1) Community volunteers and good citizens can play an important role as first responders in providing immediate medical care and safely transferring patients to appropriate healthcare facilities, especially in rural areas. 2) Training community volunteers in basic first aid and life support skills can help save lives until certified responders arrive. 3) There are different types and levels of ambulances that are equipped to handle different medical emergencies, from basic to advanced life support.

1. Its very challenging to provide round the clock medical care to the
ever growing population of India which is adding to patient over
load . Role of community volunteers , good citizen and community
spirit can play vital role of first responders in Pre hospital Health
care settings particularly in immediate and safe transfer of patient
to the appropriate Health care facility

2. Prevention is always better than cure and community needs to follow discipline and
Road safety guidelines . A good example of this is following traffic rules ;
preferably use public transport/shared vehicles ; use of solar energy/Compressed
natural gas/electricity as fuel to reduce pollution ; use of seat belts and helmets ;
regularly getting vehicles serviced and discarding more than ten year old motor
vehicles ;use of bicycle and pedestrian walking for short distances ; avoid
drinking and driving ;to keep mobile phone silent while driving ; getting regular
health checkup and exercise to maintain health fitness and keep medical card of
your illness in case of diabetes , epilepsy ,coronary artery disease ,hypertension
or any other medical condition along with a copy of your identification card and
driving license mentioning your blood group.

3.  Pre-hospital trauma technicians certificate course is for duration of
9 months and is being conducted by department of Anesthesia
and Intensive Care since 2007 in Lady Harding Medical College ;
Safdarjung Hospital and PGIMER DRRML Hospital CHS New
Delhi .Now the course has been upgraded to 12 months with 3
months compulsary casualty Internship from the year 2014.

4.  (CATS) is an Autonomous Body of Govt. of NCT of Delhi,
 (Dial 1099 /102 toll free number) providing round-the-clock free
Ambulance Service to the victims of accident and trauma, since
1991.The control room of CATS is also connected with Police
control room and Delhi fire Service through a two way radio
communication
 CATS Private partner is Fortis hospital ,New Delhi

5.  1. Reaching the site of accident as early as possible
 2. To carry out first-aid and to provide emergency
management at the site of accident
 3. Quick and safe transportation of the patient to
the nearest definitive care facility
 4. To spread knowledge and awareness about
first-aid through demonstrations and training of
public
 5. To liaise and serve with other organizations
such as POLICE, DFS and any other government
agencies in times of disaster

6.  Basic life support awareness amongst community
is being spread by training volunteers in these
hospitals because in majority of situations they are
the first responders as bystanders or as community
members until a certified responder reaches the
scenario or the victim is safely transported by them
to the nearest health facility within the Golden
time with the aim of saving life. School children
are motivated to learn the basics of first aid and
Basic life support again to spread awareness in the
community . Apart from training community ,
nursing orderlies and technicians of the hospitals
are also being trained in Basic life support

7.  A Community First Responder Scheme3 is made up of groups of
volunteers who, within the community in which they live or work,
have been trained to attend emergency calls received by the ,
NHS(National Health Service) Ambulance Service providing
potentially life-saving treatment and first aid until an emergency
ambulance arrives.
 Our prehospital trauma technicians and centralised accident and trauma
paramedics are already spreading community awareness

8.  The average cost of RTA in developing countries
is estimated at 65 billion dollars. 8. Trauma related
death occurs in India every 1.9 minutes.5
 The RTA rate of 35 per 1,000 vehicles in India is
one of the highest in the world ... India has the
highest proportion of deaths due to road traffic
accidents
 National Highways Authority of India (NHAI) has
decided to install vehicle ... one ambulance and
one patrolling vehicle for every 50 km stretch6

9.  Ten states in India are using 108 as ambulance
number: Soon, there will be two-wheeler
ambulances1 known as "first responders" across
the country to provide emergency medical care
to people in congested areas, by-lanes and
crowded zones where other types of
ambulances cannot reach. This category of
ambulance is popular in countries including
US, UK, Australia and Sweden which can
provide first-aid, but don't transport patients.

10.  In emergency medicine, the golden hour (also known
as golden time) refers to a time period lasting for one
hour following traumatic injury being sustained by a
casualty or medical emergency, during which there is
the highest likelihood that prompt medical treatment
will prevent death 4 . It is well established that the
patient's chances of survival are greatest if they receive
care within a short period of time after a severe injury;
however, there is no evidence to suggest that survival
rates drop off after 60 minutes. Some have come to use
the term to refer to the core principle of rapid
intervention in trauma cases, rather than the narrow
meaning of a critical one-hour time period.

11.  1) Type A Road Ambulance /Medical First Responder
 Road Ambulance designed to provide emergent out of
hospital medical care to patients when stationary. This
vehicle maybe any CMVR approved Category M or L
vehicle suitable for the terrain to be used in but will not
have the capability to transport patients in supine state
or provide them medical care inside the vehicle.
 2)Type B Road Ambulance/ Patient Transport Vehicle
Road ambulance designed and equipped for the
transport patients who are not expected to become
emergency patients

12.  3)Type C Basic life support ambulance is
equipped with life support equipment like an
oxygen cylinder, BP monitor and stethoscope.
This type of ambulance can be used for
emergencies that are not very grievous or
when the patient can be transported to the
hospital quickly.

13.  4)Type D Advanced Life support Ambulance or the Cardiac care
ambulance . This ambulance is fitted with advance life support
machines such as defibrillators (a machine used to restart the
heart), ECG machine (used to keep a check on the heart rate of a
person), Ventilators, Oxygen cylinders, Pulse oxy meter (used to
check for the mount of oxygen in the blood) , Resuscitation kit,
suction machine, nebulizer and BP apparatus. This kind of
ambulance can be used in cases where the patient is either
unconscious, has had a heart attack or is a known patient of heart
disease. It can also be used in cases the patient has to be
transferred to a hospital that is far away, or he/she is immobile
and on life support. Irrespective of the type of ambulance you
choose all ambulances will usually carry basic life-saving tools
and medicines that may be required during an emergency.
operational by July, 2010. These Ambulances and First Responders
would be fitted with GPS and controlled

14.  These Ambulances and First Responders would be
fitted with GPS and controlled
 through a state-of-the-art Emergency Response Centre.
All the Ambulances, Emergency Response Centre and
all Government Hospitals in Delhi would be connected
through a dedicated wireless radio network.
 Expansion of the existing fleet of ambulances will be
provided by including 150 new ambulances
comprising 141 Basic Life Support (BLS) units, and 9
Advanced Life Support and 20 First Responder
vehicles (two-wheelers). Of this fleet 39 ambulances
would be operated through CATS, coordinated and
monitored through the same emergency response
center, and the rest would be handled by a separate
private contractor.

15.  CATS private partner, Fortis Emergency Services,
role includes providing Emergency Medical
Response (EMR) services in coordination with
police and fire officials within a response time of
15 minutes and provide pre-hospital care
(including basic stabilization) to patients under the
supervision of trained personnel at all times in
their transportation to the nearest hospital.
Ambulances and first responders are equipped
with wireless sets & two way radio
communication, with tetra compatibility and GPS
communication systems.

16.  In some cases the only way to transport a
patient safely and quickly is in an Air
ambulance. This service is meant for patients
in remote areas, those who are on life support
or for those patients who are too grievously
injured to be transferred by road. During such
emergencies, time is of the essence and
transporting a patient quickly and safely to the
hospital is essential. There are certain agencies
in India that provide this service and can
transport patients within India or to countries
abroad.

17.  1The times of India .com June 8., 2013
 2National Ambulance Code) AIS-25 THE AUTOMOTIVE RESEARCH ASSOCIATION OF INDIA Pune
 3(National Health Service Ambulance) service UK
 4 American College of Surgeons (2008). Atlas, Advanced Trauma Life Support Program for Doctors. American collegeof Surgeon
ISBN978-18806963164
 5Epidemiology of Road traffic accident 6. National Highways Authority of India (NHAI) has decided to install vehicle
... one ambulance and one patrolling vehicle for every 50 km in India·