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1, issue3, 15 may’12 pages 4

THE AMBULANCE TIMES ~Touching ever yone associated with Emergency Medical Ser vices~

At Safdarjung, private vans masquerade as ambulances

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UP demands 100 ambulances to carry road accident victims

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Rough weather caused Faridabad air ambulance crash

New Delhi: A probe into last year’s crash of an air ambulance in Faridabad has found that strong gust of wind and very rough weather had caused the accident that claimed 10 lives, including that of a patient it was carrying to Delhi from Patna. The small Pilatus PC-12 aircraft, which was converted into an air ambulance, had crashed into two houses in the Parvatia colony of Faridabad at 10:43 pm on May 25. While two pilots and five passengers, including two doctors and the patient, were killed, three residents also lost their lives on ground. “It is probable that a series of up and down drafts, turbulence (moderate to heavy) and in dark night conditions caused the crew to become disoriented”, leading to mishandling of controls that caused the aircraft to enter into a spin and crashing, the probe report said. While positioning itself on to the approach path for landing, the aircraft

started losing height very rapidly barely five-seven minutes before the crash, it found. The single-engine turboprop passenger and cargo aircraft, manufactured by Pilatus Aircraft of Switzerland, was not equipped with Flight Data Recorder or Cockpit Voice Recorder. Without the black box, the probe was carried out with the help of the wreckage, air traffic control data, weather condition, the departure from the flight (approach) path and other factors. The probe team, however, found that the plane was in airworthy condition to undertake the flight and had sufficient fuel on board. Its maintenance was carried out in accordance with the approved programme and no snag was reported before the accident. “The rapid onset rate of the spin and high descent rate resulted in the crew being unable to recognise

the phenomenon, which they were experiencing, perhaps for the first time. “This probably caused them to react erroneously resulting in an aggravation of the situation and ultimate loss of control till impact with the ground,” the inquiry, set up by the DGCA, found. The inquiry found that the small aircraft “was hit by a strong gust”, resulting it to turn left and then stall. Emergency message - “Into Bad Weather” - was received twice by the air traffic control at 2240 hours and 2241 hours. Thereafter, the ATC stopped picking up the aircraft on the radar and repeated attempts to contact it on Very High Frequency radio failed to get any response. In conclusion, the inquiry said, “The probable cause of the accident could be attributed to departure of the aircraft from controlled flight due to an external weather-related phenomenon, mishandling of controls, spatial disorientation or a combination of the three” Goodmans Rescue provides medically trained and certified staff for on-site pre-hospital medical care for • • • • • • •

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Congestion on city roads delaying ambulances CHENNAI: Several more lives are being lost on city roads as ambulances are taking longer to get to the spot in the last three months due to bottlenecks. The Emergency Medical and Research Institute, which handles ambulance services in the city, says the delays are because of congestion caused by one-ways and infrastructure works, such as Metro Rail and road repairs. The agency’s records show that the average response time has increased by more than two minutes, from 11.5 minutes in the last quarter of 2011 to 13.29 minutes in the first three months this year. Response time is the gap between the ambulance receiving the

call to it reaching the spot. In some areas, the average response time has gone up to eight minutes, which could make a life-and-death difference to trauma patients. While it takes up to 30 minutes for some neo-natal ambulances, regular ones take an average 15 minutes to reach emergency locations. For instance, the average time it takes for an ambulance near Raj Bhavan, which covers 5km in and around Guindy, has nearly doubled to 13.23 minutes this quarter, from 6.77 minutes in the last quarter of 2011.

Punjab comes up with Mobile Ambulance for Animals Animals in Punjab may now receive more prompt medical attention as the state government has decided to start a free veterinary mobile ambulance service to provide instant treatment to them. This will be on the pattern of ’108′ mobile ambulance services for people, Animal Husbandry Minister Gulzar Singh Ranike said here Sunday. Ranike said the service would be operational soon with an QUICK TIPS

aim to give instant and free treatment state, Punjab also has an established to the animals. The mobile ambulance dairy network. service would be provided at all 22 district headquarters and will connect the whole state through a toll free number, he said. The mobile ambulance vans would be equipped with ultra-modern medical facilities to provide medical care to animals, added Ranike. Though primarily an agriculture

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The Ambulance Times

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UP demands 100 ambulances to carry road accident victims NEW DELHI: Uttar Pradesh, which ranks third among the states as far as road fatalities are concerned, has demanded 100 ambulances for quicker transfer of accident victims to nearby hospitals. Sources in the road transport and highways ministry said that UP CM Akhilesh Singh Yadav had put forth this demand when he met Prime Minister Manmohan Singh here recently. “We are looking into the demand. The state government has claimed that they need more ambulances, and around 50 cranes for road safety across the state,” said a

senior ministry official. In 2010, at least 15,175 people had died in road accidents in UP, and the state accounted for 11.3% of total fatalities across the country.Kanpur, Lucknow and Varanasi have an unenviable record for their killer roads. So far, both the ministry and National Highways Authority of India ( NHAI) have provided about 750 ambulances to all state governments for rescue and fast shifting of accident victims. But, officials said that they have no clue of how these ambulances were being used by state governments. It has asked all state governments to

furnish details of these ambulances and the number of accident victims shifted to hospitals using these vehicles. “It’s one way of carrying out an audit of the resources we provided to the states. Once we get the feedback, it will help us take better decision about deployment and allocation of ambulances to states,” said a ministry official. There have been allegations galore about under-utilization of these ambulances, or the vehicles being used for purposes other than ferrying accident victims.

Limited service of ICU ambulance KOCHI: Of the two ‘working’ ambulances, the ICU ambulance is not allowed to run outside of the state. Sources said that they are helpless in cases where the patients are asked to be taken outside the district or the state, for they did not have the permission from the authorities concerned. The ICU ambulance is owned by the National Rural Health Mission (NRHM), Kerala Medical Services Corporation Ltd and the state government.

This particular ambulance is maintained by the Hospital Development Committee (HDC) of the General Hospital. However, in times of emergencies, the ambulance is allowed to go outside the district and the state with the District Collector ’s permission. Besides, the NRHM has every right to recall the service of the ICU ambulance, if the need arises. Such a problem would not arise, if the hospital owns an ICU ambulance

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The Ambulance Times

At Safdarjung, private vans masquerade as ambulances At Safdarjung, private vans masquerade as ambulances. No medicare on board, vans charge random rates; owner claims there is no system for ambulance registration; Health Secretary says rules exist Cocking a snook at health department rules for registration of ambulance services in Delhi, a fleet of private ambulance vans has been operating from the Safdarjung Hospital premises, charging sums ranging from Rs 250 to Rs 1,500 per patient per ride. Parked round-the-clock outside the hospital emergency wing, Tata Sumo and Maruti vans of the Ajay Ambulance Service lack lifesupport equipment and paramedics. Painted white with the red cross sign, ambulance written in bold and beacons placed atop, these vans have yellow number plates with letters in black meant for taxis and commercial vehicles. To transport a patient to the AIIMS Trauma Centre across the road, these vans charge Rs 250 to Rs 300, depending on how “serious” is the condition of the patient. To carry a patient to the Fortis Hospital in Vasant Kunj, drivers quote negotiable rates ranging from Rs 1,000 to Rs 1,500. When his comments were sought, Ajay Kumar, who runs the Ajay Ambulance Service, said: “I have been operating from the hospital for the last 30-32 years. I have not applied for registration of my vehicles since there is no system for All-India ambulance registration. Delhi rules apply only to Delhi vehicles, my vehicles run across the country.” Asked about the absence of necessary life-support equipment on board these vans, he said: “We ply only to nearby hospitals like the AIIMS Trauma Centre for very serious patients. In the case of other patients, relatives

accompany us. We only transport bodies to other states.” Vishnu Kumar used the Ajay Ambulance Service to transport his brother Raj Kumar from Safdarjung Hospital to AIIMS. His brother had sustained head and chest injuries after a fall from the terrace during Holi. “We had to hold my brother’s head since no paramedic was on board. They charged us Rs 200. How were we to know that it was not a hospital ambulance?” Safdarjung Hospital Medical Superintendent Dr B D Athani said that as far he knew, these vehicles were parked on the Ring Road outside the hospital. “I am told they have been operational for a long time and are of help to

patients when we are short of hospital ambulance. If they are parked within the compound, I need to look into it.” Hospital administration officials said there have been attempts in the past to keep out these vehicles but they always return. “It is clear there is a demand for them. We have six functional ambulance of our own. Often, these are not enough. These are reserved for admitted patients who need to be transferred. For emergency services, when patients have to be taken to other hospitals, relatives rely on these vehicles,” an official said. N S Bhatti, Secretary of the Delhi Ambulance Service Association which represents private ambulance

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operators, said repeated attempts to regulate ambulance operators had failed. “There is no administrative support, no drives conducted, people hesitate to stop an ambulance for inspection. This is a big problem in Delhi,” Bhatti said. Delhi Health Secretary Anshu Prakash said: “It is unfortunate if unregistered ambulance vehicles are plying like this. As per rules, a health department committee clears an ambulance operator after inspection. There are requirements for three grades of vehicles — advanced life support, basic life support and patient transport vehicles. But each has to be registered with us.” After the health department clearance, the transport department provides licences for these vehicles — with white number plates. Dr Shakti Gupta, Medical Superintendent of the AIIMS Trauma Centre, also chairs the national committee working on a standard code for ambulance design in the country. “Patients transported to us are usually those who sustain grievous injuries, head and spinal being most common. If these vehicles have yellow number plates, they are obviously not registered and can pose a serious threat to patient life,” Gupta said.

RNI No. DELENG/2012/41958. PRINTED AND PUBLISHED BY : Satish Kumar Bhardwaj, EDITOR: Satish Kumar Bhardwaj, PUBLISHED AT: M-2, Greater Kailash-1, New Delhi - 110048, PRINTED AT: Intergraphic reproductions Pvt. Ltd. A11 DDA Sheds, Okhla Industrial area, Phase-1, New Delhi - 110020


THE AMBULANCE TIMES