Medical emergencies – like road accidents, cardiac problems, convulsions, and so on – can occur at any given time. It is an established fact that a patient who receives basic medical care from trained professionals and is transported to the nearest healthcare facility within 15-20 minutes of an emergency has the greatest chance of survival.

What is Emergency Medical Services (EMS)?

In medical terms, the “Golden Hour” is the first hour after a traumatic injury, when emergency treatment is most likely to be successful. It is this term that highlights the importance of Emergency Ambulance Service or Emergency Medical Services (EMS). EMS is an essential part of the overall healthcare system as it saves lives by providing care immediately. EMS is also known as ambulance services or paramedic services; one can avail of this service by calling a toll-free Ambulance number.

Under EMS, trained technicians or paramedics provide first aid to the patient i.e. pre-hospital clinic care, and shift the patient to a suitable facility. EMS can be provided in two forms—pre-hospital services and in-patients care. Pre-hospital medical benefits incorporate ambulatory services, transportation of the patients to or from spots of therapy, and intense clinical consideration (likewise called emergency treatment). EMS also helps to transport in-patients during critical medical emergencies.

The expression “emergency medical service” was promoted when these administrations started to emphasize determination and treatment at the scene. In certain countries, a significant part of EMS calls does not result in a patient being taken to hospital! Emergency Medical Services (EMS) in India

The Indian EMS story started with the inception of the Emergency Management and Research Institute in April 2005. Earlier, people were mostly dependent on the ad-hoc emergency provider networks in which hospitals and taxis provided the services to meet the emergency needs. Later in 2005, the concept was conceived by National Health Mission (NHM) (then National Rural Health Mission) and initiated Emergency Response Services (ERS), popularly known as the “108 Ambulance Service Project” to ensure emergency care for rural India along with urban India. The number ‘108’ corresponds to the toll-free ambulance number which allows the patients to report the emergency cases to emergency response centers in each state.

Earlier, ambulance numbers in India were largely unregulated. But over the last 2-3 decades, a regulated system has emerged. Recognizing the importance of EMS, several advancements have been made over the years through research and development. PPP projects initiated by the Indian Government along with private partners are working relentlessly towards making healthcare accessible and affordable to each individual in the country. These services include:

1. 108 Ambulance Services: Basic Life Support and Advanced Life Support services to care for fatal emergencies. Currently, 108 Ambulance numbers are operated by Ziqitza HealthCare Limited in Madhya Pradesh, Odisha, Jharkhand, Punjab, and Sikkim and had previously served people of Bihar, Kerala & Rajasthan.
2. 102 Janani Shishu Services: Ambulance Services to pregnant women and newborns to reduce the infant and maternal mortality rate by increasing deliveries assisted by skilled birth attendants.

102 Ambulance numbers is a toll-free number that transfers patients to the nearest government hospital free of cost with trained paramedics on board.

1. 104 Health Helpline Number: Medical assistance for several minor physiological illnesses, ailments, and mental distress, along with directory information, details on health schemes, a grievance redressal mechanism, and more to rural areas.
2. MMU – Mobile Medical Unit: Free clinics staffed with a professional team to provide healthcare like medical check-ups, investigation facilities, awareness programmers, post-natal services, electrocardiography, and medication at the grass root level to ensure quality healthcare for all.

Since 2008, Ziqitza Healthcare Limited has been one of the proud partners in the Public-Private Partnership initiative. We provide free 102 and 108 Ambulance Services across 5 states, namely Madhya Pradesh, Odisha, Punjab, Sikkim, and Jharkhand. These ambulance numbers services have a team of fully trained professionals, technicians, and medical staff well versed with Basic Life Support (BLS) and Advanced Life Support (ALS) equipment so as to introduce necessary medical aid while the patient is being transported to the hospital. Apart from ambulance services, Ziqitza also operates 104 Medical Helplines and MMU for various state governments.

Current Challenges in EMS

In the last two decades, there have been considerable efforts made by the states across India to develop emergency services. The Central Health Ministry too has played an active role to avoid preventable deaths and disabilities and has planned to have a common effective system that could provide emergency care with equity of access. However, the state of EMS in India varies drastically from developed countries like the 911 emergency services of the USA.

In spite of the development in the healthcare sector over the past decade, India took a long time to create a single, comprehensive EMS that can be accessed throughout the country. Recently, the Central Government launched a single emergency number 112 which integrates all the existing 6 helpline numbers to reach Police, Fire, and Women helpline numbers. This is similar to 911 in the United States.

Awareness:

Attention to accessible administrations and readiness are obligatory among the overall population for the accomplishment of an EMS administration. An EMS that individuals don’t know about is pretty much as great as non-existent.

Ziqitza has been actively working towards educating and empowering individuals to become First Responder. We pride ourselves in having trained over 7 lakh people as First Responders in Madhya Pradesh, Odisha, Punjab, Rajasthan, Bihar, Kerala, and Jharkhand. Our team works to create First Responders at the grassroots levels – Schools, Colleges, Police Stations, Corporate offices, Gram Panchayats. Ziqitza emphasizes elevating school students as First Responders by providing early exposure to our program.

Another challenge to consider is as the service is free, the chances of misuse are very high due to ignorance about the significance of these services. Therefore, responsible Ambulance Service Providers follow customer feedback protocols to ensure no misuse happens at the ambulance level between the patient’s family and the staff.

Technology:

The services are dependent on technology like GPS, GIS, and other information and communication technologies (ICT) including the internet of things (IoT). The GPS innovation fails miserably in some rural parts of India which powers the framework to have manual intervention in locating the incidents.

Ziqitza’s strong technological background and belief in constant technological improvements have enabled us to work around these challenges and provide world-class healthcare services.

Infrastructure:

Physical reach is one of the basic determinants of access to the required healthcare. Beyond the somewhat well-connected urban populations to the urban underprivileged, and to their rural counterparts, the lack of infrastructure is still a challenge.

While the Government, along with private partners like Ziqitza, has been successfully trying to bridge the accessibility gap, we still have a long way to go in terms of infrastructure.

Centralized System:

There is high variability in the emergency numbers which creates confusion among the people. The recommendation for a single number at the national level for all emergency cases is yet to be implemented and plans are underway to merge all the helpline numbers into one centralized number to avoid confusion during an emergency situation.

Standard EMS Training:

The lack of standardization in EMS education creates problematic situations as EMS requires highly skilled labor. Variability also exists in EMS education standards with the establishment of courses like Emergency Medical Technician-Basic/Advanced, Paramedic, Diploma Trauma Technician, Prehospital Trauma Technician, and Postgraduate Diploma in EMS.

Trends in EMS

Having looked at the challenges in the EMS domain, there is a long journey for India to travel. However, there are few notable developments and trends that are witness to the positive scope of improvement.

Earlier, emergency services were being provided only with the means of road transport. Air ambulance was introduced later as an answer to the limitations of infrastructure, with more standards being formed to make services better. India also has a helicopter ambulance service available in the metros and is expanding it to rural areas. There are also bike ambulances with sleeping arrangements with all the essential equipment such as a first-aid kit, oxygen cylinder, siren, and fire extinguisher. These are quite useful for reaching out to patients in remote and rural areas and are helping in comfortably moving them to the nearest hospitals by dialing the ambulance number.

Future of EMS in India

The significance of a reliable EMS can’t be overemphasized, particularly in India where the public authority has the obligation of really focusing on a greater part of the populace. At the point when the accentuation on forestalling harm is more prominent than any time in recent memory, the arrangement of pre-emergency clinic care will be the way to guarantee that lives are not lost due to avoidable circumstances. It can be argued that a nation of a billion people has been deprived of a decent EMS for too long now.

The Indian Government’s ‘Make In India’ campaign has called in for a lot of development in the healthcare industry. Its success is evident enough of the need for EMS and what it will take to ensure that it works as expected. The regionalization of EMS, appropriate budgetary provisions, standard training process, and improving awareness among the general community will surely improve the performance of EMS in the coming years.

The corporate sector has also witnessed a growing awareness of the need for instant and professional emergency response. With employee health and welfare becoming a priority, there is a visible increase in the demand for on-site – continuous and accessible – basic and advanced healthcare services. One can avail of the service by dialing the ambulance numbers given to them.

While the pandemic did bring a health crisis and an unprecedented time, it has also opened discussions and paved the path for improvements in the EMS and healthcare sector in general.