“Trauma Care begins with the safe rescue of a victim from the scene of the accident. I would request healthcare training institutes to take the initiative and introduce awareness programs for the public on Trauma Care. I would be the happiest person if I see the Government of Kerala implement a chapter on BLS, Trauma Care and First aid for school students so that change can happen at the root level.”
How is a typical day at the hospital for you?
Each person who is brought into the Emergency Department (ED) never fails to remind us about the ultimate power of God. So, a typical day for me starts with prayer. A simple prayer that all human beings should be in good health and my patients should not have to suffer much. Once my prayers are done, I step into the ED. The first thing that crosses my mind is to doubly make sure all life-saving equipment are in working order and that my team members are prepared to handle any type of emergency situation.
Soon after, I move around to check the patient attendance, carefully considering those who have been waiting in the ED and also gauging the broad spectrum of their medical condition when they were brought in. As you may understand, ED waiting times have a serious impact on patient mortality.
Thus, it is very important for me and all physicians for that matter, that we attend to patients as best and fast as we can. I take over the duty from my colleague who had been working the earlier shift and extend care to patients who need immediate attention. As the day progresses, I attend to incoming patients as and when they are brought in to the ED.
What exactly is Trauma Care? Is it beyond responding to emergency situations?
The word is self-explanatory. In layman’s terms, Trauma Care is the initial care or first aid provided to victims of trauma, right from the scene of the accident to the nearest hospital.
What could go wrong in Trauma Care?
Trauma Care has been lacking in our country for eons. However, thanks to the involvement of numerous Government and non-government agencies, the scenario is changing in a positive manner. You know what? The major problem in Trauma Care is the distinct lack of relevant awareness and non-availability of resources in our country.
The major challenge is the safe transportation of victims to the nearest health facility. In fact, the Emergency Medical Technicians (EMTs) play quite a life-changing role in this initial rescue and management of trauma victims.
So, you mean to say Trauma Care begins at the scene of the accident?
Trauma Care begins with the safe rescue of a victim from the scene of the accident. After that the patient is promptly transported to an ambulance and offered lifesaving first aid inside the ambulance until they reach the nearest hospital. Now this is called Pre-hospital Trauma Care.
As soon as the patient reaches the hospital, the ED team receives the victim following a proper triaging process. Then the team led by a doctor provides the necessary treatment for the victim as per the Advanced Trauma Life Support (ATLS) protocols. As you are aware, the golden hour in trauma are is the initial few hours following the accident. As a health care provider, our priority is to treat a life-threatening injury by stabilizing the Airway, Breathing, Circulation and moving on to the management of specific injuries.
What are the different skill sets required to become a doctor in Trauma Care?
The most important skills required starts with a proper Basic Life Support (BLS) training, followed by Advanced Cardiac Life support (ACLS) and ATLS training. I feel this is the basic requirement of all health care providers dealing with Trauma Care.
Is an ACLS certification mandatory for a Trauma Care physician?
Yes, of course. As I mentioned earlier, it is the basic requirement of any doctor to get ACLS certification before managing any patient.
Why did you choose Trauma Care as one of your specialties?
After graduation, I began my career as a Casualty Medical Officer at AIMS, Kochi. While on duty, I witnessed the suffering of quite a lot of trauma victims. My Chief, Dr. Gireesh Kumar K P was very keen on bringing about a change in the field of Trauma Care and he was the driving force behind the launch of a full-fledged Emergency Medicine department at AIMS, Kochi. Moreover, our Medical Director, Dr. Prem Nair was equally keen on the future development of the department. I would say this has been my motivation to take up Trauma Care.
In fact, I also felt that death due to trauma could be prevented if proper trauma care is given to the accident victim. So, in an effort to improve further we started the BSC EMT program that has been in force for the past 6 years wherein training is extended to personnel in the field of Pre-hospital Trauma Care.
How strong, would you say, is the Trauma Care facility in Kerala?
Compared to the myriad treatment facilities available in Kerala, our state has health standards equivalent to that of a developed nation. We need to improve upon this by providing quality Trauma Care as well. What we need to improve most is the pre-hospital system as well as the adequate training of doctors and paramedics in ATLS. I am very happy to see that Government agencies – both at the Central and State levels – are trying their best to improve Trauma Care in the state.
When a critically ill patient is brought to the Trauma Care unit, have you wished the common man could have taken life-saving measures to improve the chances of survival?
Yes, very much. This is exactly what I said about the lack of awareness among the public in providing basic first aid care to trauma victims. I would request healthcare training institutes to take the initiative to introduce awareness programs for the public on Trauma Care. I would be the happiest person if I see the Government of Kerala implement a chapter on BLS, Trauma Care and First aid for school students so that change can happen at the root level.
I am truly happy that our Academy for Emergency Trauma and Critical care Medicine (AETCM) and Department of Emergency Medicine, AIMS Kochi has provided awareness programs for more than one lakh individuals in the past one year (including school students, Army personnel, Police personnel, Fire fighters and Auto / Taxi Drivers among many others.
The Healthovation team would like to add that the world depends on the public to extend BLS to victims as this will help buy time until the ambulance arrives and gift victims a few seconds extra chance at life. We cannot press a button to make an ambulance instantly appear in front of a victim or patient. Therefore, the public can get trained in BLS to effectively don this role of “buying time” until the ambulance makes its way to save a life.