Immediately, the patient is put on mechanical ventilation and is rushed to the operation theatre for emergency surgery after resuscitation. An hour later, a doctor comes out of the operation theatre and tells the family that blood accumulated in the abdomen has been cleared and the patient is stable. Contentment is writ all over his tired face.
"Working in a trauma facility is hectic, true, but it is gratifying also. We save lives of people who would die at once if timely medical support is not provided," said Dr Piyush Ranjan, a senior resident doctor.
Official records show more than 56,000 trauma patients are brought to the trauma centre every year but only about 15,000 get admission. So how, does the hospital decide whom to admit?
Nirmal Thakur, the hospital spokesperson, said they have categorized injuries as life-threatening, dangerous but not immediately life-threatening, and wounds. The three categories are colour-coded red, yellow and green, respectively.
"Any patient who is unconscious and losing blood or who has severe head injury comes under code red. They are never refused admission. We take them to the resuscitation bay immediately and follow it up with necessary tests and surgeries. Code yellow patients are kept in observation for some time and the green ones are discharged after first aid," Thakur said.
Dr M C Misra, chief of the centre, said almost 40% of the cases involve young people injured in traffic accidents. "The other common causes of admission here are fall from height, assault and railway track accidents. Some patients are also referred from other states for better treatment," he said. Misra said more cases arrive on weekends and festivals like Holi. "Normally we get about 200-250 cases daily. But on these days the numbers double. We get cases of drink driving and assault, among others," he added.
The 178-bed trauma care facility that was started five years ago has also handled disaster situations such as the Mehrauli blast in 2008 and the Delhi high court blast in 2011, among a host of others.
However, there remains a huge gap in demand and supply. Incidents of relatives manhandling doctors for not admitting their patient or allegedly overlooking one patient to look after another have been reported. Most recently, a group of youths smashed the glass ceiling of the hospital's emergency block and threatened the guards posted there alleging that their friend was not being looked after properly.
"Recently, we have appointed nursing coordinators to deal with such cases. It has been seen that women are able to handle such situations better. Also, display boards have been put across the corridor where all patients' details—their present condition and intervention required—are updated on real-time basis. One major problem we face is of referrals. Many private hospitals and even the government hospitals refer their patients to us without consulting with doctors here about the availability of beds. There is an urgent need for the health ministry to come up with an inter-hospital referral and transfer policy.
"Also, rehabilitation facilities for terminally-ill patients are needed. We have many head injury and spinal trauma patients who have been at the hospital for more than six months because the family cannot take them home. They do not require any surgical intervention, only oxygen support and monitoring," said Dr Misra.
The AIIMS Trauma Centre is run by 40 faculty members, 200 resident doctors and around 350 nurses. "I have been working here for three years. Often, we have to work for about 30 hours at a stretch. But then it is a great learning experience," said Dr Piyush Ranjan.
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