8:30 A.M., 29th August 2010, Mumbai.
Saurav was the vice-president of a famous advertising company. He had a sudden cardiac arrest. His wife called 108 for an ambulance, but the ambulance reached the place after 30 minutes and it could not save Saurav’s life.
5:00 P.M., 6th September 2010, Hyderabad.
One calm evening, in old city, fire broke out in Madina Hotel. People saw the smoke coming out and one noble person instantly called up the fire station. By the time fire engines arrived at the spot, almost everything is turned into ashes and they could do little.
What is common between these incidents? The Emergency vehicles were not able to reach the spot in time to save the lives or damage to property.
Saurav would have survived if he were provided with a defibrillator within eight minutes of the cardiac arrest. A heart patient's chance of survival decreases by 7-9% every minute and chances of survival after eight minutes are very little. Damages to property in high-rise building can be minimized if the fire engines reach the spot in less than ten minutes of the occurrence of accident. Emergency vehicles’ commuting is a serious problem in the cities because of heavy traffic jams.
Let us give a serious thought on how we can improve the whole system. Creating a separate lane for the emergency vehicles is not feasible because of limited road space, which is already just not sufficient. Increasing the number of emergency vehicles is not an economical solution because of high capital costs involved.
Presently, sometimes, traffic police at junctions try to preempt traffic on the way of an ambulance but this is not an effective way of management. Primarily because ambulance still waits in traffic jams at the signals where there are no traffic policemen. Also traffic policemen are not clear about the priority of emergency. The frequent preemption for not so minute critical cases would cause disturbance and problems to regular road users.
I think that Traffic Signal Preemption for emergency vehicles would be most economical and feasible alternative solution for this problem. In traffic signal pre-emption, the traffic signals are manipulated to stop conflicting traffic and allow the emergency vehicle right-of-way, to help reduce response time and to enhance traffic safety.
There are two types of preemptions that can be used based on the criticality of emergency. Low priority preemption increases the holding time for green signal for a certain path whereas high priority preemption overrides all other signals.
Some of the advantages of Emergency Vehicle Pre-emption (EVP) are:
- It reduces emergency medical service response time and patient transport time, saving critical minutes and increasing the survival chances of the cardiac arrest/ trauma patient.
- It reduces the potential for an Emergency Vehicle to be in an accident en-route to the emergency scene or to the hospital, thereby reducing liability.
- It is a cost-effective alternative to build new stations or to add new vehicles by increasing the effective service radius of current facilities.
Earlier the preemption systems were expensive which might have been a deterring factor for their implementation in India. But, with the current state of art technology, they can be implemented easily. Initially I thought we may need to replace the present traffic signal systems, but after some analysis and research on the functioning of preemption systems, I realized that preemption system can be used as a plug-in to the existing traffic signals thereby involving minimum replacement costs. We can just make preemption logic to override the existing traffic signal on receiving communication signal from an emergency vehicle.
To manage emergency vehicle preemption effectively and to decrease the inconvenience to regular road users, we need to prepare guidelines for its usage. All the stake holders - hospitals management, traffic police, road users and government policy makers – must actively participate in preparing guidelines. Let us make our tiny efforts to educate road users and stake holders about signal preemption and its advantages.
(The writer's email id is: santosharjun@gmail.com)
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Comments
Helicopters!? Other ways to avoid the drive?
Will small helicopters, with 15-20 strategically placed helipad like spots (large road intersections, sizable rooftops, park playgrounds) to cover the city areas do it? Just curious, after all, lives are important, and we all know how easy it is to work with our traffic.
Does Bangalore Police not deserve a Helicopter!? Its a big city now. Little more aggressive fines and parking charges, and the City may be able to fund a few choppers. If not, share it with a few local news networks. Or, worst case, Reddy bro's could donate a few :)
On other note - you are assuming that long drives through winding traffic are necessary. There is now a hospital of some sort literally every half kilometer in the city. Connecting them, and putting them on a service network along with Traffic Police is perhaps all you need. Nearest participating hospital would respond. City could fund the vehicles, and parking space. City could force each hospital to particpiate in the program. It sounds such a simple logical thing to do that I am sure some people are working to make it happen as we speak.
Few more points to be considered
I think, I should have covered some more points, but I tried to keep the post as small as possible so that people are not discouraged from reading it.
A basic helicopter costs few crores and each helipad costs much more. I do not think our goverment has so much funds to spend for our lives.
secondly, I hadn't seen hospitals for every half kilometer, I don't know if you have any facts for that.
Thirdly, This signal preemption technology is not just for ambulances, it is very much needed for fire engines as well. I don't think we can build a fire station for every kilometer (economically not feasible).
FInally, The implementation of this technology costs us less and still it provides us benefits in an economical way. I had highlighted economical because each 108 ambulance costs around few tens of lakhs. Where as to implement signal preemption for a city like Bangalore, we can do it in less than the cost of 1-2 ambulances. By using preemption system emergency vehicles(please note that it is both ambulances and fire engines) can reach destination quickly.
Building and developing infrastructure is necessary but by implementing this technology, we can take advantage in the current situation.
I think that every second counts in few cases, without signal preemption, emergency vehicle has to slow down at every signal and it takes few minutes for it to cross a signal. With this we can make the system better.
In conclusion, this is one of the ways to improve the emergency response and we cannot neglect this. we have to consider all the options and implement the economically feasible options.
thanks for responding
hey please, please don't see this as criticism of your suggestions. I am just adding and building on, that is how things work at praja.
While solutions to provide priority to emergency vehicles (or public transport as well, refer BPS) are welcome, we all know the core issue is our own attitude which makes any "soft barrier" based solution harder to implement. Bus signal or Emegency signal or whatever, people will obstruct. How about a start towards priority for emergency vehicle via enforcement. A hefty Rs 3000 fine for not yielding to emergency vehicles, and then we will see :)
Extend that further, and add a monthly tax for each hospital that doesn't participate in the "emergency service network". This "use the nrearest hospital" (or dispatch centers around the city) approach has support of lot of people in the city. Just that nobody may have taken the initiative to make it happen.
How about we take a step back to check sity's investments in emergency/disaster services?. Do we know:
I bet the numbers have not kept pace.
Good Idea - Challenging though
Santosh, your idea is a good one, but challenging to implement. BPS and BRT lanes when implemented can help ambulances, fire brigades better. People have become too selfish and greedy for space on our roads. If this selfishness goes off and give way to emergency vehicles, as we have seen in foreign countries, emergency services can save much more lives. Hefty 3,000 rupees fine is the right idea, 'Dhandam, Dhashagunam'.
But, as silkboard suggested, helicopters are expensive, but it is used for joy rides of our elected representatives, instead could have been used for save lives.Whenever I see this IPL bidding, I feel people are ready to spend crores for hiring players. Why not such auctioning for improving these kind of facilities, our infrastructure, etc... Just a thought.
I had a recent experience of an emergency at home which I shared on Praja, and I opted for the nearest hospital although not so great hospital just to get the first aid quickly.
Thanks for your feedback
@silkboard, sorry for my tone in the reply. Thanks for your valuable points. Yeah, hefty fines is the best way to make people follow rules.
In one of the posts on praja, someone had met 108 team and they had mentioned that 70% of the calls are hoax or wrong calls. I think, they can charge Rs500 for every hoax/mis used calls to emergency services. This can be done only if Govt can make it mandatory for service providers to cut the balance or charge the given mobile/landline number.
I don't know if the fire department will provide me with those details.
Your idea of networking the hospitals is really a good one. But, I need some guidance from experienced folks like you. How to take this forward? How can i convey the feedback that i received on this blog to authorities and make the point to them. can anyone of you share your experiences?
@Vasanth, Thanks for your encouraging response. I read your personal experience with 108 and details about further meeting with them. I really liked the professionalism shown by 108 team.
Zonal Hospitals and Telemedicine
Special hospitals are now opening multiple branches such as Manipal Northside Hospital, Sagar Apollo branch at Kumarswamy layout etc. We need much more good hospital networks to come up in multiple localities. Let they have smaller buildings, particularly meant for nearby people. We also need network of Government hospitals too for those who cannot afford private hospitals.
Today, communication and Bio-Medical sciences have improved like anything. ECG,EEG, MRI, X-Ray, CT-Scan etc can be transmitted over internet. Unless a requisite is needed for the doctor to manually check and treat the patient , for examples in the case of accidents, burns, surgeries etc, we do not need specialists to visit each and every hosptial.
General doctors can take the instructions from the specialists and can give the necessary treatment. Situations like cardiac arrest could be easily treated by general doctors on the advice of specialists - Cardialogist in this case.
Video conferencing, internet etc. should be well used to treat a patient locally whenever possible rather than shifting a patient to a remote hosptial during the Golden Hours.
This approach is used in UK (I have not seen, but watched in Discovery Channel) where a general senior doctor and multiple assistants will be available in local dispenseries. A bridge line of multiple speciality doctors will be available. Doctor will dial the particular bridge and take the advice of the specialist.
Although this is little outside topic than the signal pre-empting for emergency vehicles, this could be an easy solution.
Importing technology is Expensive
@Vasanth,
I resonate with your ideas and they would help us immensely. But most of these technologies are developed in foreign countries and they will be expensive for developing countries to adapt them. We being in silicon city of India, we develop IP for MNC's. Our government should work on policies to encourage more research oriented organizations that are focussed to solve problems in our country. But how can we convey these things to policy makers and pursue with them to implement these? do you have any idea?