Helping save lives by addressing the No. 1 killer of people in Pakistan
With rising number of road traffic accidents and gun-related violence, trauma has emerged as the number 1 killer of the people in Pakistan. On a single day [Feb 6, 2005 (Basant)], 85 stray bullet injuries were treated by doctors of the surgical unit on call at Mayo Hospital Lahore. Around 80,000 people died in the devastating earthquake in Northern Pakistan. In fact, trauma is the leading cause of death in the first four decades of life in every country of the world including US and UK. Year 2002 statistics from one surgical unit at Mayo Hosp. showed that of the 2764 patients admitted over one year, more than half of the deaths [87/ 173 (50.2 %)], were caused by trauma including burns. Recent tragic loss of > 80,000 persons and enormous amount of disabilities from Earthquake in Northern Pakistan has highlighted the role of trauma in human suffering.
For every trauma death, 3-4 further persons get maimed or disabled. Hence, not only is trauma leading cause of death, it is a major producer of disabilities as well. Trauma affects the most productive members of a society. Apart from producing orphans, it takes away the earning capacity of many survivors. Thus, social and economic implications of preventing injuries and promptly transporting and treating the victims of trauma are enormous.
Deaths following Injuries follow a tri-modal pattern. Immediate deaths occur within minutes before arriving to ER rooms and only treatment for them is prevention through education. Early deaths within hours occur from immediately life threatening injuries. Whether the patient lives or dies after injury depends upon the action taken by the treating doctors during the first hour of arrival in emergency room – “the Golden Hour”. Main thrust of trauma course is on emphasizing the urgency and prioritizing the early management of trauma during this golden hour. Potentially life threatening injuries cause late deaths over ensuing days from sepsis and multi-organ failure. These also need to be recognized and managed efficiently to prevent needless morbidity.
KEMU Trauma course has been adapted from concepts taught at American College of Surgeons ATLS® courses. The course consists of 12 interactive lectures and 12 skills stations taught over 3 days. The skills are taught on fresh human cadavers. This course equips the trainees to deal effectively with immediately life threatening situations in Emergency Room. The trainees are provided a self running course CD and a course manual. Certification is done upon satisfactory evaluation of cognitive and psychomotor skills.
Trauma is the single most important surgical disease which needs to be taught and highlighted at both undergraduate and postgraduate level in our country. Realizing the necessity of trauma education, all western countries and Middle Eastern states now require a mandatory 3 day trauma course as a pre-requisite for any doctor working in emergency or acute care surgical wards. The course is being run for the last 7 years virtually “for free” with philanthropist help,. More than 50 professors and other teachers from across the country have been helping with this national cause. Teachers are in reality the ‘true VIPs' of a nation. We have also conducted trauma courses at Nishter Medical College Multan, Punjab Medical College Faisalabad, POF Medical College Wah Cant and Sughra Shafi Hospital Narowal. Help in the form of course material / instructor training etc. has also by provided to Allama Iqbal Medical College, Postgraduate Medical Institute Lahore, and CMH Lahore in their endeavors for trauma education.