“Sisters and Brothers…
At the outset, let me extend a warm welcome to all the delegates and experts who have gathered here to attend the 10th Asian Conference of Emergency Medicine (ACEM) being held for the first time in India.
Founded in 1998 by Prof V Ananthraman, I am told that Asian Society for Emergency Medicine (ASEM) has a membership from 12 Asian countries, including India. I have been informed that ASEM has been encouraging research and development in emergency medicine with a special focus on the problems pertaining to Asian countries, apart from conducting biennial conferences for exchange of knowledge.
I am glad to know that the theme of this conference is “Affordable care, bridging the gaps and creating the Impact”. I confident that this meeting of the minds on emergency healthcare will provide an impetus and help in expanding the footprints of this crucial life-saving branch of the medicine in India.
Indeed, providing affordable and quality healthcare are the need of the hour given the rising treatment costs and the huge out-of-pocket expenditure, borne by the patients, most of the time.
In this context, schemes such as Ayushman Bharat would greatly help the poor and needy in accessing quality healthcare and emergency medical services. Irrespective of insurance coverage or a person’s capacity to pay, no hospital can deny the right to treatment in emergency cases.
As you all are aware, the Casualty Departments of the good old days have now been transformed into emergency medicine or accident and emergency medicine departments.
The word casualty emanated from war fields where-in the wounded soldiers in the war were isolated and given lifesaving treatment and transported to field hospitals. These casualty departments were managed by non-specialists.
Around 1970, the western countries realized the importance of transforming the casualty departments to Accident and Emergency departments and recognized emergency medicine as one of the specialties.
In India too, some hospitals like Apollo Hospital at Hyderabad and the Christian Medical College, Vellore realized the need to upgrade their casualty wings into Departments of Emergency Medicine and develop the required manpower.
They also started Post-graduate Fellowship in Emergency Medicine in collaboration with institutions from western countries, mainly the UK and the USA. Thus, the birth of SEMI (Society of Emergency Medicine India), a member of ACEM, took place in Hyderabad around 2001.
In 2009, the Medical council of India recognized Emergency Medicine as one of the Post-graduate specialty courses and started Post graduate MD, followed by DNB courses by National Board of Examinations in 2013.
I am glad that the Government of India has made it mandatory for all medical college hospitals to have full-fledged Emergency Departments by 2022 with an aim to improve trauma care. In a vast country like India, there is an urgent need to create a large pool of medical professionals with expertise in emergency medicine to treat acute illnesses and injuries for all age groups.
Apart from upgrading the infrastructure in all major hospitals to meet the requirements of this emerging specialty, there is also a need to include Emergency medicine and trauma care in curriculum of Undergraduate courses. Medical students must be trained to deal with whole gamut of situations relating to emergency medicine. There is also a need to provide simulation training in Emergency medicine for undergraduates and develop the necessary modules in this regard.
Dear brothers and sisters
Emergency medicine is gaining momentum across the globe and advancements have been made in identifying and treating life-threatening conditions arising out of natural disasters, accidents, epidemics and other related events.
As you all are aware, various life-threatening medical emergencies like heart attacks and strokes are being instantaneously diagnosed and stabilized by the emergency physicians. Modernized and advanced cardiac life support Ambulances are reaching the doorstep of the patients and starting the required treatment in a pre-hospital setting and thereby saving hundreds of lives. I am happy to note that several state governments have launched such ambulance services.
According to WHO, strengthening pre-hospital care by training community-based providers and using staffed community ambulances has been estimated to cost less than US $100 per life saved and has been shown to reduce mortality by 25-30 per cent in some low and middle income country contexts.
It is estimated that over 3,700 die in accidents on world’s roads every day and tens of millions get injured or disabled every year. Children, pedestrians, cyclists and older people are among the most vulnerable of road users. A number of road accident deaths could be prevented by providing immediate pre-hospital care and with adequate knowledge of handling emergency situations, especially by the staff manning ambulances.
No doubt, the emergency medical service scenario in urban India has undergone a major transformation in the last few years. Our cities have a number of hospitals providing critical care. We still have considerable challenges in setting up robust emergency medical services in the country, particularly in the rural areas.
Providing quality healthcare to rural population is a vital component of national development. It is also equally important to ensure that every village or a cluster of villages is connected to an established emergency service network. Well-structured Emergency Medical services are crucial in saving lives during medical emergencies.
There is an urgent need to attach high priority to emergency medicine and services in India. We have to invest in providing timely and high-quality Emergency Health Services in the country.
We need to develop programs and manuals to train citizens in emergency first aid procedures such as Cardiopulmonary Resuscitation (CPR) as it would help in saving a life while waiting for emergency services. Bystander training and protocols for trauma resuscitation are important elements in improving the architecture of emergency medicine.
With your expertise in Emergency Medicine in different parts of the world, I suggest that this conference must discuss best practices in emergency care and help governments in setting up robust emergency medical services with an interdisciplinary approach. I am sure that there will be useful exchange of knowledge on various aspects of emergency medicine. Our younger generation of doctors specializing in emergency medicine should utilize this opportunity and gain new insights.
There is also a need to adopt standardized treatment protocols by all hospitals that are dealing with emergency and trauma cases.
I feel that the area of behavioral emergencies needs the attention of the experts gathered here. Instead of straightway recommending a patient with severe panic attacks or anxiety disorders to see a psychiatrist, emergency care specialists should also get trained to treat such cases.
Taking into consideration the topographical and other diversities between India and the Western countries, the Asian Society of Emergency Medicine should come up with tailor-made solutions to the emergency conditions peculiar to this region with particular focus on reaching the rural population.