Background and Need: Emergency medical services (EMS) is a complex integrated system that provides coordinated response and patient care for life threatening injuries and illnesses, and safe transport to appropriate healthcare facility. Mortality, short- and long-term morbidity can be reduced by provision of prompt emergency care and rapid transport to healthcare facility by utilizing services of a well-organized Pre-hospital care ambulance service integrated with hospital system. Statistical data about pre-hospital mortality and morbidity is not available in Kashmir valley, however according to media reports J&K has recorded 665 deaths in Road Traffic Accidents in 2017 alone with patients being declared Brought Dead to hospital1-3.
Assessment: There is well documented need for critical care and emergency medical services in developing countries4 and Kashmir is no exception. The existing ambulance structure in Kashmir is not at par with international standards for to qualify for EMS service due death of trained staff, and equipped ambulances. This paradigm was changed by KASHMERs introduction of EMS service in Aug 2019. 2861 patients have been transported by EMS KASHMER from Aug 2019 until Dec 2022.
Aims: Reduction in mortality, short- & long-term morbidity by providing free fully equipped critical care Ambulance service to the people suffering from serious health conditions. Triage physician after assessment dispatches trained staff to the spot to help patient with initial first aid and safe transport to proper healthcare facility.
Implementing Partner: HELP Foundation
Start Date: Aug 2019
Design: Flagship EMS Pre-hospital care project in Kashmir valley in collaboration with HELP Foundation as implementing and operational partner was launched in Aug 2019 in Srinagar. This service was introduced to provide prompt emergency care and rapid transport by an Advanced Life Support ambulance to critically ill and injured patients to help reduce mortality & morbidity. EMS KASHMER with its control room located at Srinagar is run by well-trained Triage physicians, EMTs and pilots. After successful implementation in Dist. Srinagar the EMS KASHMER service has now been extended to Dists. Baramulla, Kupwara and Anantnag. KASHMER intends to further extend EMS to all districts of Kashmir valley.
Personnel:20 (03 Triage physicians, 08 EMTs, 08 Pilots, and 01 Project Assistant)
Numbers/Key Performance Indicators
Assessment of the impact: Positive impact of the project is evident by gradual increase in number of patients transported in all stations depicting gradual acceptance of service by people. Smooth operations in all the four districts are making significant impact in society. Other than common public, trust gained by District hospitals on EMS KASHMER is evident by seeking our support in transferring very serious patients to tertiary care hospitals and air ambulance at Srinagar airport. Services of EMS KASHMER at present are limited to 4 districts of Kashmir valley.
Current status: Project EMS KASHMER is operational in 4 districts of Kashmir valley with gradual increase in the number of patients transported. KASHMER EMS service is expected to be expanded to other districts with investment in infrastructure.
- https://www.ncbi.nlm.nih.gov/books/NBK201058/
- Craig D. Newgard, MD, MPH,Robert H. Schmicker, MS, Jerris R. Hedges, MD et al Emergency Medical Services Intervals and Survival in Trauma: Assessment of the “Golden Hour” in a North American Prospective Cohort Ann Emerg Med. 2010 Mar; 55(3): 235–246.e4.
- Alistair Maddock, Alasdair R Corfield, Michael J Donald, Richard M Lyon et al Prehospital critical care is associated with increased survival in adult trauma patients in Scotland. Emerg. Med. J 2020;37:141–145.
- Junaid A Razzak, Arthur L Kellermann Emergency medical care in developing countries: is it worthwhile? Bulletin of the World Health Organization 2002, 80 (11)