On an average, almost 20 people lose their lives in road accidents in India every hour, mostly young, productive individuals. In many cases, however, it may not be the actual injury that causes the death of accident victims, but rather what happens immediately after the accident.

Understanding trauma care

In its most basic form, the ‘golden hour’ theory states that the faster emergency medical treatment is administered to a seriously injured patient, the greater the probability of survival. The phrase does not strictly denote a one-hour period; rather, it is a reminder of the high mortality rates associated with delayed medical intervention.

Unfortunately, in the context of India, the golden hour is frequently missed. According to various studies, very few patients who suffer serious injuries are able to reach a medical facility within the first hour, even when they are nearby.

Trauma care doesn’t start in an emergency department. Care begins right at the site where the incident occurs. The few individuals at the scene of an accident or emergency may be complete strangers to one another, and yet they can mean everything to the victim. Simple, immediate measures such as calling for medical help, stopping major blood loss, or maintaining an open airway can make the difference between life and death.

Prevention and precautions

Approximately 1.7 lakh fatalities happen annually on Indian roads, and almost all of them can be prevented by wearing helmets, wearing seat belts, not over-speeding, and avoiding distractions. The most effective treatment for trauma is the prevention of trauma.

The strength of a trauma system is directly proportional to public participation. Various ‘Good Samaritan’ movements have tried to make citizens provide medical assistance to victims of accidents without fearing repercussions. However, hesitations exist even now, mostly because of lack of knowledge.

Here are some simple steps every citizen can take during a crisis:

• Yield the right of way to ambulances
• Make calls to emergency services without any delay
• Avoid congestion around the scenes of accidents
• Supply correct information to rescue teams

These measures may not be medical, they are lifesaving measures nonetheless.

Strengthening systems

Injuries continue to be one of the major causes of fatalities amongst Indians under the age of 30. While prevention should be the goal, it is also crucial to strengthen response systems, including ambulances and access to high quality trauma care. This apart, basic steps taken by citizens who may be at the site or may be passing by, can also go a long way towards helping victims. Ultimately, the goal to focus on is not just about saving people during golden hour, it is about ensuring that the golden hour is not lost in the first place.

(Dr Kesavan A. R. is clinical lead & senior consultant - trauma and orthopaedics, department of orthopaedics, MGM Healthcare, Chennai. kesavan.ar@mgmhealthcare.in)