Inside Bengaluru’s emergency rooms: Where the Golden Hour slips away

The government talks about the importance of the ‘golden hour’, the crucial 60 minutes after a serious medical event, to save lives. But do government hospitals understand the urgency? DH journalist Amullya Shivashankar goes incognito to find out

As Bengaluru winds down for the night, the emergency room at Victoria Hospital is a hive of activity. Outside, the wail of an ambulance siren pierces the air, briefly drowning out the groans of patients and the desperate prayers of families waiting for hours. Amid the chaos, a young man paces up and down,
pleading for a doctor to help his mother, slumped in a wheelchair and gasping for breath after a severe asthma attack. While they wait, the golden hour, the crucial first 60 minutes, quietly slips away. Over the next few days, I learn that this is the story of a majority of patients who turn up at government hospitals.

In early 2025, the Supreme Court in the S Rajaseekaran vs Union of India case, ruled that access to trauma care during the golden hour is a constitutional right under Article 21 (the right to life). The court directed the Union government to roll out a nationwide cashless treatment scheme for accident victims by March 14, 2025. The court also warned that non-compliance would be charged under contempt of court. As a health reporter for this daily, I am keen to know how this is being implemented.

That is how I find myself at the hospital, near K R Market in the heart of the old city, on a weekday evening in late October. My idea is to spend a few hours in the emergency room and write a fly-on-the-wall account of how it works.

Suicide attempt

Around 11.30 PM, an elderly man staggers in with his son, who is around 35 years old. The young man has attempted suicide by consuming phenyl. With tears in his eyes, the father walks around looking for a doctor and a vacant bed. He is unsuccessful on both counts. The victim is trembling as his body cannot handle the chemical reactions. A post-graduate student posted at the hospital checks his vitals 50 minutes after their arrival. 

A man is rolled in on a stretcher after a heart episode. Fast forward 35 minutes and the patient still lies there waiting to be attended to. Finally a doctor shows up, checks his vitals, and leaves to fetch an ECG machine. He only returns after 40 minutes. Before the patient is sent in for further treatment, two hours  have passed. 

As I watch, a road accident victim is wheeled in by two women of his family. No ward boys are in sight. A patient suffering from liver failure lies on a bed while his family waits for a bed to be allocated. Chairs meant for attendants become beds as doctors hook some patients with IV fluids.

Caught on camera

Amid the anxious families waiting outside, a woman pulls out her phone to take a photo of the ward. She immediately faces the ire of a member of the housekeeping team, who forces her to delete the photos. A few minutes later, another man approaches her and points to a CCTV camera and tells her he saw her taking a photo. She explains that it is only to reassure her family back home that she is being attended to. Ignoring her explanation, he snatches the phone and goes to the picture gallery. Talk about priorities — preventing photography, rather than saving lives, comes first!

Bowring experience

The scenes are no different at the Bowring and Lady Curzon Hospital located in Shivajinagar. A woman in her early 20s walks into the emergency room complaining of breathing problems and chest pain. The doctor points her towards a bed. A few minutes later, a doctor checks her vitals and blood pressure and recommends an ECG. She wheels in the ECG machine and asks her to take off her shirt. I look around. The emergency room is filled with male patients, their attendants, security guards and doctors. She requests the doctor to draw the curtains for privacy. She refuses and tells a senior doctor that the patient is uncomfortable getting an ECG with the curtains open. The doctor, without missing a beat, says: “Give her some tablets and send her away. There is nothing we can do if she does not want the ECG.”

Five hours 

I strike up a conversation with a family. A man collapsed at home due to liver issues. Though the doctors advised immediate treatment in the ICU, the family has been in the emergency room for about five hours, holding a file and waiting for attention. He has been put on IV fluid but they have lost hope, sitting around and waiting for a bed.

The family holds Below Poverty Line (BPL) cards, and is eligible for free treatment but was asked to pay up. “We shelled out Rs 3,000 already. We don’t have thousands and lakhs to pay at a private hospital, so we come here,” a young woman says when I ask her why they are waiting instead of going elsewhere. 

A 24-year-old woman, an accident victim, is wheeled in by her family, with no hospital staff to help her. She is in severe pain and needs immediate attention. It takes almost 25 minutes for the doctors to just attend to her.

Marginally better 

K C General Hospital in Malleswaram is relatively better. It could be because the emergency room does not see as many people as the other two big government hospitals.

A young woman with breathlessness enters the emergency room, and the doctors are faster. After the usual blood pressure test, the doctor prescribes an ECG but no female staffer is around to do it. The female nurses arrive more than half an hour later. They close the curtains to do the test. Privacy not compromised.

Three people in different instances who came in with dog bites are sent out to buy the anti-rabies vaccine (ARV) — neither the hospital nor the attached pharmacy has it in stock. According to the National Rabies Control Program, all government hospitals must provide the vaccine free of cost to everyone who comes in with a dog bite, irrespective of their economic status. 

The gate closest to the emergency ward is closed. This forces ambulances to take a longer route, resulting in an additional detour that takes four to six minutes. Many inoperational ambulances are parked on the hospital premises. Even as the government continues to invest in new ambulances, idle vehicles stand as a reminder of maintenance neglect.

To reach my cab, I walk through poorly lit premises. People are fighting and physically abusing each other. It is like a gang war. I walk past the gynaecology ward. The entrance has at least 80 patient attendants sleeping on the floor waiting for the pregnant women inside to deliver.

After a week of observing the emergency wards, I arrive at my final location — Sanjay Gandhi Institute of Trauma Care and Orthopedics in Byrasandra, Jayanagar. The hospital is mainly meant to treat victims of road accidents. Head injuries, especially, call for super-quick attention. I enter the emergency department but can find no doctors for 30-35 minutes. 

An accident victim with broken limbs arrives in an ambulance. After a few minutes, the doctor checks the patient in the ambulance and comes back. About 30 minutes pass before the patient is brought into the emergency room. The sheer lack of urgency is appalling. The patients and their families complain that the doctors take a long time to attend to patients. BPL card holders pay non-subsidised charges for X-ray and other tests. 

Critical hour

Senior neurosurgeon Dr Sunil V Furtado, explains that ‘golden hour’ is the time immediately after a life-threatening medical event — it is when medical and surgical treatment can prevent complications like bleeding, organ damage and failure, and long-term disability, and improve chances of survival. 

Studies show up to a 25% reduction in mortality for trauma patients and a 50% improvement in recovery outcomes for patients who receive timely treatment, he explains. 

An Indian study published in the International Journal of Medicine and Public Health found that about 42% of a sample population was aware of the golden hour for heart attacks and stroke. 

In government hospitals across Bengaluru, which shoulder most of the emergency load, especially of the less privileged, scenes like these unfold night after night — a blur of bodies, noise and unanswered calls for help. Every delay — caused by shortage of beds, missing stretchers, closed gates, apathetic staff — eats into the crucial hour that can determine whether a patient lives or dies. The golden hour care is not a luxury. It is a right. 

Govt emergency care schemes

Many schemes are intended to help during the golden hour, but not much help is forthcoming on the ground.

Mukhyamantrigala Santwana Harish Scheme: Free and urgent treatment for the first 48 hours after the accident to all accident victims regardless of their economic status. All injuries, including burns, fractures, and head and spinal trauma, are covered.

The Karnataka government launched the Dr Puneeth Rajkumar Hrudaya Jyothi in 2023, after movie star Puneeth Rajkumar died from a heart attack. It is meant to provide emergency cardiac care within the golden hour. Cardiac arrest-linked deaths that were screened and treated under this scheme were 608 in 2024-2025 and 229 in 2023-2024.

In 2024, the Karnataka government bought 65 new ambulances, including 26 fitted with ventilators, for quick transportation of patients during the golden hour.

Clock ticking

EMERGENCY                    GOLDEN HOUR

Heart attack                    One hour

Accident                          One hour

Respiratory and
airway crisis                     One hour

Stroke                             3.5 to 4.5 hours

Internal bleeding              One hour