That frantic ambulance call

Sudden, unexpected and utterly traumatic, an accident could completely turn your world upside down in a micro-second. Writhing in pain, the victim would cry out in extreme agony for an ambulance to rush him medical help. But does Bengaluru care? Does it have an accident-response mechanism quick and smart enough to beat the City’s notorious traffic?

It is a tough question. Thrown off his bike, his bones and ribs broken, factory manager Premdas definitely found no answers as he helplessly lay there for an hour on Chintamani Road near Hoskote last Saturday. No ambulance responded to frantic calls by him and a dozen onlookers. No car stopped by to help. Precious seconds ticked by as the lines remained engaged!

The accident spot was far out of the City centre, and traffic congestion was barely an issue. As Premdas realized, it was a problem of inadequate numbers. It was a problem thousands in his State would encounter every day. For, on the highways and other roads leading to the City, quick response is an alien concept.

Struggling traffic cops
Deep within the City, caught up in mindboggling vehicular numbers, the traffic police struggle to let ambulances pass. But outside their jurisdiction, on the city’s periphery, the police are out of reach. So are the hospitals, the paramedics and the entire mechanism!
Additional Commissioner of Police (Traffic), M A Saleem reasons that major super-specialty hospitals are now accessible on Hosur road, Bellary road, Bannerghatta road and Tumkur road. But he agrees that Old Madras road is a problem area. KR Puram remains an incorrigible traffic bottleneck.

Yet, even if such hospitals exist and a vast majority of ambulances roam around within the city, how do we rush accident victims on highways to these health centres? Saleem reminds that the State police had introduced 33 highway patrol vehicles for 11 districts including Bengaluru last year. Eleven more are expected this year.

But no such patrol vehicle is visible today, at least on the city’s periphery. Ten years ago, the then united Andhra Pradesh had a working highway patrol system in place. A Bengaluru family had a firsthand experience. Barely 10 minutes after a head-on collision between two cars near the Karnataka-Andhra border, an AP police vehicle rushed the injured family to a health centre 20 kms away.    

Ambulance tracking
In the city proper, ambulances are finding it increasingly tough to squeeze through high congestion areas. Saleem talks about adopting a technology currently on pilot mode, which connects the ambulance driver, a traffic police control room and the destination hospital, to ensure quick passage. “The driver is given a GPS device that can be tracked from the Traffic Management Centre. Signals can be remotely turned green as the ambulance approaches,” he explains.

Currently, the constable at a junction manually changes the signal. This reaction is triggered by the siren of an approaching ambulance. However, the lead time is often seen as too short for smooth passage of the ambulance, trapped behind a chaotic line of vehicles. 

The technology was piloted with a device called Opticom, which is to be installed on the ambulances and traffic signals. The embedded GPS receiver on the ambulance will determine its location, direction and speed. This data will be passed to the radio receiver in the signal once every second.

The moment the ambulance is within 760 meters of the signal, the light turns green and once the vehicle passes it instantly goes red. Bengaluru city’s 350 signal junctions could eventually be fitted with the devices. But funding issues would mean the project will not be completed in a hurry.

Bike ambulances
Meanwhile, the State Health department has found a partial solution of its own to this access problem: Two-wheeler ambulances. In April this year, Health Minister U T Khader launched 30 first responder bike ambulances, 21 of them to be stationed at strategic locations in the City.

The bike riders are all trained paramedics with a mandate to reach an accident spot within 10 minutes. They are also equipped to give first aid on the spot and begin resuscitation measures to save the victim before the arrival of a bigger, four-wheeler ambulance. The 40 medical items on each bike will include a stethoscope, pulse oxymeter, bandages, IV normal saline and 53 basic drugs.

GVK-EMRI, the organization behind this initiative, is already active in the ambulance sector, operating the 108 Arogya Kavacha service across Karnataka. “There should be more awareness about our reach. Each ambulance currently handles 3.7 to 4 trips a day. It can be increased to six, with more communication,” informs S S Perveez, who handles GVK-EMRI’s Karnataka operations.

Launched on November 1, 2008, GVK-EMRI has handled 6,1613 Trauma Vehicular Emergencies so far in Bengaluru urban district, and 15,922 in the rural district. The vehicles take an average of 12 minutes to reach the spot from the time a call is received in the urban district. This response time is about 13 minutes for Bengaluru rural, informs Perveez.

Good Samaritan guidelines
Good Samaritans could help in places where ambulances are too far to reach. But the fear of getting caught in medico-legal cases invariably makes them hesitant to take the victim to the hospital. It is precisely to help these Good Samaritans that the Union Ministry of Road Transport and Highways came out with 15 guidelines to be followed by all hospitals, the police and other related authorities.

The guidelines mandate that once an accident victim is hospitalised, the Good Samaritan should be allowed to leave. Besides their address, they should not be asked to furnish any other details. They should also not be liable for any civil and criminal liability. Even those making a phone call to alert the police or emergency services about a person lying injured on the road should not be compelled to reveal name or other personal details.
It is also made clear in guidelines that disciplinary or departmental action would be initiated against officials guilty of coercing or intimidating anyone for revealing his/her personal details. If the Good Samaritan is also an eyewitness to the accident, he/she should be examined only once. To prevent harassment and inconvenience, the eyewitness could also opt for examination through video-conferencing.