KARACHI: “Where does Pakistan stand in emergency medicine? Unfortunately, we are far below other countries,” said Dr Ashfaq Ahmed, consultant for emergency medicine at the North Middlesex University Hospital, UK. He shared these views at a symposium titled ‘Emergency Medicine and trauma management’ at the Ziauddin University Hospital on Saturday.

Trauma was a leading cause of death in young patients, he said, adding that Pakistan needed to implement certain standardised procedures for managing trauma adopting techniques that are used by other countries in the world. “Emergency medicine in the world has progressed tremendously, but Pakistan lags far behind.”

Speaking about trauma leadership and management, Dr Ahmed encouraged students and medical practitioners working in emergency departments in Pakistani hospitals to adopt these techniques to maximise efficiency.

Dr Ahmed then shared the case of a 20-year-old hit by a car and suffering from heavy impact injuries. Step by step he went through the procedures that must be adopted by those who wish to lead the trauma team.

He explained different stages of the process, from self-protection, to taking charge of the trauma patient, ascertaining the level of training of the team, and delegating the roles according to the standard procedures of managing a trauma patient.

‘Emergency medicine in the world has progressed tremendously, but Pakistan lags far behind’

Dr Munira Burhany, haematologist, explained to the students the importance of massive blood transfusion protocols for trauma patients.

“Blood coagulation is a very delicate balance between the homeostasis and thrombosis and unless one does not understand this delicate balance, one will not be able to manage the patient in the trauma centre.”

Haemorrhage and blood loss causes innumerable deaths and usually it’s caused if a trauma centre incharge is unable to secure bleeding and maintain homeostasis in trauma patients. Thus, said Dr Burhany, there was a need to develop a massive transfusion protocol.

“The development and implementation of massive transfusion protocols have been associated with a reduction in mortality and overall blood product use in trauma centre.”

Disaster management and dealing with trauma cases in the advent of man-made or natural disasters was also discussed by Dr Nadeem Ullah Khan, who is associate professor, emergency medicine, at the AKUH.

He spoke particularly about how deaths caused by disasters were far higher in poor countries than in wealthy nations. “Pakistan is among the top 20 countries with the probability of disaster deaths, which is alarming. This is why there is a need to establish disaster management and preparedness techniques in hospitals as well as outside.”

Biological and chemical warfare, he said, could be used by militaries to create disasters because they were much cheaper alternatives than nuclear or conventional warfare. Yet it wreaked a similar intensity of havoc and casualties.

He also spoke about the necessity of disaster response and preparedness which could help save countless lives. To achieve this, he explained, hospitals needed to be well-equipped to handle emergencies. Governments too are not exempt from this and need to put into place policies that will help them cater to threats and emergencies based on previous data.

The symposium was an attempt to update students of emergency medicine with the latest techniques, protocols, research, and technological advancements in the field of trauma management.

Published in Dawn, January 14th, 2018