Healthcare can never deliver excellent results unless it is supported by a robust pre-hospital care system. Most sick patients cannot be transferred to the hospital safely, or get treated in appropriate time if there is no effective pre-hospital care system. There is a misconception that pre-hospital care is designed to take care of trauma, and that other patients without trauma only require basic transportation. This can delay important treatment for the patients reaching the Emergency Department in transport vehicles and some of them face avoidable harm. Then there are patients who cannot get any sort of transport vehicle and come to the ED with the help of bystanders or relatives fighting the traffic in busy roads or travelling long distances in the rural or out of big city areas.
Our pre-hospital care used to be confined to only transportation of patients from the point of sickness to the nearest hospital. The ambulance was equipped with oxygen only with no trained staff present. The victim in case of any road side or other accident, or the sick person carried from his/her home was carried to the emergency department in order to get evaluated and treated. Till that time the attendant accompanying the victim would be the only people caring for the patient. Edhi Foundation did this job for a long period of time, and then slowly other organizations were formed and provided similar help.
In 2004 the government of Punjab launched the 1122 pilot project from Lahore. The initial task was to provide pre-hospital care in the urban cities of Punjab. The services are accessed through the toll free number of 1122. After the success of pilot project, now the service is expanding and present in all 35 districts of Punjab and the average time of response is 7 minutes.
The 1122 works under well-established hierarchy where all districts are attached to headquarter and the headquarter is directed by the Director General of 1122. Each district is appropriately staffed and also has the control room. Rescue 1122 has rescued millions of emergency victims through its Emergency Ambulance, Rescue & Fire services and Community Emergency Response Teams while maintaining its swift response and standards in all districts of Punjab province with an estimated population of over 110 million.
The 1122 has a robust teaching and training program and all EMT ‘s has atleast four months of training through the Emergency Services Academy created by 1122 organization. The Emergency Services Academy has been established in Lahore to ensure sustainable human resource development of emergency services in Pakistan which has so far trained over 20,000 emergency services personnel of all provinces of Pakistan. They have created and updated the curriculum, which includes medical knowledge as well as training in dispatch, documentation, fire and water safety. The Pakistan Rescue Team of this Academy is the first United Nations INSARAG certified team in South Asia. The Academy also organized the first SAARC Rescue Challenge.
This Emergency Rescue Service has so far rescued over 12.4 million victims of accidents and disasters and saved losses over Rs. 607 billion by providing timely response and professional fire fighting in over 207000 fire incidents. The Motorbike Ambulance Service has also been launched to further improve emergency response in congested areas and traffic jams. This Motorbike service has responded over 1.3 million emergencies with an average response time of around 4 minutes which is an achievement even internationally.
Reports about 1122 performance can be seen here:
Punjab Emergency Service Department (rescue.gov.pk)
The story like this is very important for us to move forward. We need to make sure 1122 gets more training, expands its covering area and increase the trained cadre, in order to continue helping fellow citizens of Pakistan.