Urgent care centres can save many lives

One hears a constant refrain in the media and industry circles that India’s infrastructure is in a decrepit state across most cities, towns and rural regions.

But the horrendous consequences caused by lack of infrastructure almost never arrests popular attention – 160,000 deaths due to road accidents every year. Had the infrastructure been up to the mark, many of those lives could doubtless be saved.

Such statistics drive home the point that trauma care as it exists in developed nations is virtually non-existent in India. In the case of accidents and other medical emergencies, it is imperative that patients are rushed to the ICU during the ‘golden hour’ when the chances are brightest to save lives. Immediate supportive care in life-threatening cases during the ‘golden hour’ can reduce fatalities significantly.  Almost always, though, this never happens. To begin with, an ambulance may never be available immediately to rush a patient to hospital. When an ambulance is available, there is every chance that chaotic traffic may make it impossible to reach the hospital in the shortest possible time, diminishing a patient’s chances of survival. This is especially true in metro cities such as Delhi, Mumbai and Bangalore where traffic congestion is a year-round problem.

Improving chances

Emergency Medical Care or Urgent Care seeks to administer basic care by trained medical professionals to the patient at the earliest and then transports the person to the nearest emergency healthcare facility within 15-20 minutes of an accident or emergency. This ensures the greatest chance of survival for the victim or patient. Despite developments made by the country’s healthcare sector, Urgent Care across Indian cities has not been part of this advance.

Urgent Care can truly be a lifesaver in cases such as road accidents, cardiac arrest, strokes and other life-threatening conditions. The moment such a case is notified, trained nurses or paramedical personnel provide immediate first aid or pre-hospital care to the person. The patient is then shifted in a well-equipped ambulance to the nearest medical facility.

Considering the bad condition of roads in India, an alternative emergency mode of transport could be via an air ambulance – either a well-equipped helicopter or small aircraft. But given the high costs of air transport, an air ambulance would be restricted to the select few who could afford it.  Emergency care apart, the concept of Urgent Care Centres (UCCs) has slowly been gaining prominence across the world. In developed nations, UCCs have been operational since the 1970s. Through this, ambulatory and emergency care for immediate medical treatment is available outside a hospital’s emergency department on an unscheduled time or walk-in basis.  UCCs primarily treat patients who have an injury or illness that needs immediate attention. UCCs are well equipped with the latest diagnostic tools and life-saving procedures, backed by experienced doctors, nurses and staff.

It is not only critical cases that could be treated by UCCs, but common injuries and conditions such as burns, cuts, flu and high fever too. In an overpopulated country such as India, UCCs could be located in densely populated urban and suburban areas to capitalise on the ‘golden hour’ in case of emergencies. If a patient was suffering a heart attack, the UCC would stabilise the patient’s condition, place the person on a ventilator if required, ensure the provision of fluids and other important items needed to stabilize the patient during the golden hour, before taking the person to a tertiary hospital of his or her choice or whichever facility is nearest, as necessary. UCCs are meant to increase the healthcare options of primary physicians and hospital emergency rooms with facilities that include OPD clinics, preventive screenings, immunization and basic diagnostics.

The United States already has more than 10,000 UCCs. Canada, Ireland, England, Australia and New Zealand are the other nations where UCCs are operational, saving precious lives every year. The swift growth of UCCs is driven by the public need for convenient access to unscheduled emergency medical care and the major savings that such centres provide over the expensive care in a hospital’s emergency unit.

Moreover, their very location within populated centres allows UCCs to save more lives due to the quicker response time and the 24x7 availability of these facilities and their medical personnel. Considering their multiple benefits, the government should initiate policy measures that encourage the establishment of such UCCs in all regions across India.