With the elections renewed hopes are pinned to the old and ongoing problems that are shelved for a long time and never made it to top priorities of our government officials.Pre hospital care and its liaison with the emergency department is one of the issues that have never brought to lime light. We don’t see pre hospital care as a priority and had left that arena for either NGO or patients families to deal with.Let me make it clear for all to understand “pre hospital care is most of times a difference between life and death, normalcy or continued disease state and despair or satisfaction”. It gives hope, satisfaction and sense of belonging regardless of outcome. Without pre-hospital coverage, I do see patient’s family struggling to bring patients o emergency department in their own vehicles. Struggling through the traffic, stressed and worn out and not knowing if their loved ones will be alive by the time they reach to the ER. When they do so, mostly of the time they are told they are late. Some of them bring patients from far flung areas traveling days to reach the hospital. It causes agony, stress and senses of helplessness. It causes them to spend a lot of money which sometimes they don’t have, but they have to take this journey.Pre hospital care is basically providing medical care to people in need before they could reach to the hospital emergency department. It is important because of following aspects
- Disease state is of the extent that waiting is actually disastrous, and if intervention does not start early, life may be at stake.
- Patients are too unstable to transfer to hospital without first stabilizing.
- Patient may need not to go to hospital and can be treated at home and reassured.
- Patients may be adversely bleeding and control of bleeding early is most important.
There are countless other examples to prove how important pre hospital care may be. Now this care could be provided by either trained doctors, paramedics or trained family members of the patients.Because of various presentations of the disease and their management we cannot depend on family members to act in the best interest of patients especially in the time of crisis. We need to establish the proven system of EMS(EMERGENCY MEDICAL SERVICES)and extends its reach to all areas of Pakistan.Looking at the system and its deliverable we can safely say that it saves lives, money and improves mortality. Although it is the work of the government to provide reasonable health care to its citizens but it is also important for the people to help the Govt. out in all the steps of establishing this important service.We have seen improvement is a lot of respect in the health care system and which is the teamwork of all physicians, paramedics, policy makers and opinion leaders but these improvements are mostly in big cities and only cater to very limited number of patients. We need to expand pre hospital services to the small cities, towns and then ultimately rural communities.With all the elections and the hype of attracting voters by promises is now over. Now the real test starts where the new elected members has to deliver. I believe pre hospital is one of the areas where small intervention may result in big improvement in care. Expanding role of 1122 services and its collaborations with local emergency departments should be top priority. Also we need to establish EMS network on city level and then on province level and ultimately to the national level. This network can oversee the emergency care, pre-hospital work, disaster response of the medical community and the preventive medicine efforts to contain a disease.Either as government lead program or a public private initiative to incorporate emergency medicine physicians and EMS personnel to work together in this area of need is the need of the time. We will be doing a big service to our people if you are able to provide them with the care that they deserve.
I can be reached at askhan65@yahoo.com.