Poor transport facilities for serious patients a major cause of death in Pakistan

Over 200 patients received expired in six months at allied hospitals

Rawalpindi

From January to July 2016, over 200 critical patients could not survive while transporting to the three allied hospitals in town mainly because of poor transport facilities and all such patients were labelled as “Received Expired”.

These patients were alive when shifting was started but died on way to hospitals or died in minutes after reaching the hospitals because of a number of factors that exacerbated the critical condition of such patients showing that there is no concept of retrieval medicine in Pakistan.

From January to July this year, as many as 61 patients were received expired by Holy Family Hospital, 74 by Benazir Bhutto Hospital and 71 by District Headquarters Hospital, said Intensive Care Consultant at HFH Dr. Muhammad Haroon while talking to ‘The News’ on Sunday.

He said a survey conducted by a group of critical care physicians revealed the shocking data. Death of over 200 patients while transporting to hospitals in six months period in one district show that the concept of retrieval medicine is much poor in the country, he said.

Retrieval medicine is a major branch of health system that deals with safe transport of critical patients from one place to other. The major components of retrieval medicine include fully equipped and functional ambulances lead by well trained experienced doctors and paramedics/nurses.

Dr. Haroon said in developed countries, the most senior doctor usually shifts a critical patient but in Pakistan the most junior doctor is given the job all the times.

Talking of the factors that worsen the condition of critical patients on way to hospital, he said unavailability of trained doctor and paramedics in ambulance, absence of basic life support on way to hospital, traffic blockades, and lack of lifesaving equipment inside the ambulances were found among major factors. It was also found that in a number of cases, the family members brought patient in personal vehicles instead of calling an ambulance with no airway and breathing support while in almost all cases, no information was given to receiving hospital before shifting, he said.

According to Dr. Haroon, experts in emergency medicine at the allied hospitals endorsed the issue but ironically a huge percentage of doctors are even unaware of retrieval medicine and its components. It was also found that doctors are not interested in accompanying critical patients during shifting, he said.

There is no proper handing over and taking over of sick patients at the healthcare facilities and in routine, resuscitation is not attempted even once during transport.

He said father of a deceased child told him that he called an ambulance when his 5-year-old son had electric shock. His son was breathing and his heartbeat was ok before shifting and there was a burn on his right hand. During shifting, Murree Road was blocked and they had to wait for 25 minutes and at that time, his son stopped breathing. The ambulance driver attached oxygen but it was found that the cylinder was empty. The father gave mouth to mouth breathing to the son but on reaching BBH emergency, doctors told him that patient has expired a few minutes ago.

To a query, Dr. Haroon said the health facilities are very poor in our country but a few simple steps can save hundreds of precious lives.

All ambulances must be accompanied by trained doctors and lifesaving equipment should be available in every ambulance. Basic life support training should be included in compulsory curriculum. Advanced life support training should be a must for all doctors and nurses, said Dr. Haroon.

He said it is a dilemma that majority of doctors do not even know about proper life support techniques. All obsolete ambulances should be replaced by new swift vehicles and necessary equipment like defibrillators, ventilators etc should be installed.

He said it is media that can play a vital role in creating awareness in public about basic lifesaving first aid techniques. Even a single manoeuvre like chest compression can save a dying person, said Dr. Haroon.