Published in IJCP July 2019
Original Research
Ambulance Services in Delhi Need an Ambulance Care
July 12, 2019 | KK Aggarwal, Ira Gupta
     


KK aggarwal*, IRA Gupta

*Group Editor-in-Chief, IJCP Group
Advocate and Legal Advisor, HCFI

Any city needs one basic ambulance for 50,000 people and one advanced ambulance for 1 lakh population. Delhi, therefore, should have a minimum of 190 advanced life support (ALS) ambulances and 380 basic life support (BLS) ambulances.

As Delhi has a population of over 1.9 crore, Heart Care Foundation of India (HCFI) vide Right to Information (RTI) application dated 26.09.2018 had asked as to how many BLS ambulances and how many ALS ambulances are available in Delhi.

Vide reply dated 02.11.2018, Centralized Ambulance Trauma Services (CATS), which is an autonomous body of Government of National Capital Territory of Delhi (GNCTD) had stated that CATS have only 108 BLS ambulances and only 31 ALS ambulances.

In view of this shortage, Delhi Government should use the Essential Commodities Act. Under the Essential Commodities Act, 1955, the schedule to Section 2(a) drugs (as the meaning assigned to it in clause (b) of Section 3 of the Drugs and Cosmetics Act, 1940) is included as essential commodity. Also, under the section, the state government has powers to control production, supply, distribution, etc., of essential commodities.

An ambulance (which provides essential drugs) being an essential service, the Delhi Government can link all the private ambulances with CATS under one loop. In cases of life-threatening emergencies one can call 100; PCR personnel have been trained in life support CPR.

It is indeed pitiable that the Delhi Government’s CATS department does not even want to publicly display the information as to where the CATS ambulances are physically located. For this, they want Rs. 12/- to be deposited to get the information. Is this not a public information, which should be displayed all over for public convenience?

Fortunately, Delhi has two big trauma hospitals, Sushruta Trauma Centre in North Delhi and Jai Prakash Narayan Apex Trauma Center at AIIMS, New Delhi. But shortage of ambulances will not cover the golden hour and lives will be wasted.

Importance of ambulances

The term ambulance comes from the Latin word “ambulare” as meaning “to walk or move about”, which is a reference to early medical care where patients were moved by lifting or wheeling. The word originally meant a moving hospital, which follows an army in its movements.

An ambulance is a medically equipped vehicle which transports patients to treatment facilities, such as hospitals. In some instances, out-of-hospital medical care is provided to the patient in an ambulance.

Ambulances are used to respond to medical emergencies by emergency medical services. For this purpose, they are generally equipped with flashing warning lights and sirens. They can rapidly transport paramedics and other first responders to the scene, carry equipment for administering emergency care and transport patients to hospital or other definitive care facilities. Most ambulances use a design based on vans or pick-up trucks. Others take the form of motorcycles, cars, buses, aircraft and boats.

Following are few examples, which illustrate the importance of ambulances.

  • Rajesh Pilot died on June 11, 2000 in a car accident in Dausa 45-90 km from Jaipur. His Maruti Gypsy collided head-on with a Rajasthan Roadways Bus. He was shifted to Sawai Man Singh Hospital, Jaipur. He was in a coma when admitted at 5:15 pm. If he was carried in an advanced cardiac life support (ACLS) ambulance, would the situation have been different? Obviously, the golden hour was lost.
  • Giani Zail Singh, 78, the former Indian President, died in Chandigarh on December 25, 1994 after receiving multiple injuries from an accident on November 29. The accident happened near Kiratpur Sahib in Ropar district. He was shifted to Chandigarh 45 km away. Was he shifted in ACLS ambulance or provided a golden hour first aid in Ropar?
  • Sahib Singh Varma died on June 30, 2007, when his car collided with a truck near Jonaicha khurd, on the Jaipur-Delhi Highway (NH-8). He was taken to nearby Shahjanpur Civil Hospital 13 km away. Obviously no ACLS care was available for 13 km.
  • Gopinath Munde: At 6 am on June 3, 2014, his car met with an accident at Prithviraj Road-Tughlak Road roundabout. Later, he was brought to the hospital by his driver and assistant. Doctors at AIIMS said that Munde was not breathing when he was brought in. Had the ACLS ambulance reached the spot….?
  • Amitabh Bachchan was saved because of ambulance: On August 2, 1982, he had a near-fatal accident on the sets of his film Coolie. He was shifted to nearby hospital and ONLY LATER shifted to Mumbai. The early treatment did help to save him.

Analysis of Ambulance RTI

Sr. No.

RTI application dated 26.09.2018

Reply by CATS (an autonomous body of GNCTD) dated 02.11.2018

1

Is it mandatory for all hospitals both private and government hospitals to have BLS and ALS ambulance for 24 hours?

Information does not pertain to CATS

2.

If answer to query No. 1 is “no”, then please provide the details of the hospitals for whom it is mandatory to have ambulance for 24 hours?

Information does not pertain to CATS

3.

How many BLS ambulances are there in Delhi?

CATS have 108 basic life support ambulances. Information about whole of Delhi is not pertaining to CATS.

4.

How many ALS ambulances are there in Delhi?

CATS have 31 ALS ambulances. Information about whole of Delhi is not pertaining to CATS.

5.

How many hospitals have BLS ambulance available for 24 hours in Delhi?

Information does not pertain to CATS

6.

Provide the list of hospitals having BLS ambulance available for 24 hours in Delhi.

Information does not pertain to CATS

7.

How many hospitals have ALS ambulance available for 24 hours?

Information does not pertain to CATS

8.

Provide the list of hospitals having ALS ambulance available for 24 hours in Delhi.

Information does not pertain to CATS

 

Analysis of Ambulance RTI

Sr. No.

RTI application dated 28.11.2018

Reply by CATS (an autonomous body of GNCTD) dated 11.12.2018

1.

Provide the details of all the hospitals, both private as well as government, which are attached with CATS for BLS ambulances.

For operational purpose, CATS ambulances are deployed at a few Govt hospitals but they are not attached with the hospitals.

2.

Provide the details of all the hospitals, both private as well as government, which are attached with CATS for ALS ambulances.

Answer same as Sr. No. 1

3.

Provide the details of all the public places in Delhi where CATS ambulance is stationed for that particular public place.

Please deposit Rs. 12/- @ Rs. 02/- per page for 06 pages of the required information.

4.

Provide the details of all the public places in Delhi where CATS ambulances are stationed but the same are also available for any patient in emergency outside that particular public place.

List of CATS ambulances deployed is as per Sr. No. 03 above. These ambulances can attend any assigned call in Delhi.