This is Usha Periyanayagam, guest posting on the blog.
The following day I visited the Trauma center in AIIMS (All India Institute of Medical Sciences). The trauma center and the emergency department actually two entirely different buildings. The trauma center was a staffed only by surgeons and approximately 1 km away from the emergency department. It was a new building and an impressive political achievement for New Delhi.
We actually started in their Sim lab with an ultrasound lecture. Their teaching center reminded me of our teaching center in medical school.
We then arrived at the entrance to the Trauma bay. The trauma bay was organized very differently than our bay. With the green and yellow areas, lower risk traumatic patients were mainly managed by NP/midlevels and the resuscitation bay of approximately 8 bays contained the sicker trauma patients. Unlike the EM system in the US, patient were usually triaged to the lowest level of care and then up triaged as necessary.
The fast track area of the trauma bay.
Overall a productive visit to the Trauma center. It was an amazingly well managed and relatively well resourced center. Definitely a different experience than the US.
The INDUS conference has been a whirlwind of people and information so far. I personally went to present my research project and participate in the conference. I was also hoping to meet other people interested in international EM both in the US and abroad and learn about the projects occurring. I got into Delhi late Tuesday night and started with the presummit the next day. The topic of the presummit was Medical Response to Mass Casuality Event in India. We started with the inauguration of the conference. In typical Indian fashion, the inauguration was a grandiose gesture honoring all the people who helped make the conference happen, each person giving a speech and then receiving a placard. The head of the department of New Delhi Public Health Department actually spoke, and did a brilliant job of mixing hope for India’s progress with a poignant message of ways improvement was necessary.
The focus of the presummit was general disaster planning as well as medical skills useful in these situation. All types of disasters were covered, however, terrorism preparedness as well as medical response was the focus of the entire second day. This was slightly surprising to me, because I had assumed the number of people affected and deaths from a natural disaster was higher than the number from a terrorist attack. In the United States, it’s not uncommon for disaster medicine to be focus on terrorism or urban warfare, however, I personally expected it to be different in India.
Looking back I think this reflects the relative frequency of terrorism, specifically urban bombing in the Indian society. While most attacks are relatively minor, it plays on the psyche of the public, who like in the US force public health officials to devote their energy to the field. The increasingly educated and informed Indian public’s worry about terrorism is further fueled by media portrayal of attack. In any disaster, the poorest/least influential people are the most susceptible, however, in a terrorist attack the influential middle class feels vulnerable. The conference was responding to this demand by creating a forum to address disaster preparedness, from hospital plans to medical knowledge. The audience was a mix of physicians, paramedics and nurses and the level of discussion comprehensive, although focused on people new to the field.