222 Trauma care response assessment on high-fatality highways: gap analysis & improvement strategies

Background Road Traffic Injuries (RTIs) constitute a major global public health problem with India bearing a significant burden each year. A fully functional chain of survival, encompassing adequate emergency care services, is critical to minimise mortality and morbidity. This abstract presents findings from assessing ambulances and trauma care receiving facilities along high-speed corridors in India bearing a disproportionately high mortality burden, accounting for over 100,000 deaths in 2022 in India. Objectives This assessment across nineteen high-fatality highway stretches sought to understand gaps in trauma care along in India by examining the functional status of ambulances and trauma care facilities, validating their compliance with governmental standards.1. Method Undertaking crash data analytics to identify the 19 most critical highway stretches, a mixed-method approach was used, combining field surveys, in-depth interviews, and questionnaires with quantitative data modeling to collect data from over 50 ambulances and 100 receiving centers along the identified stretches. The ambulance assessment involved evaluating the operational capacities of ambulances and assessing the knowledge, training, and capabilities of Emergency Medical Technicians (EMTs) while the medical facility survey checked infrastructure, manpower and general facilities in the emergency rooms. Results 54% of audited ambulances had response times exceeding the standard 20 minutes. Only 60% of ambulances were hygienically maintained. 35% of EMTs possessed the requisite qualifications and training. Only 9.5% of Level-I facilities fully met all parameters. Across all levels, 26.7% of facilities had the required equipment, 7.6% had necessary human resources, and only 1.9% met all parameters. Conclusions The study reveals critical gaps in emergency care services along high-fatality corridors in India. Recommendations include strengthening trauma response frameworks, establishing access to trauma care as a fundamental right, and ensuring uniform application of emergency response parameters nationwide. Operationalising a consistent, uninterrupted chain of survival uniformly across India is crucial to ensuring that road crash injuries do not result in disability or fatality. Reference The standards referred to are the IPHS Standards and MoHFW Operational Guidelines for Trauma Centres.