India needs trauma centers to avoid accidental deaths
India has no plans for accidental deaths
We hear a lot about trauma centers in our country but the fact is that there are very few such centers in our country compared to the industrial growth rate, increasing number of vehicles, increasing political and social incidents, rapes and other public unrest which are increasing the number of seriously injured patients in our country. Most of the persons injured in accidents do not reach to proper hospitals in time and the ones who reach to a hospital do not get the proper treatment which could have saved them from death or permanent disability. In fact, if we had proper hospital facilities in our country we could have saved at least 10% people from death.
Actually, India is a country that has very poor health facilities and as far trauma centers are concerned we are too far behind in developing trauma centers. There are plans for developing network of trauma centers on different highways especially the Golden Quadrilateral which is the highway network connecting many of the major industrial, agricultural and cultural centers of India. The initial plans is to begin with 140 trauma centers one at every hundred kilometers from each other but the scheme never took off.
India has no proper roads development program which adds to the existing problems of comparatively more accidents. India has only one percent of vehicles at the moment but the cases of roads accident are 6% and number of death accounts for 10% of the total number of such deaths in the world. This clearly indicates that there is not enough arrangement of treatment despite having a very high rate of accidents. In fact the number of deaths due to road accidents account for 9th highest number of deaths which will become the 2nd highest by the year 2020.
Poor planning for accidents and treatments
It is hard to believe but presently there is no scheme coming up for establishment of trauma centers in our country apart from few centers in New Delhi and other metros which are just not enough for a country of the size of India. For instance we have a good trauma center at AIMS but this serves a limited area of NCR. We need to have thousands of such centers throughout the country to serve our citizens better and help save their lives and limbs. In fact, we should start working on such a method in multiple phases beginning with pre-care of accident victims before they reach to a proper hospital. The state governments are working on this scheme posting mobile hospitals and ambulances at important highways.
However, the efforts are not enough as we need a trained paramedic force to look after accident victims before they reach to a hospital. Our next priority should be to maintain a good networking facility between the hospitals and providing a proper communication system that will help taking good care of the victims. The fourth and the most important phase of the plan should provide the best possible treatment to the victims as the chances of survival increase if a victim reaches to the proper care center within two hours of accident and better still if he gets the needed surgery within four hours of accident.
What is trauma?
It is a common question which has a varied answer as the trauma is not limited to physical injuries but has lot more than that. A trauma center is not just an emergency treatment center like ICU but has multiple ways of treatments. To be specific a trauma center is an specialized hospital which is capable of handling and equipped with doctors, staff and equipment which can provide treatment to patients who are suffering from diseases which are not common accidents but come under the category of major injuries which could be physical to mental or having social reasons. A trauma center also treats general emergencies in case of major accidents but is in no way common emergency treatment centers.
What does trauma cover?
The Trauma Centers not only provide the patients mental health services but could provide treatment to dissociation, GLBTQ issues which deal with lesbian, gay, bisexual, transgender, and young people having multiple questions about multiple topics, the youth and adults survivors during wars, crime victims and victims of hate crimes, group physical abuse, emotional abuse and neglect, and of course suffering from sexual abuse facing psychological trauma, accidents and injuries, chronic trauma and complex trauma, parents of traumatized youth, attachment trauma, children and families involved with the adoption/foster care/child welfare system, divorce related mental problems, old age related mental problems, intimate partner violence and inter-generational trauma and there is so much more to this complex problem which the doctors at trauma centers face day in and day out.
Trauma- a complicated problem
Trauma, which means a deeply distressing or disturbing experience, serious injury to the body, as from physical violence or an accident has lot more than which could be an experience that causes severe anxiety or emotional distress, such as rape or a mental or physical injury during war. The sufferings could be in form of social, mental, physical or the victim might have gone through a phase which made him feel ashamed of an incident where he/she had no control on the situation. Most people suffering from trauma find them in a stage where they feel unsecured, afraid, lonely and absolutely helpless and the worst of all hapless. However, we can categories the trauma patients-
Physical Trauma- We can easily categories patients suffering from physical trauma as these are the victims of road accidents, fire, falls and violence. The road accidents are the major reason of such victims causing almost 20 million hospitalizations and almost 5 million succumbing to injuries throughout the world every year and the number is increasing at a rapid rate. India is major sufferer in this category as it accounts for more than one million deaths and much more left limbless.
Emotional Trauma- Many people suffer from different other reasons even if they do not go through any physical suffering but loss of a near or dear one, divorce and other family problems are some of the major reasons besides the failure in certain fields like love, exams and competitions and of course the victims of rape and crime, group violence, religious violence, post surgery etc also cause traumatic problems. If we have to believe the reports almost 80% people face some or the other traumatic accident during their life time and almost 30% of them face post traumatic stress disorder (P.T.S.D) and there is another important factor that women suffer more from P.T.SD.
The symptoms of Trauma
There are various obvious and hidden symptoms of trauma which do not appear immediately but surface as the time passes by, some of the obvious symptoms are-
- Doubt or disbelief
- Anger, sudden change in mood or disruption
- Anxiety and emotional distress
- A sense of helplessness or self-blame
- Difficulty in concentration
- Excitement or feeling loneliness
- A patient suffering from traumatic disorder becomes the victim of sleeplessness or nightmares as he constantly go through the bad dreams during his short duration of sleep
How to face traumatic disorders
It’s easier to say so but in fact very hard in real life but one has to face the facts. One cannot change what has happened so to live a normal life one should try to bring himself in the mainstream as soon as possible which is the only way to live in this society. If the family members help the victim coming to normal course the chances are he faces the situation far easily. But patient has to keep his views positive which plays a major role in his comeback attempt. The experts say watching comedy and entertaining movies, reading jokes and spending time with children is a good way of coming out of stressful mental situation.
The patients should try to sleep normally, exercise regularly and practice yoga along with breathing exercises. People suffering from traumatic disorders should avoid alcoholic drinks and smoking which only increases the problem as the patient might go under the effect of anxiety, stresses and loneliness. As mentioned earlier regular exercise helps bring the normalcy as it gives the body of the patient a feel-good factor and also helps sleep better. Eat normal food and mix in social activities which will bring you faster in the normal lifestyle. Medical help, psychiatric treatment, psychoanalysis is helpful but the support of the family and friends is what helps patients suffering from traumatic disorders.
Medical support is must
People must see an expert as soon as possible in case the symptoms persist even after the weeks of the accident or mishap although people try to avoid going to psychiatrists or experts of handling such cases because they feel they are not sick but suffering from temporary symptoms which will go as the time passes which is not true in all cases. According to experts one should immediately make it a point to contact a trauma expert if
- The person suffering from severe emotional or mental distress caused by an experience beyond his control
- The person is not able to come out of the incident or not feeling normal even after 6 weeks of the incident
- Not able to sleep properly or behaving carelessly
- Not able to work properly or smoking or drinking more than in normal course
- People are suggesting to see a doctor
What a person suffering from traumatic disorders should do?
The symptoms indicate that the person is suffering from traumatic disorders and perhaps the best thing he can do is to write his experiences on a paper regularly. That will help bring him to normal course up to some extent and in case of minor problem this could save you from going to a doctor. Writing your problems on a paper helps you sort out the problems since you exactly know about your problems. One has not to be an expert writer while writing about his problems but he must write in detail as he feels at that particular moment. And this has been proved scientifically that the people who write regularly about their sufferings and problems easily find a solution easily.
How they treat at trauma centers?
The post trauma treatment is kind of combined treatment with traditional surgery, medicines and psychotherapy according to trauma effects on a particular patient. A trauma center determines the intensity of the effects and treats the patient according to his needs as per the physical and mental condition of the patient. Obviously, a patient suffering from psychological problems gets psychotherapy and talk therapy or a special therapy developed by an American doctor which is a special therapy known as Cognitive therapy or the therapeutic approaches within the larger group very much helpful in cognitive behavioral therapies.
Certain people need exposure therapy which helps them retrain their mental problems. In this procedure the patients is trained to fight with his fears by sending the fear signal even when there is the slightest chance of fear or any such danger around. It's mostly with patients who exaggerate their fear phobia and feel extremely fearful. The therapy helps the patient come out of his fear psychosis. The patients find themselves troubled by hallucinations, sensory problems in which they find lights too bright and noises too loud. The patient gets confused easily or finds himself in false personal beliefs which have either no base or incorrect beliefs about the reality.
Group therapy is another way of treating people going through the similar psychotic disorders and experiences. The patients in such groups share their experiences with each other and try to sort out their problems. In fact many patients feel comfortable talking to each other. Meanwhile the patients are given anti-anxiety and anti-depressant medicines which help them keep calm.
The way the injuries and other related problems are constantly going up in India and becoming the major health problem this is time we wake up and find a proper solution. As I have mentioned earlier road accidents will be the second biggest killer in India and the third largest killer in the third world countries. We have done very little in this direction and must act immediately to get the dubious distinction of becoming the worst nation in handling this killer situation.
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