KARACHI: Raising concern over the growing number of deaths caused by injuries, experts at the inaugural session of 5th AKU Surgical Conference on Friday underscored the need for taking safety measures and adopting a systematic approach to improve trauma care.

Titled ‘Trauma: Striving for Change’, the event was organised by Aga Khan University’s department of surgery.

Elaborating how a systematic approach would help improve trauma care, speakers said it would ensure that life-saving interventions were performed in a timely manner and that no life-threatening conditions were missed.

In this respect, they also referred to the WHO guidelines according to which such an approach could consist of emergency care in the form of first aid being provided by a trained bystander, who could also call an ambulance — equipped with necessary life support and at least two personnel — one to monitor and manage the patient and the other to drive.

The ambulance personnel should be able to communicate to a relevant hospital prior to arrival, if needed.

During the handover, it was pointed out that the ambulance provider should share critical information with the hospital personnel, who then triage patients according to a system of priorities based on the seriousness of their condition.

During the event, Prof Syed Ather Enam, chair of AKU’s department of surgery, referred to a case of a two-and-a-half-year old boy, who sustained three gunshots at point-blank range.

The child was unresponsive when the terrified family brought him to the emergency department of the Aga Khan University Hospital after trying two nearby hospitals.

When the patient did not respond to initial resuscitation efforts, a team of paediatric, cardiothoracic and orthopaedic surgery, and paediatric anaesthesiology specialists was taken on board and he was moved to the operating room immediately.

“Today, he is a healthy four-and-a-half-year-old schoolgoing child. There could be thousands of people who were not lucky like him. That’s because our hospitals lack multidisciplinary teams of specialists and the emergency care system as a whole is short of fully equipped ambulances and trained bystanders,” Prof Enam said.

The conference brought together national and international professionals with expertise in pre-hospital care, mass casualty, rehabilitation, prevention and disaster management.

“Since blood loss is the leading cause of preventable death following injury, rapid control of bleeding at the scene of an event can be lifesaving, especially if bystanders can step in to help before emergency responders arrive,” said Eileen Bulger, a professor of surgery at the University of Washington.

Speakers also noted that provision of emergency care was essential to many targets of the United Nations’ Sustainable Development Goals (SDGs).

Under the SDG 3, they said, post-crash emergency care and rehabilitation had been estimated to play a role in preventing 40 per cent of road traffic deaths. Also, timely emergency care access was critical to effective universal health coverage.

“Emergency care could also contribute to efforts to achieve targets under 10 more SDGs by addressing non-communicable diseases, obstetric complications, child health issues, and injuries related to disasters and violence,” said Hasan Badre Alam, a professor of surgery at the University of Michigan.

AKU vice provost Anjum Halai, dean of the AKU’s Medical College Adil Haider and chair of the event’s organising committee Hasnain Zafar also spoke.

On the second day of the conference, the upcoming Centre of Excellence for Trauma and Emergencies of AKU and its partners will launch a national life-saving initiative focused on bystander training in life support.

Published in Dawn, February 15th, 2020