The Ambulance Times - January I Vol 2 Issue 19

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19, 15th January ’13, Pages 4

THE AMBULANCE TIMES ~Touch i ng ever yone as soci ated w it h E mergenc y Med ic a l Ser v ice s~

SBI donates free medical equipment, ambulance Pratib Chaudhuri, Chairman, State Bank Group, handed over medical equipment worth Rs 19,92,770 to Regional Cancer Centre, under the Bank’s Corporate Social Responsibility (CSR) initiatives at a function held at the SBI Local Head Office here on Thursday. A Krishna Kumar, MD&GE(NB) donated an ambulance to Sree Chitra Thirunal Institute for Medical Sciences and Technology (SCTIMST) at the function.

Three years on, AIIMS yet to get Air Ambulances New Delhi: More than two hours were wasted in making arrangements for shifting the girl to Singapore. The time could have been saved if the facility was available. Delhi’s All India Institute of Medical Sciences (AIIMS), the country’s biggest government hospital, is yet to get its air ambulance facility,

for shifting the girl to Singapore. That time could have been saved if an air ambulance facility was available with either AIIMS or Safdarjung Hospital where she was admitted,” a government official familiar with the developments said. Hospital sources say that the proposal to have an air am-

dling the air ambulances,” the official said. A fully equipped air ambulance costs around Rs 10 cr. Presently, four private hospitals in Delhi have their own air ambulances, Fortis, Gangaram, Apollo and Medanta. Several private companies provide air ambulances to fly patients from one place to

three years after it mooted the proposal. It was because the government did not have any air ambulances that it was forced to use a private chartered flight to send the 23-year-old gang rape victim to Singapore for treatment. “More than two hours were spent to make arrangements

bulance facility along with a helipad at AIIMS’ trauma centre was sent to the Ministry of Civil Aviation in December 2009. “However, no one knows what happened to that proposal. The hospital proposed that it would create a pool of doctors and nurses who would be han-

another. Despite repeated attempts, the spokesperson of AIIMS was not available for comment. The queries sent by the newspaper to the spokesperson also went unanswered. Source: The Sunday Guardian

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The Life S aving Gadgets Found in an Ambulance Ambulances are packed with many kinds of medical equipment that cost thousands of dollars. Such devices are designed to save lives while the vehicle is on the go. These tools are used by very skillful emergency medical technicians (EMTs) or ambulance technicians. So, aren’t you just a wee bit curious about what medical tools EMTs are going to use on you in case you become unfortunate enough to ride in an ambulance? (Knock on wood.) Well, here are some of the most commonly used medical gadgets in ambulances. Let’s see how they work. The Cardiac Monitor is essential for a paramedic crew to assess a patient’s condition. The cardiac monitor measures

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Angels in ambulances honoured for selfless service MADURAI: They work under enormous pressure, navigating through dense traffic snarls while administering life-saving procedures to the accident victims in their battle to survive. Through their timely action and speed, they save hundreds of lives that could otherwise be lost. They are the pilots and staff of the 108 ambulance services, who were honoured on Tuesday during the National Ambulance Day organised by GVK EMRI. Thirty-seven staff members of 108 ambulance service from 12 southern districts coming under Madurai district were distributed with certificates and prizes.

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Toddler dies in MP after ambulance carrying her had no oxygen Dhar (MP), Jan 4: A twoyear-old girl suffering from breathing problems died after oxygen cylinders in the ambulance that was shifting

her to Indore exhausted enroute, due to alleged negligence of the hospital staff, official sources said today. The victim identified as Zia was admitted to the Dhar district hospital yesterday after she complained of breathlessness. The doctors after initial treatment referred her

to Indore in an ambulance. However, the oxygen cylinder got exhausted enroute following which she died on the way, sources said. The vict i m ’ s parents l a t e r s u b m i tted a memorandum to the D h a r Collector C B Singh demanding action against those responsible for the tragedy. The Collector has ordered a probe in this regard which will be conducted by City Magistrate, Vishal Singh, sources added. Source : India TV

Police in dock for doctor’s death probe NEW DELHI: Delhi Police commissioner Neeraj Kumar has been asked to file a compliance report on a sessions court’s order to probe afresh the death of a doctor whose body was found in an ambulance parked inside the nursing home of another doctor. Metr opolit an magistrate Chetna Singh issued notices to the main accused and his four employees. District judge R K Gauba had sent the case to Singh to examine lapses in police probe. “Court notice should be also issued to the complainant for the next date of hearing on February 26,” the court said. Earlier, Gauba had directed cops to probe afresh the death of private practitioner Akchad Biswas, whose body was found in an ambulance inside main accused Dr Ajit Gupta’s nursing home premises at Malviya Nagar on the intervening night of January 27-28, 2006. The court had directed reinvestigation on the plea of the victim’s wife who said it was murder and not death due to negligence as concluded by police. Seeking prosecution of Gupta and his employees, she told the cour t that Gupta invited Biswas for an annual party but two days later informed her of his death. Source : The Times of India


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Is Allahabad ready for 10 crore pilgrims during Kumbh? ALLAHABAD: Before sunrise on Monday the first holy dip would have taken place at the Sangam, the confluence point of the rivers Ganga, Yamuna and the mythical Saraswati. It would mark the start of the Mahakumbh, a once after every 12 years Hindu religious congregation at Allahabad. The confluence point is also called the Triveni Sangam (m e e t i n g of three) and Hindus believe that a bath her e purifies the soul and frees the individual from the cycle of birth, death, and rebirth. Ten crore people are expected to visit the city in the next 55 days starting with the first of the six ‘shahi snans’. With just about a day to go, TOI surveyed the 58 sqkm Kumbh Mela area to assess the preparedness for such a massive gathering and found gaping holes. The entire Kumbh area is plastered with toll-free helpline numbers of the police control room (1944), fire service (1945) and ambulance (1946) but none of them are functional. The tents given to the general public are sub-standard and the toilets meant for the non-VIPs are filthy despite the fact that the crowds have still not landed. There is no

dearth of toilet facilities but water is scarce. Municipal corporation’s mobile toilet vans are an exception.

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vugamoor thy, emergency medical technician rushed to save Senthilkumar, 30, of Achampattu in August last year. Senthilkumar was lying somewhere on the tracks in pitch dark and the staff had great difficulty in locating him in spite of reaching the spot within eight minutes. “We waved high beam torch across the tracks and found him after we asked him to wave his mobile phone torch in the dark to locate him. We rescued him and rushed him to GRH where he was saved. I would never ever forget the incident in my life,” he stated. In another incident, which took place on September 9, 2012, the 108 staff acted swiftly to save the life of Surender, 24, of C Pudupatti in Theni district, after he met with an accident in mid-

Mobile signals dropping in the area are an irritant for new-age gurus and other visitors. Network congestion

has become a permanent feature. Local BSNL officials said this was because the setups of private operators have still not come in. Potable water is a big health hazard. Robin Davis, a Scottish traveler, said that he’s had a bad stomach upset from the day he first had water. Doctors at the central hospital also confirmed that a large number of patients had stomach problems. UP Jal Nigam officials said the water is being provided through deep boring. It has not been filtered properly. Many akharas have installed RO filters inside their camps and shopkeepers can be seen using common aqua guards. Nearly 30% of the staff performing Kumbh duties has

developed symptoms of chilblains - a tissue injury that occurs when a predisposed individual is exposed to cold and humidity. Though mercury tends to rise with the Makar Sankranti approaching, nights on the banks of the Sangam are colder than other parts of the city. “The recent fall in temperature to s u b -ze r o levels led to chilblains in more than 300 personnel posted on Kumbh duty,” joint director and in-charge of medical ser vices, Major (Dr) BP Singh said. The power supply is a problem for the entire state as six power units tripped off in three days beginning Wednesday this week but the problem is not so grave in the temporary arrangements. A 100-bed central hospital has been set up on the banks of the river but it is short of doctors and ambulances. “More than 10 crore are expected to come here. We have tried our best and are constantly improving,” said a sector magistrate. When contacted, chairman, Kumbh Mela Committee, Devesh Chatur vedi, said he would initiate remedial steps. Source : The Times of India

Angels in ambulances honoured for selfless service They were selected on the parameters including highest number of cases attended, efficient documentation of the care, best maintenance of the instruments and the vehicles, said G Thanigaivel Murugan, Madurai district manager, GVK EMRI. The drivers and emergency medical technicians who were honoured had many touching stories to narrate and each of them felt proud of carrying out a service that demands greater stress but saves the precious lives. Sharing his experience, M Manickaraja, pilot of a 108 ambulance stationed at Periyar bus terminal said in one instance the victim himself called the ambulance after he fell from the moving train and legs completed amputated. He, along with R Se-

night. Surender was pierced with a 21-inch long iron rod across his body, from neck to abdomen after he skid and fell from his twowheeler. It was a very critical case and the staff cut the rod using equipment. The public, who had gathered at the place were dead against such move fearing the boy will be killed on the spot but the staff had to convince them a lot while carrying out their work. Surender was rushed to the GRH and his life was saved after a crucial two-hour long surgery, said Thanigaivel Murugan. Every one of the staff had their stories of braver y where they raced against time to rush the accident victims to hospital in that precious gold hour. Source:The Times of India

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T he Life S av ing Gadgets Found in an A mbul ance continued from page - 1

the electric pulses of the heart and allows the paramedics to keep a close watch on the patient’s vital signs. For heart attack victims, paramedics use a portable EKG (electrocardiogram), which registers the heart’s cycle. Using a 12-lead EKG device alongside the cardiac monitor, paramedics can send a 3-D EKG image and other important information back to the hospital. Defibrillators save many heart attack victims every year by giving a shocking

medication during an emergency. Mechanical CPR Machines are coming into style for the new generation of ambulances. These machines perform chest compressions while the paramedic team is able to use their hands for other lifesaving procedures. It is programmed to assess the patients’ weight and height, and delivers the compressions with the calculated amount of pressure and frequency for the patient’s needs. In 2005, the preliminary studies in-

dose of electricity. The device depolarizes the heart muscle and kicks the heart back into its normal rhythm. Ambulances have portable defibrillators. Some have cardiac monitors built into them. Pulse Oximeters are clipped onto patients’ fingers. Such devices monitor the amount of oxygen in the blood and calculate the pulse. It works through two lights at different wavelengths. Whether the blood is oxygenated or not affects how much light is absorbed. Through this, the oximeter calculates how much oxygen is in the blood. This device can warn paramedics and doctors of serious conditions, such as hypovolemia (low blood volume) or vasoconstriction (tightening of the blood vessels). The Nebulizer is one of the most recognizable devices in the medical field (other than the stethoscope, of course). Like an inhaler, the nebulizer administers medication through inhalation. It’s one of the quickest ways to give

dicated that patients who received CPR from the machine were 35% more likely to have their hearts beating again by the time they arrive at the hospital. Other Essential Tools: Ambulances are well-stocked with syringes, needles, IVs, c annulas, ne c k br ac e s, sphygmomanometers (blood pressure meters), resuscitators, burn kits, and so much more. Though these items seem small, they are vital in any medical procedure. Because of the equipment they carry, ambulances are able to do most of what a hospital can do for you. They are your best chance for survival. This guest post is from Claire Hunt. Claire Hunt is a freelance blogger and a nurse. She writes about several topics, such as disease-causing organisms, illnesses, healthcare, and other issues related to medicine. She also contributes material for CIA Medical where you can find details about top quality medical equipment brands. Source: The Pick Drop


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THE AMBULANCE TIMES

Despite increased awareness, issues remain for ambulances COIMBATORE: The f ir st ever recorded ambulance service in India was provided by St. John’s Ambulance Association in 1914. Almost 100 years later, as the World Ambulance Day is being celebrated on Tuesday, the concept of transporting those in need of emergency care has undergone a quantum change in the country. While public awareness on making way for ambulances has undergone a paradigm change for the better, issues continue to fester in areas such as administering critical first aid and CPR (cardiopulmonary resuscitation) during the ‘golden hour’ and evacuating the critically injured. According to H. Mohan, regional manager (Western Region) of GVK EMRI-108 Ambulance Services, the basic first responder training must be taught at schools, as was being done in many Western countries. In accidents, a lot of lives could be saved if the gener-

al public had knowledge on how to arrest bleeding, spot spinal fractures that require complete immobilisation of the victim and that the seriously injured must be kept conscious by talking so as

responder training was already at the scene, it would be of invaluable help.” G. Bakthavachalam, chairman of KG Hospital, said that emergency medical transpor tation and pre-

to keep the brain active. “All 108 ambulances have a driver, trained in CPR and basic first, and an emergency medical technician (EMT) who had undergone specialised training to handle even pregnancies and cardiovascular emergencies. But before they arrive, if someone with first

hospital care was a major issue for India, where 1.4 lakh lives were lost in road accidents every year and over 350 people died in every city because of lack of medical care during the ‘golden hour.’ While Coimbatore region had a high level of awareness, he said that there was

a need for more trained good Samaritans who can keep the accident victim alive till the ambulance reached or safely transport the injured to hospitals. On the standards of ambulances, he said that his hospital had deployed two state-of-the-art ambulances which act as mobile ICUs and were equipped with advanced medical equipment. In fact, all ambulances in the city coordinated with the police control room to reach accident spots quickly, added Dr. Bakthavachalam. A senior traffic police official said that they ensured there was no inordinate delay in movement of emergency vehicles. The personnel manning the automatic signals had been instructed to use the ‘manual override’ option to make way for ambulances. Further, the cooperation from the public in this regard was very high. Source: The Hindu

UK Health Minister visits 108 Ambulance Service Control & Dispatch Centre in Trivandrum British Health Minister, Ms Anna Soubr y MP visited the 108 Control and Dispatch Center (CDC) at Ziqitza Healthcare Ltd (ZHL) in Technopark. The Minister was accompanied by Mr Nick Tomlinson, Deputy Director, EU & Global Affairs, Department of Health and Mr Mike Nithavrianakis, British Deputy High Commissioner, Chennai. Ms. Soubry’s visit was to see first-hand a major emergency service and to support the London Ambulance Service’s partnership with emergency

services in India. She was received by Ms. Sweta Mangal, CEO and Co-Founder, Z H L and Mr. R a d he e sh, Regional Head – South India, ZHL. As a token of ap preciation, the London Ambulance Service members Mr. Jason Killens,

Deputy Director Operations and Mr. Stephen King, Executive Officer of London Amb u lance S e r vi c e were felicitated by Ms. Anna Soub r y at the Z H L office in this event. Ms Sweta Mangal, CEO and

Co-Founder of the Ambulance Project said, “We are delighted to welcome the UK Health Minister Anna Soubry to our CDC in Trivandrum. We have been able to establish a successful ambulance network across India since our inception in 2002. IMs Anna Soubry was in Kerala to discuss strengthening the UK-Kerala healthcare partnership in areas such as: education & training, research development and medical technology, equipment and devices. Source: India IT News

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Baby girl dies in ambulance after oxygen cylinder ran out Dhar, Madhya Pradesh: A twoyear-old girl suffering from breathing problems died after oxygen cylinders in the ambulance that was shifting her to Indore exhausted enroute, due to alleged negligence of the hospital staff, official sources said on Friday. The victim identified as Zia was admitted to the Dhar district hospital on Thursday after she complained of breathlessness. The doctors after initial treatment referred her to Indore in an ambulance. However, the oxygen cylinder got exhausted enroute following which she died on the way, sources said. The victim’s parents later submitted a memorandum to the Dhar Collector C B Singh demanding action against those responsible for the tragedy. The Collector has ordered a probe in this regard which will be conducted by City Magistrate, Vishal Singh, sources added. Source : NDTV

SBI donates free medical equipment, ambulance continued from page - 1 Paul Sebastian, director, RCC; K Radhakrishnan, director, SCTIMST; R Sankar Kumar, medical superintendent, SCTIMST; S K Jawahar, Administrative Medical Officer, SCTIMST; M Sreenatha Sastry, Chief General Manager, SBI, Kerala Circle; Arun Kumar Agarwal, General Manager, Network 1, SBI Kerala Circle; Antonio Jose DSouza, General Manager, Network 2, SBI Kerala Circle also attended the function. Source: The New Indian Express

183 people injured in accidents Govt to implement measures to prevent on December 31, January 1 accidents on Pune-Mumbai expressway HYDER ABAD: As many as 183 people suffered grievous injuries in road accidents between December 31 midnight and January 1 midnight in the twin cities and the neighbouring Rangareddy district. A substantial 60% of the cases pertained to New Year revelry and were reported in the night. Officials from the state-run ‘108’ ambulance service that attended to these cases said that a chunk of the accidents were reported from L B Nagar, Punjagutta, Uppal, Saroornagar, Jubilee Hills, Kacheguda, Trimulgherry, Dilsukhnagar and Paradise. Officials further noted that most of these accident cases reporting head and limb

injuries were rushed to Osmania General Hospital and Gandhi Hospital, with few others also admitted into private clinics. On regular days, the ‘108’ ambulance service caters to 60-80 injuries but on New Year, the number rose to more than double. during December 30 midnight and December 31 midnight, the ‘108’ ambulance service recorded 97 accident cases. “Despite taking preventive measures, the accidents were on the higher side this year as well. In some cases, the injuries were serious,” said an official. He added that a considerable number of these revellers were in a drunken state as well. Source:The Times of India

PUNE: The state government has proposed to implement several short term and long term measures for prevention of accidents on the Mumbai-Pune expressway stretch, district collector Vikas Deshmukhsaid here on Tuesday. Inaugurating the road safety fortnight programme at Urse toll plaza on the expressway, Deshmukh said that the expressway was one of the biggest achievements of the state. “However, in recent years there have been several accidents on the expressway. The government has thus planned various short term and long term measures to prevent accidents. A modern trauma care centre, along with well-

equipped ambulances, has also been proposed so that accident victims get immediate treatment,” he said. The proposal for trauma centre will soon be approved, he added. Appreciating that the road safety fortnight was being observed just at the start of the new year, Deshmukh said that awareness about road safety should spread among all people. He released a booklet and a compact disc on ‘safe driving’ on the occasion. He also inaugurated a special van designed to spread awareness about road safety in schools and colleges. District police superintendent Manoj Lohia informed that every year 2,000 peo-

ple died in road accidents in Pune district. “This is an issue of serious concern. The causes of accidents should be investigated thoroughly. There is also a need to issue separate driving licenses for the expressway,’’ he said. Regional transport officer Arun Yeola said that the objective of the road safety fortnight was to reduce road accidents and spread awareness among people about road safety. Among others present on the occasion included highway police superintendent (Pune division) Dilip Bhujbal and Lonavla municipal council chairperson Surekha Jadhav. Source : The Times of India


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News

999 call takers offered rewards for sending fewer ambulances London Ambulance Service insists that many patients with minor injuries or illnesses do not need to be sent ambulances Staff at Britain’s largest ambulance service are in line for rewards under an incentive scheme if they can reduce the number of ambulances sent to 999 calls. The scheme – which reports say involves cash bonuses – was defended by London Ambulance Service, which said that demand for its services has continued to rise and that a change of policy surrounding the dispatching of ambulances was designed to ensure that they were available for the neediest. “Traditionally, when people with minor illnesses and injuries call 999, we have sent them an ambulance,” said Paul Woodrow, director of service delivery for London Ambulance Service. “We are no longer doing this as these patients do

not need to be treated by an ambulance crew and they don’t require hospital treatment. We need our medics to be available to respond quickly to patients in lifethreatening situations or with serious injuries.” He added: “To ensure ambulances are available for people who really need them, we provide advice over the phone to patients with minor conditions or refer them to other healthcare providers like their GP orNHS Direct.” He insisted that all 999 calls were still subject to a triage process to determine the determine the priority that should be attached to individual patients on the basis of their condition and that those with life-threatening conditions would get “a fast response”. Patients with a minor illness or injury get a second call from a clinician, who will carry out a further assessment of their condition. Patients assessed as not need-

ing an emergency response would be referred to NHS Direct, another healthcare provider or be given advice over the phone. Woodrow said that the incentive scheme was “to encourage staff to manage lower priority calls more appropriately, so that people who call us with conditions like coughs, colds and splinters are not sent an ambulance response.” The Daily Telegraph quoted a spokesman for the service as saying that control room staff would receive the bonus if, on average, they referred 30% of callers deemed to have minor health problems to other health providers. A spokesman for the Patients Association told the newspaper: “The only criteria for the use of an ambulance should be the extent of the medical emergency, not the impact on the pocket of the call handler.” Source : theguardian

New wheels for the ambulance district A new Chevrolet ambulance from Wheeled Coach very similar to unit 413, purchased last year, shown

above, will arrive nex t month for the Barry-Law-

rence Ambulance District. Paramedic Lee Flory, shown above, said the new units have LED lights, including some colored blue, unlike the older rigs with rotating lights. One feature the new ambulance will have unlike all earlier models will be two backup ox ygen tanks. The interior compartments all light up and the rig has a smoother ride,

Flory said. The new units also require a diesel exhaust fluid in a separate tank, which helps clean emissions. All of the BarryLawrence fleet is now Chevrolets. Board chairman Daryl Fenski said he hopes the district can maintain replacing ambulances every four years, thus spending less on maintenance and preserving resale value on the units. S our c e Times

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Wait for ambulances ‘putting lives at risk’ Sh o c k ing f igur e s s h ow the number of paramedics waiting for ambulances to transport their patients has rocketed in the past 12 months. In November last year, there were 376 occasions in Hertfordshire when solo

claiming that cutbacks are “putting people’s lives at risk”. Neil Storey, director of operations for the East of England Ambulance Service NHS Trust, said: “The increase from April 2012 is actually due to better reporting and

responders were left waiting more than 30 minutes after the request for back-up from an ambulance, compared with just six in the previous year. Around 427 patients in September were left to wait for more than 30 minutes. Of these, 17 waited for more than two hours and one for more than three hours.

rise in calls, rather than an increase in delays.

During the period November 26, 2011 to November 2012, 2,618 patients were left waiting for more than half an hour. Of these, 2,395 were in the eight months to November last year. In neighbour ing Es sex, 12,639 patients were left waiting for more than 30 minutes in the same period. Last month the under-fire service was refused foundation trust status by regulator Monitor, and several working paramedics have spoken out over the past few weeks

“December 2011 compared to December 2012 represents a rise of nearly 20 per cent in calls in Hertfordshire and Essex and the operating system for recording these back-up times was not fully embedded until April 2012. “We only missed our target to get back-up to patients by 0.1 per cent last year and are actively working on improving times by the end of this financial year. “These figures related to all calls which got back-up, regardless of how urgent the need was, so while back-up was provided it may not have been an emergency requirement in many of the cases bearing in mind less than a fifth of incidents are classed as emergencies.” Source : Royston, weekly news

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