CATS ambulance responding to more calls, but taking 15 minutes longer to reach patients
The average time taken by the Centralised Accident and Trauma Services (CATS) ambulances to reach callers went up from 10 minutes in 2009-10 to 25 minutes in 2017 even as the number of calls it responded to each month went up four times.
The time taken has gone up despite CATS adding 221 ambulances to its fleet since 2010, taking the total to 265. Of these, 124 are patient transport ambulances, 110 are basic life-support ambulances, and 31 are advanced life-support ambulances.
The internationally accepted response time set by the National Fire Protection Association (NFPA) is 8 minutes.
In 2009-10, 70,768 calls were received over a period of 12 months, 72% of which were responded to. The ambulance service now responds to an average of 20,000 calls every month, with CATS responding to nearly 29,000 calls in January.
“Eight to 10 minutes is what an ambulance should take to reach the site of a trauma to ensure that patients receive proper care within the golden hour— the first hour after trauma when the chances of survival are the highest,” Dr Shakti Gupta, head of the department of hospital administration, AIIMS, said.
The Delhi government has started a “modern” control room that can dispatch ambulance closest to the caller based on GPS location, response remains slow because in 2016, the scope of CATS ambulances was expanded to include all medical emergencies, rather than trauma and pregnancies that it catered to previously.
“Earlier, there were very few ambulances, so some calls from far-off locations might have been rejected. Now we respond to all calls,” said Dr Rana. In 2009-10, when Dr Gupta and his team, analysed the CATS call records, they found that the ambulance service rejected 28% of all calls that came in. The number of calls has also shot up.
A site response time of 3-5 minutes, achieved by having an ambulance for every 50,000 population stationed every 5 square kilometre, for the CATS ambulances had been recommended by the All India Institute of Medical Sciences (AIIMS), under the aegis of the health ministry.
With a population of 1.8 crore, Delhi would need 360 ambulances.
“Although, CATS has 265 ambulances, there are more than a thousand private ambulances that run in the city. So there is no shortage. However, the problem is that there are several areas in Delhi that are congested and the ambulances take time to reach,” said Dr LS Rana, who heads CATS. Dr Gupta agrees, “the ambulances take longer in areas like Chandni Chowk where navigating the narrow lanes and traffic takes a long time.”
To address this issue, the government is in the process of launching a pilot project with 16 first responder vehicles – two wheelers with paramedics equipped to stabilise emergent patients.