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April 2018
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DIRECTOR MESSAGE
Chief Patron Message from Chief Patron & Director, GVK EMRI 01
Mr. K. Krishnam Raju Mr. K Krishnam Raju
Associate Editor
Dr Sanket Pa l
ORIGINAL RESEARCH ARTICLES
The Essen al Prehospital Care Refresher Course 11
Peter Acker, Danielle Mianzo, Elizabeth Pirro a,
Editorial Assistants Ma hew C. Strehlow, Swaminatha V. Mahadevan
Ms. Aruna Gimkala
Ms. Rani Janumpally Effec veness of CBR Training on ASHA Workers 17
Ankita Brahmarout, Purva Rajendra,
Editorial Board Rajini Danthala, GV. Ramana Rao
Dr Manu Tandon
Do all Poster abstract presenta ons
Dr MNV Prasad
get due recogni on and publica ons
Dr Narmada Devi Hadigal compared to oral presenta ons? 33
Dr Raghav Du Kumara V. Nibhanipudi
Dr Raja Narsing Rao
Dr Rama Padma CASE STUDY
Dr Shailendra Singh Paraphimosis 39
Dr Srinivasarao J Kumara V. Nibhanipudi
Dr Tiameren Jamir
Dr V.S.V. Prasad REVIEW ARTICLE
Dr Vivek Singh Good Samaritan Law 43
Dr G.V. Ramana Rao
GVK Emergency Management & Research Ins tute, Hyderabad. email: ramanarao_gv@emri.in
291)
10. Manual of Medical equipment,
GVKEMRI.
MD, MPH, FACEP, Clinical Assisstant Professor, Stanford University, Email: packer@stanford.edu
instructors), fi y took both the pre- and emergency care - primarily life-saving
post-tests. For the pre-test, their mean skills, at each step in the pa ent care
score was 72.3% (SD 10.6%) and for the process: Ac va on of EMS personnel by
post-test, their mean score was 85.3% (SD the emergency call center, the ini al
9 . 6 % ) , c o r re s p o n d i n g t o a m e a n assessment and treatment of the pa ent
improvement of 13.6% (S D Δ8.3%, by the EMT, pa ent monitoring during
p<0.001). Of the thirty topic areas transport, consulta on between the EMT
assessed, par cipants showed the and call center physician, and transfer of
greatest ini al competency in cardiac the pa ent to a healthcare facility. The
monitoring (98%pre-test average), CPR resul ng Essen al Prehospital Care
(96%pre-test average), and ven la on Refresher Training Course comprised high
(92% pre-test average). The greatest quality lectures and hands-on skills
improvement was seen in extremity workshops to be delivered over a two-day
hemorrhage control (Δ +74%), OPA/NPA period (Figures 1, 2).
usage (Δ +42%), and EMS roles and
responsibili es (Δ +32%), while decreased While this ini al data suggested that the
performance occurred in documenta on inaugural refresher course was very
(Δ -18%), airway obstruc on (Δ -9%) and effec ve in addressing a number of
ven la on (Δ -5%). educa onal deficiencies, a poten al
limita on of our analysis was that the
Discussion: MCQs were not validated prior to tes ng;
This novel assessment indicated that furthermore, no control group was
many essen al concepts and cri cal pre- available against which to compare the
hospital skills were not retained by the performance of par cipants. We will also
EMTs and highlighted the need for a need to determine the reasons for the
highly focused training strategy to address decreased performance in certain subject
these deficiencies. In response to this areas.
need, during the fall of 2013, Stanford
faculty created a new EMT refresher In addi on to the pre- and post-tes ng,
course curriculum. Rather than replicate we also solicited direct feedback from the
the G V K E M R I 6-week founda on course par cipants regarding the course
training, this new curriculum focused on (Figure 3). The informa on gathered from
knowledge and skills essen al to the the course feedback forms as well as the
op mal delivery of pre-hospital MCQ tes ng has already prompted a
reassessment of both pre- and post-tests, India in November, 2013. We found the
and revision of the teaching materials course was an effec ve teaching tool for
themselves, prior to their wide-scale EMT instructors leading to improvement
deployment to prac cing EMTs. in their knowledge across numerous key
prehospital care content areas. The next
Our next steps include the video taping of steps include assessment of this training
the course lectures and development of a course u lizing prac cing Indian EMTs
printed course syllabus. Subsequently, and development of other focused
trained EMT instructors will disseminate refresher training programs (e.g., medical,
the new refresher training curriculum to trauma, pediatric, obstetric).
prac cing EMTs in their home states.
900 PRE-TEST
Based on the success of the inaugural 930 EMS ROLES &
refresher course, plans are also in place to RESPONSIBILITY
develop a second refresher training (OVERVIEW)
course focused on common medical chief 945 ROUTINE
complaints, such as seizures, chest pain, MEDICAL/TRAUMA
and abdominal pain. This follow-up MANAGEMENT
(OVERVIEW)
refresher training program will be piloted
1000 PRE-ARRIVAL
in near future. The course content will
PREPARATION
again be focused on the most essen al 1015 SCENE-SIZE UP
informa on and skills that EMTs need to 1030 INITIAL ASSESSMENT
possess in order to save lives. 1045 GENERAL IMPRESSION
1100 POSITION PATIENT
Conclusion: 1115 TEA BREAK
Our novel assessment of prac cing Indian 1130 CIRCULATION
1145 AIRWAY
E M Ts during the summer of 2013
1200 BREATHING
iden fied cri cal gaps in their knowledge
1215 EXTREMITY
and skill reten on following their ini al HEMORRHAGE CONTROL
EMT training, and highlighted the need (PROCEDURE)
fo r a h i g h l y fo c u s e d e d u c a o n a l 1230 CPR (PROCEDURE)
interven on. In response, the Essen al 1245 AED (PROCEDURE)
Prehospital Care Refresher Training 100 LUNCH
Course was developed and deployed in 200 SUCTIONING
(PROCEDURE)
Excellent
Average
Good
Poor
ADMINISTRATION
Fair
the quality of
(PROCEDURE) the Stanford
Instructors?
945 CARDIAC MONITORING
(PROCEDURE) The level of Strongly disagree
Strongly agree
the medical
Disagree
1000 IV ACCESS (PROCEDURE)
Neutral
Agree
information
1015 GLUCOSE CHECK discussed is
(PROCEDURE) appropriate
1030 MEDICATION
Strongly disagree
Strongly agree
ADMINISTRATION The lecture
Disagree
Neutral
Agree
Fair
Strongly disagree
· Overall my favorite part of the
Strongly agree
I would like to
Disagree
course was (please list specifics):
Neutral
watch a video of
Agree
the lectures · How will the content of these
again.
sessions be helpful to you
(CIRCLE all that apply)?
A. To increase my personal
Strongly disagree
I would
Strongly agree
recommend a Disagree
knowledge
Neutral
Agree
similar course
to a B. To provide improved pa ent
peer/colleague. care
C. To improve my teaching of
I believe these EMT students
Strongly disagree
Strongly agree
sessions will D. I am unsure of the
Disagree
Neutral
Agree
allow me to
educate EMT's
usefulness
more effectively E. It will be useful in other ways
in the future. (please describe below)
My level of · What topics addressed today
Some Knowledge
Expert
emergency
medicine topics · Please make any other
BEFORE the comments to help improve the
course was: course here:
My level of Figure3: Essen al Prehospital Care
Some Knowledge
about these
Beginner
Expert
emergency
medicine topics
AFTER the
course was:
Excellent
Overall how
Average
Good
Poor
Fair
Introduc on: The ASHA (Accredited Social Health Ac vist) worker program was set up by India's Ministry
of Health and Family Welfare in 2005. The goal of the program was to bridge the gap between ci zens in
rural areas of India to the health facili es that they may need, specifically with women's health, neonatal
care, and hygiene. According to the Memorandum of Understanding (MoU) between District Medical
Health Office (DMHO)- Rangareddy District and GVK EMRI on 8th August, 2012, 100 ASHA workers from
the Shameerpet & Medchal Mandal were trained in the Community Based Resuscita on (CBR)
Programme; it was a 01 day programme. The main objec ve of the programme was to train the ASHA
workers in Basic life Support (BLS), normal delivery, and recogni on of emergencies and management.
Objec ves: The main objec ves of this study were to iden fy the usefulness of CBR training in service
delivery by ASHA workers, obstacles in applying the skills, and determine the need if any, for future
training.
Methodology: The study used both qualita ve and semi-quan ta ve methods: Focus Group Discussion
(FGD) & telephonic interviews through stra fied random sampling. Telephonic interview were
conducted using semi-structured ques onnaire prepared in light of the findings of the FGD. Quan ta ve
Data Analysis using Microso Excel was an appropriate method to determine the degree of the impact.
Results: FGD was conducted for 09 ASHA workers, and the remaining 91 ASHA workers were interviewed
over phone. Out of 91 members, we received a response from 52 members. The age group range of
par cipants in the study was 35-48 years, majority (57%) had passed SSC & Backward Class (OBC)
category. 55% of par cipants said common emergencies in their area of work are related to pregnancy.
90% of ASHA workers called 108 in emergency situa ons. 90% of ASHA workers said the CBR training was
excellent. 62% of them used it in conduc ng deliveries, 12% in pregnancy-related emergency handling.
Discussion: From the CBR training, ASHA workers u lized the advantage of some life-saving skills and the
Address: 3237 Bay Hill Lane, Round Rock, TX, USA 78705, Mail ID: ankitavb@utexas.edu,
Contact number: 512-983-8006
training has improved their confidence level to perform more effec vely in villages. Their increased social
recogni on from their ability to perform as an ASHA worker has led to some health improvement in rural
India. Most of them are sa sfied by the work they were doing, but need proper resources and financial
support to con nue health improvement in their village.
Conclusion: ASHA workers are in constant contact with the rural people of their village, especially
pregnant women. The CBR program was effec ve and helpful in emergency cases, because it was more
skill-oriented than other trainings ASHA workers had experienced. The CBR training has made the ASHA
workers psychologically feel be er about the work they were doing.
Key words: Community-Based Resuscita on (CBR) Programme, ASHA worker, Rural area, Pregnancy-
related emergencies, Delivery, Immuniza on
Introduc on
The ASHA (Accredited Social Health Ac vist) worker program was set up by India's Ministry of
Health and Family Welfare in 2005 by the is an example to what an ASHA worker's
Na onal Rural Health Commission (NRHC) role in her village is. The current training for
specifically. The goal of the program was to ASHA workers include being able to
bridge the gap between ci zens in rural communicate between rural area pa ents
areas of India to the health facili es that and hospitals, developing a health plan that
they may need, specifically with women's includes sanita on efforts, working fluently
health, neonatal care, and hygiene. “Along with other healthcare workers in villages,
with Nurse didi, the Anganwadi behen, Self counseling pa ents, ensure that pa ents
Help Group (SHG) members and the male receive the right help, treat simple illnesses
Mul Purpose Workers (MPW), you will such as colds, dispensing the right vitamins,
have some assignments to do in the village, and maintaining records. Since ASHA
like water disinfec on, or a ending the workers interact with pregnant women at
Antenatal Care (ANC) clinic/health day1.” every stage, Community Based
This quote, from Book Number 1 for Resuscita on (CBR) training includes
training the ASHA workers wri en by the useful and necessary skills to have.
Na onal Health Systems Resource Center
(NHSRC), states the beginning skills that The CBR training that was conducted at
rd th
ASHA workers are expected to master and GVK EMRI on August 23 and 24 of 2012.
the primary objec ves of the ASHA The FGD method was the best method for
5
programme is to improve social jus ce .” this study. A FGD does not discriminate
Social jus ce may include preventa ve based on people who can read or write.
measures for infec ous diseases and Considering many of the ASHA workers
assis ng pa ents in mes of dire need, have li le educa on, it is best to talk in
such as deliveries. The CBR training is a person with them. These workers may also
special training for emergency situa ons, feel uncomfortable with a one-on-one
and could improve the quality of life in rural interview and thus will not be able to speak
areas of India. their mind. A focus group eliminates that
element, and introduces a more
Studies have been conducted using the comfortable environment with a group of
FGD method on ASHA workers as well. The par cipants who are all very similar to one
World Bank in Washington D.C. in 2012 had another. A study that provides some
an objec ve of studying the performance evidence to these claims was wri en in
mo va on of community health workers, 1995 by researchers at the University of
and how it affected the ASHA program. Glasgow. “A method that facilitates the
Using surveys and F G Ds, the study expression of cri cism and the explora on
concluded that “the CHW programme of different types of solu ons is invaluable
could mo vate and empower local lay if the aim of research is to improve
women on community health largely. The services7.”Since the objec ves of this study
desire to gain social recogni on, a sense of is to determine the need, if any, for future
social responsibility and self-efficacy training and assess the knowledge and
mo vated them to perform.” However, impact of CBR training on ASHA workers,
there needs to be more amendments kept there needs to be a way to receive honest
in place to make sure the proper training opinions. The FGD is a method that
and supervision is met6. This study displays “facilitates the expression of cri cism.” If
the important aspect of mo va on. If it has there is cri cism regarding the CBR
been proven that community health training, the trainings can be modified and
workers have the desire to do well in improved for future ASHA worker classes.
society, then the FGD that was conducted
over the CBR training focused on the ASHA
workers knowledge and applica on, and Ra onale
there will be less doubt as to whether or ASHA workers play a crucial role in the
not the training competence was due to wellbeing of rural areas of India. They are
lack of interest in the workers. one of the few types of healthcare workers
assigned a number that only the objec ves through enumera on and
8
researchers were aware of, to make it tables .
easier to iden fy the par cipants. There
was a voice and video recorder during the Through the opinions of the par cipants
en re session, and there was a moderator, and their ability to correctly explain the
as well as a guide to the moderator to keep procedures done in various case scenarios,
the moderator on track. Addi onally, 2 a conclusion was made as to what kind of
observers were in the room (people who impact the CBR training had in the rural
understand the study and either communi es of the ASHA workers. The
understood Telugu or read the facial tone of the conversa on will be noted, and
expressions and body language of the any comments that trigger an emo onal
par cipants). These observers were response from other par cipants will be
assigned general topics to analyze during analyzed as well.
the session, such as “tone of the
par cipants” or “emo onal responses of CBR training conducted in GVK EMRI was
the par cipants.” Please refer to Appendix given to a sample of 100 ASHA workers.
A for more informa on over the researcher Since the FGD covered a group of 9 of these
roles and a complete list of topics the ASHA workers, telephonic interviews were
observers were assigned. Appendix B conducted with an inten on to include all
displays the ques ons to be asked to the the 100 ASHA workers, as to increase the
par cipants. At the beginning of the strength of the study.
discussion, the study was explained to the
par cipants; a form (Appendix C) with basic On calling the remaining ASHA workers for
informa on about the par cipant was telephonic interview, 52 of the 91
signed, indica ng consent. A script of the responded. The telephonic interview was
beginning and end as to be told by the conducted using semi-structured
moderator is wri en in Appendix D. ques onnaire prepared in light of the
findings of the FGD.
The means of analyzing the data was
through a Qualita ve Data Analysis. This Quan ta ve Data Analysis using Microso
method included transcribing the en re Excel was an appropriate method to
session, categorizing every statement into determine the degree of the impact. The
a code: concern, knowledge, and analysis included looking for trends and
responsibility, then further categorizing unexpected responses in the commentary
these codes into rela ons with the and telephonic conversa ons.
3% 3%
The ASHA workers were all very engaged
8%
in the discussion, and they par cipated
SSC pass
ac vely. Table 2 displays a summary of
High school educa on
Intermediate pass the points discussed for each of the
28% 57%
2 yrs undergraduate ques ons asked to the par cipants. At
Graduate
the end, the ASHA workers seemed
sa sfied and eager to help with the study.
Fig.1: Educa onal Status of Par cipants (n=61) There were about 3 domina ng
Findings and Results: p a r c i p a n t s , b u t t h e m o d e ra t o r
The age group range of par cipants in the managed to recieve a few important
study was 35-48 years. words from the quieter par cipants as
well.
Table 2: Discussion Points in FGD
Educa on Status: The educa onal status
Sl. No Facilitator Answer from participant
of par cipants of both the Focus Group Question
Discussion and the telephonic interview
1. How has - Antenatal check-up
is depicted in Figure 1. your work - Immunization
as an ASHA - Emergency situation
assistance
All the par cipants had 8 years of worker been
- Record maintenance
involvement in the A S H A worker so far?
- Educates villagers about
program. In terms of educa on, out of 61 health, family planning, and
par cipants, a majority (57%) had passed 108 usage
- Calls 108 in most cases for
SSC, while 28% received high school the patient
educa on less than SSC. 8% of them were - Distributing tablets
Intermediate pass, 3% had undergone 2 - Active role play a role in
DOT program
years of undergraduate educa on, and
the remaining 3% were graduates. 2. Let's talk 1. Spots on the patient's skin;
about some she had never seen that
emergency kind of snake bite before.
The methodology followed for further situations She immediately called
analysis of findings from FGD and you have 108 and made sure the
been in. patient's skin condition did
telephonic inter view is “Parallel
What not get worse. The patient
Synthesis” wherein both are analyzed happened made a full recovery.
independently and parallel to each other. and how did
you handle 2. Patient experiencing chest
it? pains. She advised the
A er going through the list of ques ons expected to do more than assist pa ents
and ge ng feedback from everyone, the to the hospital and treat simple illnesses.
en re session was transcribed. Along They are becoming the “li le doctors” of
with the thema c analysis of the session, the villages, as stated by several workers
the notes taken from the moderator and during the FGD. By increasing their skill
two observers were recorded and set and knowledge, they can become
analyzed as well. Every comment was more helpful to pa ents in diverse
categorized into a type of answer, such as emergency situa ons.
“knowledge, skills” or “complaints.” From
Table 3: Findings of FGD
that data, the types of comments were
Sl. No
then narrowed down into a more broad Objective: Summery
3. 2%
To determine - M a y n o t n e e d m o r e
the need if emergency training, But
any, for they want to have a OBC
42%
future knowledge in recognition SC
56% ST
training of a real emergency.
- Requesting for a refresher
programme once in a year
- Their needs are in the Fig.2 Social Status of Participants (n=52)
Anemia
Findings of Telephonic Interview: Fig.3 Common Emergencies in area of work (n=52)
Social status: At the me of FGD social As shown in Figure 3, 55% said common
status was not directly asked to the emergencies in their area of work are
par cipants to avoid any level of related to pregnancy, 25% said they are
discomfort caused by it. The social status fever and infec ous disease cases, 13%
of par cipants in telephonic interview is said accident and injury cases are most
depicted in the figure.2: common, while 4% iden fied most
common emergency as heart a ack. Very
few (2%) men oned snake bite and
anemia, respec vely.
Called 108
said while helping Sister in the hospital, Effect on service delivery a er CBR training
13%
8% said in handling a case with a 21%
Improved care to ANC
breathing problem, 8% said for giving first 11% CASES
Improvement in basic
service provided
aid, 4% used it in cord pro-lapse case, Be er deliveries
conducted
giving reassurance to the pa ent, and Confidence level
increased
bleeding control, respec vely. 55%
15%
10%
pa ent
5%
3%
0%
Medical advice Recogni on of Management of Providing Care
Required improvement for be er care
emergency emergency
related emergency handling
Figure 8.
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
As men oned in Figure 9, 25 workers said As shown in Figure 10, when asked about
they need proper health facili es with what feedback their beneficiaries gave
availability of doctors at night, 2 needed about their service, 45% ASHA workers
more medical equipment in their kit, 4 said they received good feedback, 32%
said they need more training on said they got feedback as fair, and the
pregnancy-related emergency handling, remaining 23% said they had excellent
and 1 said she needs a room to examine feedback. When asked if they would
pregnant pa ent. recommend C B R training to their
colleagues, 50 ASHA workers said they
Feedback from pa ent about ASHA would while 1 did not respond to the
workers: ques on.
Neonatal and child Dog and snake bite Infec ous diseases
Conclusion
No.of ASHA Workers
From the findings of FGD and telephonic
interview men oned above, it can be
concluded that CBR training has not
necessarily helped ASHA workers to handle emergency situa ons. Since the
conduct more deliveries, but it was a training 11 months ago, the 9 ASHA
training that ASHA workers said made workers in the FGD study had not u lized
them more comfortable and confident in the CBR training skills. Even in PPH cases,
assis ng pregnant women and which they see a lot, they are not able to
maintaining a rela onship with them. help much, except change pads on a
The CBR training has definitely improved regular basis and send the pa ent to the
the knowledge and effec veness of the hospital. The par cipants also said that
ASHA program, as interpreted from the compare to other trainings they have
ASHA workers answers to the telephonic been to, the CBR training is be er,
interviews. This was one of the objec ves because it is more skill-oriented. Despite
of the MoU. The prac cal aspect of CBR the par cipants compliments for the
was greatly appreciated. The points program and their assurance that the
shown in Table 3 and Figure 4 conclude C B R training has made them feel
that ASHA workers are doing be er at psychologically be er, it was show
iden fying and assis ng in emergency through the PPH ques on that the ASHA
situa ons, advising pa ents, and first aid workers are not u lizing their skills.
measures. This is displayed especially
through the emergency situa ons the The future work of this study should focus
par cipants described, and their ability more on the weaknesses in the ASHA
to safely and effec vely handle a program. The weakness lies in the
hypothe cal emergency situa on. inability for ASHA workers to help in their
full extent due to a lack of supplies and
ASHA workers are in constant contact money. The improvements do not
with pregnant women, and the chance of necessarily lie in training, but giving more
an emergency situa on arising is high. supplies to ASHA workers so that they
The villagers and ASHAs have to have a have the means to help villagers in case of
strong and trus ng connec on for the emergency. It was men oned by mainly
A S H A worker program to remain all the par cipants that even if they had
effec ve and be helpful in emergency to conduct a delivery, they have a
cases. Now, the par cipants are not as shortage of the supplies. If there is a weak
scared to go to villagers' homes and assist link between the government, ASHA
them. They now know they are equipped workers, and the villagers, the healthcare
with a general understanding of how to in rural areas cannot improve greatly.
h p://www.ncbi.nlm.nih.gov/pub
med/23019208. [2013 Jul 20].
7. Kitzinger, J. Qualita ve Research.
Introducing Study Groups. BMJ.
1995; 311(7000): 299-302.
h p://www.ncbi.nlm.nih.gov/pmc
/ar cles/PMC2550365/. [2013 Jul
20].
9. www.emri.in
Prof. of Clinical Emergency Medicine, NYMC & A ending Physician, Metropolitan Hosp, Ctr, NY
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Paraphimosis
Kumara V. Nibhanipudi
Prof. of Clinical Emergency Medicine, NYMC & A ending Physician, Metropolitan Hosp, Ctr, NY
Figure # 1 Figure # 2
Tight constric on band with edema of foreskin Post reduc on paraphimosis with foreskin over the glans
No regional lymphadenopathy. Rest of the PE
unremarkable.
Imp: Paraphimosia
effect and should not be used when elderly men. Am J Emerg Med. 1995
arterial compromise is suspected, May;13(3):351-3).
Regardless of the method chosen,
when In our pa ent we applied EMLA
cream over the en re edematous
foreskin and over the constric ng band
and waited for an hour. Reduc on is
applied as described in our
management. The other method of
reduc on of paraphimosis is surgical
4
emergency dorsal slit . Later on the
ul mate management for successful
reduc on of paraphimosis is
circumcision.
References:
1 ( Hayashi Y1, Kojima Y, Mizuno
K K o h r i K P re p u c e : p h i m o s i s ,
paraphimosis, and circumcision
Scien ficWorldJournal. 2011 Feb
3 ; 1 1 : 2 8 9 - 3 0 1 . d o i :
10.1100/tsw.2011.31)
4. ( W i l l i a m s J C M o r r i s o n
PMRichardson Paraphimosis in
GVK Emergency Management & Research Ins tute, Hyderabad. email: ramanarao_gv@emri.in
were covered during this survey, viz. had to, they are more likely to help a
Pedestrians, vehicle owners and patrons vic m of road accident than of violence.
at roadside establishments.
88% respondents expressed the need for
Major findings of the study: a suppor ve legal environment to enable
74% of bystanders are unlikely to assist a Good Samaritans to come forward and
vic m of serious injury irrespec ve of help injured vic ms on the road.
whether they are alone at the spot or in
the presence of others regardless of 38% of all bystanders feel that bystander
whether there were others on scene or responsibility ends with calling the
not. emergency numbers.
88% of respondents who were unlikely to 77% respondents are aware of which
assist injured vic ms stated that they emergency numbers to call to report an
were reluctant to help for fear of legal accident.
hassles, including repeated police
ques oning and court appearances. In a landmark ruling on March 4, 2016,
Supreme Court stated that it would pass
77% of respondents who were unlikely to an order on the recommenda ons of a
assist injured vic ms also stated that three-member commi ee, chaired by its
hospitals unnecessarily detain Good former Judge K.S. Radha Krishnan and
Samaritans and refuse treatment if comprising former Secretary of Road
money is not paid for treatment. Transport Ministry S. Sundar and scien st
Nishi Mi al, which had demanded
78% of respondents belonging to the protec on for those saving accident
lowest socioeconomic bracket (probably vic ms. Chronology towards Good
the poorest people on the road) are Samaritan Law in India are as follows:
unlikely to come forward to assist a
vic m. 72% of middle income and 70% of I. 2012: Public Interest Li ga on (PIL)
upper-income respondents stated that filed by SaveLIFE Founda on.
they would not come forward to help the
injured vic ms. ii. October 29, 2014: The Supreme
Court directed the Centre to issue the
58% respondents admi ed that if they necessary guidelines with regard to the
vi. March 30, 2016: The Supreme Court Even when Good Samaritans agree to
approved the guidelines issued by the become witnesses, the guidelines accord
Centre. them protec on and comfort. They
ensure that:
The guidelines lay down the following:
1. If a Good Samaritan chooses to be a
1. The Good Samaritan will be treated witness, she will be examined with
respec ully and without any utmost care and respect.
makes a phone call to inform the police or either be by way of a commission under
emergency services for the person lying sec on 284, of the Code of Criminal
injured on the road, shall not be Procedure 1973 or formally on affidavit
compelled to reveal his name and as per sec on 296, of the said Code and
personal details on thephone or in StandardOpera ng Procedures shall be
person. developed within a period of thirty days
from the date when this no fica on is
(5) The disclosure of personal issued.
informa on, such as name and contact
details of the good Samaritan shall be (9) Video conferencing may be used
made voluntary and op onal including in extensively during examina on of
the Medico Legal Case (MLC) Form bystander or good Samaritan including
provided by hospitals. the persons referred to in guideline (1)
above, who are eye witnesses in order to
(6) The disciplinary or departmental prevent harassment and inconvenience
ac on shall be ini ated by the to good Samaritans.
Government concerned against public
officials who coerce or in midate a (10) The Ministry of Health and Family
bystander or good Samaritan for Welfare shall issue guidelines sta ng that
revealing his name or personal details. all registered public and private hospitals
are not to detain bystander or Good
(7) In case a bystander or good Samaritan, Samaritan or demand payment for
who has voluntarily stated that he is also registra on and admission costs, unless
an eye witness to the accident and is the good Samaritan is a family member or
required to be examined for the purposes rela ve of the injured and the injured is to
of inves ga on by the police or during be treated immediately in pursuance of
the trial, such bystander or good the order of the Hon'ble Supreme Court
Samaritan shall be examined on a single in Pt. Parmanand Katara vs Union of India
occasion and the State Government shall & Ors [1989] 4 sec 286.
develop standard opera ng procedures
to ensure that bystander or good (11) Lack of response by a doctor in an
Samaritan is not harassed or in midated. emergency situa on pertaining to road
accidents, where he is expected to
(8) The methods of examina on may provide care, shall cons tute
disseminated to all hospitals in the State Though the law is applicable all across,
for incen vising the bystander or good Karnataka State was the first state to pass
Samaritan as deemed fit by the State the bill in Legisla ve Assembly (2016)
Government. with a tle Good Samaritan and Medical
professional (protec on and regula on
(14) All public and private hospitals shall during emergency) where in defini on of
implement these guidelines immediately Good Samaritan used was a person who,
and in case of noncompliance or viola on in good faith, without expecta on of
2. h p s : / / e n . w i k i p e d i a . o r g
/wiki/Good_Samaritan_law
3. h p://www.canadian