Critical road accident victim ‘sent away from Nimhans after five-hour wait’

A 38-year-old man who suffered a severe head injury in a road accident was refused admission at Nimhans after waiting there for five hours, his attendant claimed.

The man was brought from Kodigehalli to Nimhans in a ventilator ambulance around 10.30 pm. But he could not be accommodated at the premier government-run hospital for the lack of ventilator beds.

Speaking to reporters outside the emergency block, the attendant claimed that no one at the hospital attended to the patient for over five hours. "If I was asked to go, I would have gone a long time ago," the attendant said.

Nimhans authorities, however, gave a different account of what happened. Nimhans Resident Medical Officer Dr H N Shashidhara said the patient was brought in around 10.30 pm after being treated elsewhere.

"He was immediately evaluated within the ambulance by our trauma team and advised that given his condition, a ventilator is a must. But as there was not a single ventilator bed available in Nimhans, he was asked to be taken to any other hospital," Dr Shashidhara said.

'Medical advice ignored'

The RMO suggested that the patient's attendant kept waiting in the portico until 12 am against medical advice, "desperately hoping to get a ventilator bed".

"The institute cannot be held responsible for a patient waiting against medical advice," he added.

The initial evaluation showed that the patient's pupils were non-reactive.

"The doll's eyes reflex was absent," said Dr Shashidhara. The doll's eyes reflex helps assess cranial nerves III and VI in a comatose patient. The absence of this reflex indicates severe brain stem injury from the midbrain level.

Head trauma

Head trauma patients have a 9% case fatality rate.

The common cause of head trauma is a road traffic accident; 13% of these patients sustain a severe form of head injury that requires intensive care. Timely care of these patients can prevent secondary injury to the brain which includes raised intracranial pressure, hypotension, hypoxia, fever and infection.

This can be achieved only by timely admission and treatment in the ICU.

Currently, only a few government hospitals in Karnataka have the necessary ICU infrastructure, monitors and trained staff to handle such cases.

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