Dr Varinder Sharma
Emergency healthcare is one of the most crucial components of any hospital, particularly in regions like Jammu and Kashmir, where the combination of terror incidents and treacherous terrain frequently results in major accidents. The emergency departments in hospitals across this region must be equipped with both the manpower and equipment to handle a high volume and variety of critical medical emergencies simultaneously. Unfortunately, this is not the case in the majority of hospitals within the region. The Jammu Division, with its extensive mountainous terrain, faces even more challenges than the Kashmir Division. This region is not only home to a large population but also hosts over one crore pilgrims visiting Jammu and Katra annually. Additionally, during the harsh winters, a significant number of people from Ladakh and Kashmir migrate to Jammu, further straining the region’s healthcare resources. As a result, GMC Jammu often finds itself overburdened, far beyond what is typical for a hospital of its size.
Despite the establishment of new GMCs and the upgrading of district hospitals, GMC Jammu remains the preferred referral hospital for emergencies in the region. The institution has long served as the backbone of medical facilities in the entire Jammu Division, and this reliance has only grown over time. However, despite the best efforts of the hospital staff, GMC Jammu struggles to provide the highest level of emergency services due to the absence of dedicated emergency specialists.
Given the Government’s ongoing efforts to upgrade healthcare facilities in the region-with the establishment of new GMCs, specialised hospitals like the Bones and Joints Hospital, and the State Cancer Institute, as well as the opening of an AIIMS OPD-the focus must now shift to creating a robust emergency department at GMC Jammu. Here comes the necessity of emergency specialists. The primary role of an emergency specialist is to quickly assess a patient’s condition and make immediate, life-saving decisions. In practice, however, this critical function is often compromised, particularly during off-peak hours, when even non-critical patients seek treatment in the emergency department. The lack of specialised emergency specialists at GMC Jammu means that the first critical moments, which can often determine the difference between life and death, are not always optimally managed.
Today, an emergency specialist is a vital and dynamic speciality that forms the backbone of any hospital’s ability to handle critical medical situations. In India, the role of emergency specialist doctors, also known as emergency physicians, has grown significantly since the speciality was officially recognised by the Medical Council of India in 2009. These doctors play a crucial role in diagnosing, treating, and stabilising patients who present with a wide range of acute and often life-threatening conditions. Roles of Emergency Specialists are so well defined now in any hospital. The challenges they face and the importance of their work in the healthcare system are beyond description.
Emergency specialists are trained to diagnose and treat patients with acute medical issues, often under time constraints and with limited information. They must quickly assess a patient’s condition and make critical decisions to stabilise them. In Jammu, where the healthcare system is often overwhelmed, this role is particularly challenging. Emergency physicians are adept at handling a wide variety of medical emergencies, ranging from heart attacks and strokes to severe trauma from road accidents. Trauma from road accidents is a leading cause of death and disability in J&K. Emergency specialists who specialise in blunt trauma are crucial in providing rapid and effective care to patients who have suffered injuries from such incidents. Their quick interventions can be the difference between life and death.
One of the most critical roles of emergency specialists is to prevent life-threatening complications. In emergencies, time is of the essence, and any delay can lead to severe consequences. For instance, a patient suffering from severe bleeding needs immediate attention to prevent shock and death. Emergency specialists are trained to quickly assess such situations and take necessary actions.
In Jammu, where GMC Hospital often faces overcrowding and resource constraints, the ability of emergency specialists to triage patients effectively is vital. They have to prioritise patients based on the severity of their conditions, ensuring that those who need immediate care receive it while others are stabilised and monitored.
Effective communication is key in emergency medicine. Emergency specialists often serve as the bridge between the emergency department and other hospital departments. They communicate clearly and promptly with other doctors, surgeons, and specialists to ensure that patients receive the appropriate follow-up care. For example, a patient presenting with symptoms of a heart attack may need to be quickly assessed by an emergency specialist, stabilised, and then referred to a cardiologist for further treatment. Similarly, patients with severe trauma may require the expertise of trauma surgeons, orthopaedic surgeons, or neurosurgeons. Emergency specialists are experts in coordinating these efforts, ensuring a seamless transition of care. In a region where hospitals can be chaotic and the healthcare system is stretched thin, the ability of emergency physicians to communicate effectively is particularly important. Miscommunication or delays can lead to severe outcomes, so these doctors are skilled in working within multidisciplinary teams and making quick decisions.
Emergency specialists primarily work in hospital emergency departments, often referred to as “emergency rooms” or “casualty wards.” However, their role is not limited to these settings. They may also work in urgent care centres, trauma units, and at the scenes of major accidents. The nature of their work requires them to be highly adaptable, as they may encounter a wide range of medical conditions on any given day. A typical day for an emergency specialist is unpredictable. They may start their shift by checking in on patients in critical condition, responding to trauma calls, or handling multiple emergencies at once. The working hours are often long and include night shifts, day shifts, and on-call duties. Despite these challenges, the work is immensely rewarding, as emergency specialists have the opportunity to make a direct and immediate impact on patients’ lives.
Emergency specialists are no longer a luxury but an urgent necessity. Their expertise can significantly improve patient outcomes by ensuring that immediate and appropriate medical care is administered without waiting for the opinion of an on-call doctor, a delay that can be fatal in critical cases. GMC Jammu has to go for emergency specialists now. Criticality doesn’t differentiate between rich and poor, or, for that matter, VVIP or an ordinary patient. It is for the betterment of the entire society to equip GMC Jammu with the best of emergency specialists. A proper scrutiny of GMC Emergency case histories will substantiate how narrow the time line between life and death is.
Given the presented facts, the recruitment of emergency specialists should be a top priority for the J&K Government. Once these specialists are in place, other essential resources, such as advanced equipment and trained support staff, can be gradually added. Simultaneously administration should push for starting PG in Emergency Medicine in GMCs. While it is undeniable that GMC Jammu has been providing commendable services under challenging circumstances, there is always room for improvement. The introduction of emergency specialists could be a game-changer, elevating the level of care and significantly enhancing patient survival rates. Continuing with the existing system without the presence of emergency specialists risks compromising patient safety. In a region where every second counts, the availability of these specialists could mean the difference between life and death. The administration must act swiftly to create and fill these critical positions, ensuring that GMC Jammu is fully equipped to handle the demands placed upon it.
The fact is that the need for emergency specialists at GMC Jammu cannot be overstated. These professionals are essential for providing the best possible care in emergencies, and their absence is a gap that must be addressed immediately. The government’s commitment to improving healthcare in Jammu and Kashmir will only be fully realised when emergency services are staffed with the emergency specialists required to meet the unique challenges of the region. The present regime is always looking for ways to improve healthcare facilities in the region, and this addition to GMC Jammu is no doubt the need of the hour. Their addition will definitely be a boon to the entire populace of the UT and will enhance the stature of GMC as the premier medical institute of Northern India.
(The writer is co-convener professional cell J&K BJP)
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