Why is India in dire need of a uniform trauma response system?

About 400 Indians die on roads every single day — a national study in 2021 had made an observation while assessing the trauma care in the country.

As per the Ministry of Road Transport and Highways, about 1.7 lakh Indians died on roads in 2025.

While transportation mishaps count for the biggest share in trauma-related injuries, Indians also suffer from accidents caused by falls, drowning, agricultural injuries, burns and even snakebites.

The country carries a large burden of trauma-related mortality and a prominent gap in the trauma response prevents its people from receiving adequate care on time — the Supreme Court made recognition of the situation last week.

Upholding the right to trauma care of citizens under the Article 21 of the Indian Constitution, the Supreme Court, in a landmark decision, directed the States to build a uniform trauma response system all across the country.

The alarming statistics make it reasonable to ask if the Indian healthcare system is prepared enough to tackle the burden of unprecedented health emergencies.

The answer is not convincing with some Indian states and cities doing well and others still trying to firm the roots.

No bystander support, no prior notification

The bench comprising Justice J.K. Maheshwari and Justice Atul. S Chandurkar were hearing a plea filed by SaveLife Foundation which aimed at seeking a prompt trauma response for victims of road accidents.

In its observation, the SC noted when any person meets an accident or suffers from an injury, they are helpless and disoriented to make a decisive call for medical help. In these situations, the bystanders are the only hope for those who need immediate care.

However, a bystander in India often goes through a reactive paralysis where they hesitate to offer support in fear of legal proceedings or being summoned by the police. Some are not able to witness the sight of blood or are fearful to see another person crying in pain, the SC observed.

The court noted an absence of a uniform code of conduct or no standard framework for trauma care. 

Understanding the need for systemic intervention, it asked the States to make good Samaritan policies and build more awareness around trauma care.

As per reports, the directives from the court also asked the States to operationalise ‘112’ as a universal tool free number for the Samaritan grievance system.

The Emergency toll number ‘108’ does not provide any pre-notification to the emergency departments, said a study by the All Indian Institute of Medical Sciences (AIIMS).

This often leads to overcrowding of emergency rooms with teams totally unprepared for the incoming cases. 

Slower ambulance response time

While the international benchmark for ambulance response time ranges between 8 to 10 minutes, in many Indian cities it can range between 15 to 30 minutes or even more due to traffic congestion, distributed emergency medical services and slower response.

As per a TOI report, the ambulance response time in Bengaluru urban areas dropped from 22 minutes in 2023 to 14 minutes in 2025.

A major study showed that about 98.5 percent of ambulances run on transporting dead bodies, 90 percent of ambulances run without oxygen and about 95 percent of ambulances lack trained professionals.

Another localised study based in the Kolar district of Karnataka found that most district hospitals had level 4 of preparedness (managing mild brain injuries) to tackle trauma and there were no level 1 hospitals which could provide specialised care.

No uniform triage system

A triage system is a method for rapidly sorting and prioritizing people according to their unique needs. 

Not every patient landing in an emergency room has the same kind of trauma or requires the same urgency of care. Hence, as per ideal practice, a standard triage system must be in place for quicker response.

A joint study by AIIMS and NITI Aayog (2021) studied the emergency care services of 34 secondary level district hospitals in 29 States and two union territories. Among them, 15 district hospitals had a bed strength greater than 300 beds and 19 district hospitals had a bed strength lower than 300.

The study found that there were no specialised trauma surgeons and very few trauma - specific centers in the country.

It also found that in around 50 percent of the hospitals, the orthopedic surgeons led the trauma response and in remaining places, there was no clear division of responsibilities. 

These limitations create negative clinical outcomes for patients with multi-system injury, putting them at the greatest risk.