Challenges in handling medical emergencies by ambulance drivers: A comparative study in two metropolitan cities in India

Abstract

An emergency or a disaster may occur at any time of the day or night, weekend or holiday, with little or no prior warning. Emergency service providers ensure public safety by addressing different emergencies. Drivers in the emergency vehicle often relate the efficient emergency management to quick access to the victim’s location, shorter time at the location, good support to the paramedics, and faster transport to definite care unit. The role of the ambulance drivers in emergency management is crucial, as reaching the victim quickly is more important than providing the prehospital care. The current research study attempts to understand the major challenges faced by the ambulance drivers in handling emergencies in cities. For this purpose, this study undertook a survey among the ambulance drivers of GVK Emergency Management and Research Institute, who are designated as pilots during November-December 2008 in the cities of Hyderabad and Ahmedabad in India. Data were collected from 27 pilots in Ahmedabad and 52 pilots in Hyderabad through a self-administered questionnaire. Congested street and nonavailability of lift facility were cited as the major problem in handling the emergencies in cities where the survey was conducted. A strong correlation was observed between floor numbers of the buildings and mean call to scene departure time to hospital, indicating difficulty in managing time during emergency in case of emergencies happening for residents residing at higher floor in a multistoried building. As floor number increases mean call to scene departure time also increases. It was found that in Ahmedabad the cooperation from traffic police and public was not satisfactory as compared to Hyderabad. Traffic police in Ahmedabad needs to be sensitized to help during heavy traffic and during critical vehicular trauma cases. In Ahmedabad, pilots cited that locating the proper address at night time was a problem. Since the study found that the on-scene time was more in case of victims at higher floors, it is strongly recommended to introduce trained volunteers or first responders to overcome barriers by opening locked outer doors, securing elevators, and providing directions to the patient’s location. Again with low public support during handling the emergencies, more public awareness on the role of escorts might lead to greater citizen involvement and shorter total response time.