Save the golden hour

A supportive legal framework is the need of the hour for Good Samaritans who provide emergency medical care to road accident victims in order to shield them from unnecessary legal complications

October 25, 2013 11:18 am | Updated 11:18 am IST

Most crucial time for accident victims is a few minutes after the collision. Photo: M. Govarthan

Most crucial time for accident victims is a few minutes after the collision. Photo: M. Govarthan

Every year nearly 150,000 people die in road accidents in India, the highest number in the world. The first hour of such an emergency, often called the ‘golden hour’ is widely regarded as the most critical for saving lives. The 201 report of the Law Commission had stated: “Doctors point out that at least 50 per cent of the fatalities can be averted if victims are admitted to a hospital within the first one hour.”

According to organisations working in the sphere of trauma care, “If the victim can be stabilised and transported safely to a hospital in this timeframe, his or her chances of survival increase significantly.”

Unfortunately, however, such prompt care is generally not available in the country. According to a study by the Indian Journal of Surgery in 2006, 80 per cent of road accident victims in India do not receive any emergency medical care within this ‘golden hour’.

The primary step to correct this deficiency is to set up a good pre-hospital trauma care system. While this is obviously very important, a World Health Organisation (WHO) report on ‘pre-hospital trauma care systems’ says, “Even the most sophisticated and well-equipped pre-hospital trauma care system can do little if bystanders fail to recognise the seriousness of a situation, call for help, and provide basic care until help arrives.”

According to a survey conducted for Save Life Foundation (SLF), an organisation that works in the sector, among 1,027 road-users in Delhi, Hyderabad, Kanpur, Ludhiana, Mumbai, Indore and Kolkata, 74 per cent of the bystanders are unlikely to assist a victim of serious injury. When asked the reason behind it, 88 per cent of the respondents said that they were reluctant to help because of fear of legal complications, including repeated police questioning and court appearances; 77 per cent said that hospitals unnecessarily detain helpful persons and refuse treatment if payment is not made promptly; 88 per cent expressed the need for a supportive legal environment to encourage Good Samaritans to provide badly needed assistance to road accident victims.

The WHO report says, “Bystanders must feel both empowered to act and confident that they will not suffer adverse consequences, such as legal liability, as a result of aiding someone who has been injured.”

SLF is working towards ensuring a more supportive legal framework for passers-by to help road accident victims. In addition, it is providing training to police personnel and other citizens so that they can play a more helpful role in emergency care.

According to SFL, “the first few minutes after a serious injury occurs represent a window of time during which potentially life-saving measures can be initiated, such as assisting breathing, applying direct pressure to a wound to reduce external bleeding, and opening an obstructed airway.”

Of course what is even more important is to reduce the number of road accidents. This can be done by improving the condition of roads and related infrastructure, providing special protection to pedestrians and cyclists and improving safety of vehicles, say traffic experts. They add that stricter rules while giving driving licences, wider use of helmets and seat-belts and strong action against drunken driving and use of mobile phones while driving would greatly help.

There is an enormous potential for reducing road accident deaths in India.

According to the National Crime Records Bureau (NCRB), As many as 139,091 persons died in 440,042 road accidents in India in 2012. The death toll in 2012 is 2,257 more than in 2011 — an increase of 1.6 per cent. Tamil Nadu tops the list of with 16,175 deaths, followed by Uttar Pradesh (15,109 deaths) and Andhra Pradesh (14,966 deaths). Delhi reported the most number of road accidents among the Union Territories. Accidents involving two wheelers accounted for the largest number of deaths (32,318 or 23.2 per cent), followed by lorries (26,678 or 19.2 per cent). Bicycles accounted for 3,069 deaths.

In 2011 too, Tamil Nadu led the country with 15,422 deaths in 65,873 accidents. Andhra Pradesh was second that year with 15,158 deaths in 41,066 accidents.

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