and related
issue
• Fabricated call list
• Unauthorized usage for
non emergency purposes
Equipment given in 108
are not available in hospital OT
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21. EMS Asia 2014 ;Goa ; October17,18&19

22. Angels Challenges
• Funding
• Drivers attitude
• People attitude
• Ambulance Mafia
• Non Standardized
charging patterns
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23. Angels innovations
• Emergency Medical Care
Technicians Training
• First response provider
course
• Rural emergency medical
care initiatives
• Emergency Medicine Crash
course
• App based networking
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24. Angels Bike Emergency Rescue Team
• First batch launched with
25 volunteers
• Second batch training
started 150 volunteers
• Target to train 20000
volunteer by 2nd October
2016
• 12 modules to complete
in 3 months
• Act as first responders
• Networks through mobile
apps
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25. ABERT vision
• No matter whether an ABERT volunteer saved
somebody …
• If 20000 ABERT volunteers follow proper road
culture and safe driving principle will bring
down accident rate to 30 to 40 percent
• ABERT focus on college students and youth
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26. National Ambulance Code
Design
Equipment
Classification
Standardization process
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27. National Skill development
corporation
• EMT B training program
aiming to train plus two
holders
• Wrongly utilized –
Nation wide agencies
focused on nurses
• Easy money like NRHM
• Program Hold
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28. EMT B Training proposal
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29. Last Decade
Changes in Emergency Medicine India
• MCI recognition 21st June
2009
• GWU program 2007
• MD programs in Medical
colleges 2011
• Upstate and other abroad
university programs
• Popularity on MCEM and
its liberalization
• DNB emergency
Medicine
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30. EMS 2020 Road map
• Implementation of National
ambulance code
• One Nation – One
emergency access number
• Paramedic council
• EMS BSc and MSc Courses
• Standardization of EMS
protocols
• National EMS society /
Foundation
• Integration of various EMS
systems
WAR
Water –Air - Road
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31. Our style
Ctrl+C Ctrl+V
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32. Create what we want …
which is suitable for us!!!
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33. Thank you so much …..
EMS Asia 2014 ;Goa ; October17,18&19
www.drvenu.net , www.emergencymedicinemims.com

34. EMS Asia 2014 ;Goa ; October17,18&19
www.drvenu.net