In healthcare, emergency medicine is crucial in managing urgent and life threatening surgical and medical situations. For providing effective care for ill patients it requires professional knowledge and skills. In India scope for emergency medicine is evolving and it is broad from pre hospital care to specialised emergency departments.
To strengthen emergency medicine the Indian government established the National Health Mission in 2013,which includes a dedicated program for emergency medical services and it helped in improving the quality of emergency care in the country.
Maintaining good health isn't just a yearly resolution, it's a lifelong commitment that impacts every aspect of our lives. This includes not only what we put on our plates but also our mental well-being and the ability to manage unexpected health crises.
Dr. Dharanidaran Baskaran, a Senior Resident in the Department of Emergency Medicine at Mahatma Gandhi Medical College and Research Institute Pondicherry, explained the complexities of emergency medicine, particularly in resource-constrained areas.”Managing critically ill patients is inherently difficult,” Dr. Baskaran explained, “ the absence of advanced equipment and specialised facilities in these settings further complicates the task of delivering optimal care."He emphasised the significance of effective communication, highlighting the need to calm and reassure patients' caregivers alongside providing medical treatment. “Resourceful clinical decision-making becomes crucial,” he added. “Emergency Physicians need to be innovative and adaptable to deliver the best possible care.”Dr. Baskaran recounted two instances he faced. In one case, during a busy afternoon shift, two children from the same family were brought to the Red zone,( where critically ill patients are managed)after being bitten by a snake while sleeping. Initially stable, the elder child suddenly developed neurological symptoms like drooping eyelids, breathing difficulty, and blurred vision. He promptly intubated and connected him to a ventilator, administering Anti-Snake venom (ASV). The other child, with milder symptoms, also received ASV.
After appropriate treatment and ventilator support, the intubated child recovered well and was discharged without residual symptoms after a week of hospitalisation. Another case involved a young college student who experienced an acute stroke, leading to inadequate blood supply to the brain. Similar to how we administer thrombolytic medication for acute myocardial infarction, the patient received thrombolytic therapy within the critical 3-hour window from symptom onset. After a week of intensive care in the ICU, the patient showed significant improvement and was discharged from the hospital. This case underscores the importance of timely intervention and appropriate medical management in improving outcomes for stroke patients.
Dr.Bhaskaran handled numerous cases of severe trauma where patients either lost their limbs or, in the worst-case scenario, lost their lives at a young age. He strongly advocated several safety measures like to wear seatbelts while driving cars and use good quality helmets while riding bikes,and advised against drinking alcohol while driving. He added Ideally, complete abstinence from alcohol is the safest choice, not only for the individual's well-being but also for the safety of others on the road and the broader society. Minimising the frequent intake of junk foods, which can contribute to various health issues.
Additionally, incorporating regular physical activity into one's routine, at least three times a week, promotes overall well-being and reduces the risk of lifestyle-related diseases. By prioritising these safety measures and adopting a healthy lifestyle, individuals can significantly reduce their risk of accidents, injuries, and health complications, leading to a safer and healthier community.
Dr. Dharanidaran Baskaran continued his discussion by pointing out the challenges faced by Emergency Medicine in India."Family Physicians have been the mainstay for healthcare, but Emergency Medicine is relatively new in India," Dr. Baskaran continued. The need for public understanding of emergency departments (EDs) and working under extreme stress during shifts is crucial. Emergency Departments (EDs) don't operate on a 'First come, First Serve' basis; patients are triaged based on the severity of their illness. "Many patients with minor issues visit EDs, causing frustration for those with critical emergencies," he added. Dr. Baskaran urged the government to address these challenges by:
Investing in ED infrastructure: Allocating funds to improve facilities and equipment in emergency departments.
Supporting Emergency Healthcare Workers: Offering incentives and improving compensation for emergency medicine professionals to address staffing shortages.
Enhancing Public Health Awareness: Educating the public about prioritising preventive healthcare, proper hygiene, and critical thinking regarding online health information.
Dr. Baskaran concluded by calling for more government investment in primary healthcare centres, recruitment of healthcare workers with fair compensation, collaboration with international health organisations, and increased funding for healthcare research and innovation