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Emergency Medical Services - Indian 
Scenario @ 2020 
EMS Asia 2014 ;Goa ; October17,18&19
Focus 
Why EMS 
What is the current status in India 
What are the issue and Challenges? 
What should be our EMS system in 
2020? 
How to make a hassle free road map ? 
EMS Asia 2014 ;Goa ; October17,18&19
Ground reality 
Total 3.57 lakhs (0.35 million) 
accidental deaths were 
reported during the year 2009 
with the Male-Female victim 
ratio of 77 : 23. 
J Emerg Trauma Shock. 2012 Jan-Mar; 5(1): 
49–54. 
doi: 10.4103/0974-2700.93113 
PMCID: PMC3299154 
EMS Asia 2014 ;Goa ; October17,18&19
Road accidents (37.9%), railway 
accidents, and rail-road accidents 
(7.8%), poisoning (8.0%), drowning 
(7.7%), sudden deaths (7.4%), and 
fire accidents (7.0%). 
Most of the victims of accidents 
were aged between 15 to 44 years. 
This group of people has 
accounted for nearly two-third 
(60.7%) of all persons killed in 
accidents in the country 
EMS Asia 2014 ;Goa ; October17,18&19
• Many of them die for want of timely EMS. 
• Thousands of these accident victims could 
have been saved if timely medical intervention 
were available to them. 
• Need of quality EMS in India is an unmet need 
of the masses. 
J Emerg Trauma Shock. 2012 Jan-Mar; 5(1): 
49–54. 
doi: 10.4103/0974-2700.93113 
PMCID: PMC3299154 
EMS Asia 2014 ;Goa ; October17,18&19
Mumbai Study 
• The injured victim in Mumbai usually is rescued 
by a good Samaritan passer-by (43.5%) 
• Helped by the police (89.7%) 
• Almost immediately after rescue, the victim 
begins transport to the hospital 
• No one waits for the EMS ambulance to arrive, as 
there is none 
• A taxi cab is the most popular substitute for the 
ambulance (39.3%). 
Prehosp Disaster Med. 2010 Mar-Apr;25(2):145-51. 
Where there are no emergency medical services-prehospital care for the injured in Mumbai, 
India. 
Roy N1, Murlidhar V, Chowdhury R, Patil SB, Supe PA, Vaishnav PD, Vatkar A.
Healthcare delivery system 
District hospital , Medical colleges , 
Specialty centers 
Community Health center CHC 
Primary Health Center PHC 
SC 
4, 276 
23, 458 
Sub Centers 1 ,46 ,036 
EMS Asia 2014 ;Goa ; October17,18&19
• National Family Health Survey – III, 
• Private medical sector remains the primary source 
of healthcare for the majority of households in 
both urban areas (70%) and rural areas (63%). 
• Even the quality of private sector is also questionable. 
: http://www.ncrb.nic.in/CD-ADSI2009/ADSI2009-full-report.pdf 
EMS Asia 2014 ;Goa ; October17,18&19
Emergency Medical Services 
• EMS is thus provided in two forms 
Pre-hospital services 
Treatment to inpatients. 
• EMS is an essential part of the overall 
healthcare system as it saves lives by providing 
care immediately. 
Potluri P. Emergency services in India- Counting on betterment. 
A transition in progress. Editorial Section. [Last assessed on 2011 Jan 25]; 
Asian Hospital and health care Management magazine. 
2009 18 Available from: 
http://www.asianhhm.com/healthcare_management/emergency_services_india.htm 
EMS Asia 2014 ;Goa ; October17,18&19
Intra Hospital Transfer facility 
EMS Asia 2014 ;Goa ; October17,18&19
India 
• Life and death are equally importance 
EMS Asia 2014 ;Goa ; October17,18&19
Pre-Hospital Care networks 
• National Network of Emergency Services at 
Ahmedabad, Delhi, Pune, Hyderabad, 
Chennai, Raipur, Ranchi, and Kolkata 
• Emergency Management and Research 
Institute (EMRI) at Haryana, Chandigarh, 
Uttarakhand, Rajasthan, Gujarat, Madhya 
Pradesh, Andhra Pradesh, Goa, Karnataka, 
Tamil Nadu, Meghalaya, and Assam 
Subhan I, Jain A. Emergency care in India: The building blocks. Int J Emerg Med. 2010;3:207–11 
EMS Asia 2014 ;Goa ; October17,18&19
Pre-hospital care 
• Centralized Accidents 
and Trauma Services 
(CATS) 
• Life line foundation – 
Ahmadabad 
• 1298 ambulances 
• IIEMS – international 
Courses 
EMS Asia 2014 ;Goa ; October17,18&19
NRHM -108 
• Adopted from EMRI 
• National single Number 
• Fully Funded by NRHM 
• Free to victims 
• Fully equipped 
ambulance 
EMS Asia 2014 ;Goa ; October17,18&19
Active Network Group of Emergency 
Life saves- ANGELS 
• Community based 
Ambulance network 
• 300 ambulances 
• PPP model 
• Bagged three 
International /National 
awards 
• Massive first responder 
awareness 
• EMCT 
EMS Asia 2014 ;Goa ; October17,18&19
Angels awards 
• First EMS Asia award 2013 
• AIIMS entrepreneurship 
award 2013 
• AAEMI and Lifeline 
foundation award 2013 
Best community based EMS 
Kerala is highly motivated for EMS and EM 
Angels take out Emergency Medicine 
from the hospital boundaries 
EMS Asia 2014 ;Goa ; October17,18&19
EMS - Issues and challenges 
• Big country with 
diversities 
• Rudimentary emergency 
medicine specialty 
• Uniformity and lack of 
standardization 
• National Ambulance cord 
• Paramedic council 
• Vehicle for India roads 
• Courses and Trainings 
EMS Asia 2014 ;Goa ; October17,18&19
Indian diversities influence EMS 
Regional 
Geographical 
Emotional 
Financial 
Cultural 
Political 
Individual 
EMS Asia 2014 ;Goa ; October17,18&19
Implementation of Rules 
• Mr.Rishi Raj Singh IPS-Transport 
commissioner 
of Kerala implemented 
traffic rules strictly 
• 40 percent reduction in 
RTA 
Net result – 
He has been 
Removed from the post !!!!!!! 
EMS Asia 2014 ;Goa ; October17,18&19
108 challenges 
• Scams – Prevalent in all 
states 
• Vehicle conditions and its 
issues 
• Availability of Paramedics 
• Equipments and related 
issue 
• Fabricated call list 
• Unauthorized usage for 
non emergency purposes 
Equipment given in 108 
are not available in hospital OT 
EMS Asia 2014 ;Goa ; October17,18&19
EMS Asia 2014 ;Goa ; October17,18&19
Angels Challenges 
• Funding 
• Drivers attitude 
• People attitude 
• Ambulance Mafia 
• Non Standardized 
charging patterns 
EMS Asia 2014 ;Goa ; October17,18&19
Angels innovations 
• Emergency Medical Care 
Technicians Training 
• First response provider 
course 
• Rural emergency medical 
care initiatives 
• Emergency Medicine Crash 
course 
• App based networking 
EMS Asia 2014 ;Goa ; October17,18&19
Angels Bike Emergency Rescue Team 
• First batch launched with 
25 volunteers 
• Second batch training 
started 150 volunteers 
• Target to train 20000 
volunteer by 2nd October 
2016 
• 12 modules to complete 
in 3 months 
• Act as first responders 
• Networks through mobile 
apps 
EMS Asia 2014 ;Goa ; October17,18&19
ABERT vision 
• No matter whether an ABERT volunteer saved 
somebody … 
• If 20000 ABERT volunteers follow proper road 
culture and safe driving principle will bring 
down accident rate to 30 to 40 percent 
• ABERT focus on college students and youth 
EMS Asia 2014 ;Goa ; October17,18&19
National Ambulance Code 
Design 
Equipment 
Classification 
Standardization process 
EMS Asia 2014 ;Goa ; October17,18&19
National Skill development 
corporation 
• EMT B training program 
aiming to train plus two 
holders 
• Wrongly utilized – 
Nation wide agencies 
focused on nurses 
• Easy money like NRHM 
• Program Hold 
EMS Asia 2014 ;Goa ; October17,18&19
EMT B Training proposal 
EMS Asia 2014 ;Goa ; October17,18&19
Last Decade 
Changes in Emergency Medicine India 
• MCI recognition 21st June 
2009 
• GWU program 2007 
• MD programs in Medical 
colleges 2011 
• Upstate and other abroad 
university programs 
• Popularity on MCEM and 
its liberalization 
• DNB emergency 
Medicine 
EMS Asia 2014 ;Goa ; October17,18&19
EMS 2020 Road map 
• Implementation of National 
ambulance code 
• One Nation – One 
emergency access number 
• Paramedic council 
• EMS BSc and MSc Courses 
• Standardization of EMS 
protocols 
• National EMS society / 
Foundation 
• Integration of various EMS 
systems 
WAR 
Water –Air - Road 
EMS Asia 2014 ;Goa ; October17,18&19
Our style 
Ctrl+C Ctrl+V 
EMS Asia 2014 ;Goa ; October17,18&19
Create what we want … 
which is suitable for us!!! 
EMS Asia 2014 ;Goa ; October17,18&19
Thank you so much ….. 
EMS Asia 2014 ;Goa ; October17,18&19 
www.drvenu.net , www.emergencymedicinemims.com
EMS Asia 2014 ;Goa ; October17,18&19 
www.drvenu.net

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Emergency medical services 2020 ;Issues and Challenges

  • 1. Emergency Medical Services - Indian Scenario @ 2020 EMS Asia 2014 ;Goa ; October17,18&19
  • 2. Focus Why EMS What is the current status in India What are the issue and Challenges? What should be our EMS system in 2020? How to make a hassle free road map ? EMS Asia 2014 ;Goa ; October17,18&19
  • 3. Ground reality Total 3.57 lakhs (0.35 million) accidental deaths were reported during the year 2009 with the Male-Female victim ratio of 77 : 23. J Emerg Trauma Shock. 2012 Jan-Mar; 5(1): 49–54. doi: 10.4103/0974-2700.93113 PMCID: PMC3299154 EMS Asia 2014 ;Goa ; October17,18&19
  • 4. Road accidents (37.9%), railway accidents, and rail-road accidents (7.8%), poisoning (8.0%), drowning (7.7%), sudden deaths (7.4%), and fire accidents (7.0%). Most of the victims of accidents were aged between 15 to 44 years. This group of people has accounted for nearly two-third (60.7%) of all persons killed in accidents in the country EMS Asia 2014 ;Goa ; October17,18&19
  • 5. • Many of them die for want of timely EMS. • Thousands of these accident victims could have been saved if timely medical intervention were available to them. • Need of quality EMS in India is an unmet need of the masses. J Emerg Trauma Shock. 2012 Jan-Mar; 5(1): 49–54. doi: 10.4103/0974-2700.93113 PMCID: PMC3299154 EMS Asia 2014 ;Goa ; October17,18&19
  • 6. Mumbai Study • The injured victim in Mumbai usually is rescued by a good Samaritan passer-by (43.5%) • Helped by the police (89.7%) • Almost immediately after rescue, the victim begins transport to the hospital • No one waits for the EMS ambulance to arrive, as there is none • A taxi cab is the most popular substitute for the ambulance (39.3%). Prehosp Disaster Med. 2010 Mar-Apr;25(2):145-51. Where there are no emergency medical services-prehospital care for the injured in Mumbai, India. Roy N1, Murlidhar V, Chowdhury R, Patil SB, Supe PA, Vaishnav PD, Vatkar A.
  • 7. Healthcare delivery system District hospital , Medical colleges , Specialty centers Community Health center CHC Primary Health Center PHC SC 4, 276 23, 458 Sub Centers 1 ,46 ,036 EMS Asia 2014 ;Goa ; October17,18&19
  • 8. • National Family Health Survey – III, • Private medical sector remains the primary source of healthcare for the majority of households in both urban areas (70%) and rural areas (63%). • Even the quality of private sector is also questionable. : http://www.ncrb.nic.in/CD-ADSI2009/ADSI2009-full-report.pdf EMS Asia 2014 ;Goa ; October17,18&19
  • 9. Emergency Medical Services • EMS is thus provided in two forms Pre-hospital services Treatment to inpatients. • EMS is an essential part of the overall healthcare system as it saves lives by providing care immediately. Potluri P. Emergency services in India- Counting on betterment. A transition in progress. Editorial Section. [Last assessed on 2011 Jan 25]; Asian Hospital and health care Management magazine. 2009 18 Available from: http://www.asianhhm.com/healthcare_management/emergency_services_india.htm EMS Asia 2014 ;Goa ; October17,18&19
  • 10. Intra Hospital Transfer facility EMS Asia 2014 ;Goa ; October17,18&19
  • 11. India • Life and death are equally importance EMS Asia 2014 ;Goa ; October17,18&19
  • 12. Pre-Hospital Care networks • National Network of Emergency Services at Ahmedabad, Delhi, Pune, Hyderabad, Chennai, Raipur, Ranchi, and Kolkata • Emergency Management and Research Institute (EMRI) at Haryana, Chandigarh, Uttarakhand, Rajasthan, Gujarat, Madhya Pradesh, Andhra Pradesh, Goa, Karnataka, Tamil Nadu, Meghalaya, and Assam Subhan I, Jain A. Emergency care in India: The building blocks. Int J Emerg Med. 2010;3:207–11 EMS Asia 2014 ;Goa ; October17,18&19
  • 13. Pre-hospital care • Centralized Accidents and Trauma Services (CATS) • Life line foundation – Ahmadabad • 1298 ambulances • IIEMS – international Courses EMS Asia 2014 ;Goa ; October17,18&19
  • 14. NRHM -108 • Adopted from EMRI • National single Number • Fully Funded by NRHM • Free to victims • Fully equipped ambulance EMS Asia 2014 ;Goa ; October17,18&19
  • 15. Active Network Group of Emergency Life saves- ANGELS • Community based Ambulance network • 300 ambulances • PPP model • Bagged three International /National awards • Massive first responder awareness • EMCT EMS Asia 2014 ;Goa ; October17,18&19
  • 16. Angels awards • First EMS Asia award 2013 • AIIMS entrepreneurship award 2013 • AAEMI and Lifeline foundation award 2013 Best community based EMS Kerala is highly motivated for EMS and EM Angels take out Emergency Medicine from the hospital boundaries EMS Asia 2014 ;Goa ; October17,18&19
  • 17. EMS - Issues and challenges • Big country with diversities • Rudimentary emergency medicine specialty • Uniformity and lack of standardization • National Ambulance cord • Paramedic council • Vehicle for India roads • Courses and Trainings EMS Asia 2014 ;Goa ; October17,18&19
  • 18. Indian diversities influence EMS Regional Geographical Emotional Financial Cultural Political Individual EMS Asia 2014 ;Goa ; October17,18&19
  • 19. Implementation of Rules • Mr.Rishi Raj Singh IPS-Transport commissioner of Kerala implemented traffic rules strictly • 40 percent reduction in RTA Net result – He has been Removed from the post !!!!!!! EMS Asia 2014 ;Goa ; October17,18&19
  • 20. 108 challenges • Scams – Prevalent in all states • Vehicle conditions and its issues • Availability of Paramedics • Equipments and related issue • Fabricated call list • Unauthorized usage for non emergency purposes Equipment given in 108 are not available in hospital OT EMS Asia 2014 ;Goa ; October17,18&19
  • 21. EMS Asia 2014 ;Goa ; October17,18&19
  • 22. Angels Challenges • Funding • Drivers attitude • People attitude • Ambulance Mafia • Non Standardized charging patterns EMS Asia 2014 ;Goa ; October17,18&19
  • 23. Angels innovations • Emergency Medical Care Technicians Training • First response provider course • Rural emergency medical care initiatives • Emergency Medicine Crash course • App based networking EMS Asia 2014 ;Goa ; October17,18&19
  • 24. Angels Bike Emergency Rescue Team • First batch launched with 25 volunteers • Second batch training started 150 volunteers • Target to train 20000 volunteer by 2nd October 2016 • 12 modules to complete in 3 months • Act as first responders • Networks through mobile apps EMS Asia 2014 ;Goa ; October17,18&19
  • 25. ABERT vision • No matter whether an ABERT volunteer saved somebody … • If 20000 ABERT volunteers follow proper road culture and safe driving principle will bring down accident rate to 30 to 40 percent • ABERT focus on college students and youth EMS Asia 2014 ;Goa ; October17,18&19
  • 26. National Ambulance Code Design Equipment Classification Standardization process EMS Asia 2014 ;Goa ; October17,18&19
  • 27. National Skill development corporation • EMT B training program aiming to train plus two holders • Wrongly utilized – Nation wide agencies focused on nurses • Easy money like NRHM • Program Hold EMS Asia 2014 ;Goa ; October17,18&19
  • 28. EMT B Training proposal EMS Asia 2014 ;Goa ; October17,18&19
  • 29. Last Decade Changes in Emergency Medicine India • MCI recognition 21st June 2009 • GWU program 2007 • MD programs in Medical colleges 2011 • Upstate and other abroad university programs • Popularity on MCEM and its liberalization • DNB emergency Medicine EMS Asia 2014 ;Goa ; October17,18&19
  • 30. EMS 2020 Road map • Implementation of National ambulance code • One Nation – One emergency access number • Paramedic council • EMS BSc and MSc Courses • Standardization of EMS protocols • National EMS society / Foundation • Integration of various EMS systems WAR Water –Air - Road EMS Asia 2014 ;Goa ; October17,18&19
  • 31. Our style Ctrl+C Ctrl+V EMS Asia 2014 ;Goa ; October17,18&19
  • 32. Create what we want … which is suitable for us!!! EMS Asia 2014 ;Goa ; October17,18&19
  • 33. Thank you so much ….. EMS Asia 2014 ;Goa ; October17,18&19 www.drvenu.net , www.emergencymedicinemims.com
  • 34. EMS Asia 2014 ;Goa ; October17,18&19 www.drvenu.net