Training in Trauma Care

Abstract

In a dubious distinction for the country, the World Health Organization has revealed in its first ever Global Status Report on Road Safety that more people die in road accidents in India than anywhere else in the world, including the more populous China. (Dipak Kumar Dash, TNN, Aug 17, 2009, 04.10 am IST. New Delhi) About 250 people die in road accidents in India everyday (‘Strategy on road safety must’ TOI on 7th March, 2009) and the total number of deaths every year due to road accidents has now passed the 135,000 mark, according to the latest report of National Crime Records Bureau or NCRB. Besides road traffic accidents we have our share of victims of terrorist activities, accidents at work places, natural and man-made disasters, etc. Out of these about 78% are men in age group of 20–44 years, causing significant impact on productivity. (Joshipura MK, Shah HS, Patel PR, Divatia PA. Trauma care systems in India—An overview. Indian J Crit Care Med 2004;8:93-7) No credible data is available to ascertain the outcome of trauma victims; it is generally perceived that outcomes in patients with single system injury (e.g. musculoskeletal trauma) have improved. Unfortunately, the same cannot be said for polytrauma. There is a high mortality rate amongst those with multisystem injuries, which can be attributed to the primitive state of trauma-care systems, lack of prehospital care and inadequate critical care. It is established that the mortality in serious (ISS > 16) injuries is six times worse in a developing country such as India compared to a developed country. (Mock CN, Jurkovich GJ, nii-Amon-Kotei D, Arreola-Risa C, Maier RV. Trauma mortality patterns in three nations at different economic levels: Implications for global trauma system development. J Trauma 1998;44:804-14.) For any improvement in this area, it is essential to establish trauma system in the country and have health care professionals trained to provide efficient care to trauma victims at every step—pre-hospital, in-hospital and rehabilitation. Establishment of trauma system would fall within the purview of central and state government authorities. But professional bodies such as The Association of Surgeons of India can play pivotal role in training of health care professionals. Unfortunately such efforts have remained restricted to a few pockets in our country.