title: Development and Implementation of a Novel Prehospital Care System in the State of Kerala, India.
abstract: Most low- and middle-income countries (LMICs) have struggled to find a system for prehospital care that can provide adequate patient care and geographical coverage while maintaining a feasible price tag. The emergency medical systems of the Western world are not necessarily relevant in developing economic systems, given the lack of strict legislation, the scarcity of resources, and the limited number of trained personnel. Meanwhile, most efforts to provide prehospital care in India have taken the form of adapting Western models to the Indian context with limited success. Described here is a novel approach to prehospital care designed for and implemented in the State of Kerala, India. The Active Network Group of Emergency Life Savers (ANGELS) was launched in 2011 in Calicut City, the third largest city in the Indian State of Kerala. The ANGELS integrated an existing fleet of private and state-owned ambulances into a single network utilizing Global Positioning System (GPS) technology and a single statewide call number. A total of 85 volunteer emergency medical certified technicians (EMCTs) were trained in basic first aid and trauma care principles. Public awareness campaigns accompanied all activities to raise awareness amongst community members. Funding was provided via public-private partnership, aimed to minimize costs to patients for service utilization. Over a two-year period from March 2011 to April 2013, 8,336 calls were recorded, of which 54.8% (4,569) were converted into actual ambulance run sheets. The majority of calls were for medical emergencies and most patients were transported to Medical College Hospital in Calicut. This unique public-private partnership has been responsive to the needs of the population while sustaining low operational costs. This system may provide a relevant template for Emergency Medical Services (EMS) development in other resource-limited settings. Brown HA , Douglass KA , Ejas S , Poovathumparambil V . Development and implementation of a novel prehospital care system in the State of Kerala, India. Prehosp Disaster Med. 2016;31(6):663-666.
authors.affiliation: 1Department of Emergency Medicine,Palmetto Health Richland/University of South Carolina,Columbia,South CarolinaUSA.
authors.forename: Heather A
authors.initials: HA
authors.lastname: Brown
authors.affiliation: 2Department of Emergency Medicine,The George Washington University,Washington,DCUSA.
authors.forename: Katherine A
authors.initials: KA
authors.lastname: Douglass
authors.affiliation: 3Department of Emergency Medicine,Malabar Institute of Medical Sciences Limited,Calicut,India.
authors.forename: Shafi
authors.initials: S
authors.lastname: Ejas
authors.affiliation: 3Department of Emergency Medicine,Malabar Institute of Medical Sciences Limited,Calicut,India.
authors.forename: Venugopalan
authors.initials: V
authors.lastname: Poovathumparambil
mesh_terms: D000552:Ambulances; D004632:Emergency Medical Services / Q000458:organization & administration*; D006801:Humans; D007194:India; D016730:Program Development / Q000379:methods*; D055818:Public-Private Sector Partnerships
keywords:  ABERT ANGELS Bike Emergency Rescue Team;  ALS Advanced Life Support;  ANGELS Active Network Group of Emergency Life Savers;  BLS Basic Life Support;  CATS Centralized Accident and Trauma Services;  EMCT emergency medical care technician;  EMRI Emergency Management and Research Institute;  EMS Emergency Medical Services;  GPS Global Positioning System;  ICU intensive care unit;  LMIC low- and middle-income countries;  WHO World Health Organization; Emergency Medical Services; India; ambulances; developing nations; paramedics; prehospital emergency care