NEW DELHI: Caught between the protocols for non-Covid patients on one hand, and lack of clarity over standard operating procedures for emergency referral on the other, a 21-year-old from Dehradun succumbed to his road accident injuries in the city earlier this week. The bereaved parents are left to rue the loss of a young child. The post facto analysis of the incident still doesn’t offer any clarity on how such incidents can be avoided in future.
Devinder Singh and his wife spent anxious nights starting from Himalayan Hospital in Dehradun to three hospitals to which their son was taken after suffering a major road accident in Dehradun on January 2. Devinder and his wife brought Yuvraj to Delhi after doctors at Himalayan Hospital failed to treat him and on January 4, asked them to take Yuvraj to a higher centre in view of grade 3 aortic injury. An injury where the aorta is punctured, torn or bruised is called traumatic aortic injury.
According to the National Centre for Biotechnology Information, aortic injury is one of the most time-sensitive, life-threatening conditions. Globally, it is second only to head injury. “Approximately 4-5 surgeries were required to treat him. That’s why after stabilizing him, we referred him to AIIMS where advanced services can be provided,” said Dr Anadi Singh, a junior doctor who first treated Yuvraj at Himalayan Hospital.
However, they did not inform the AIIMS administration about the patient. “We don’t have any such policy where we officially inform other hospitals about the patient. We only refer a hospital with advanced facilities to the patient’s family on a personal level.”
When Devinder reached AIIMS, he was told that the trauma centre at the institute was converted into a Covid care ward and there were no beds available. According to Devinder, the administration referred him to Safdarjung Hospital. He then rushed Yuvraj in the ambulance which they boarded for Rs 20,000. At Safdarjung Hospital, the doctors admitted Yuvraj but after testing him Covid positive they referred him further to Lok Nayak Hospital. While the doctors tried their best at Lok Nayak Hospital, Yuvraj couldn’t be saved on January 15.
According to Deputy Medical Director of Lok Nayak Hospital Ritu Saxena, it’s very irresponsible of AIIMS and Safdarjung Hospital to further refer the patients to other hospitals without giving prior notice or information about the patient.
“We did not get any prior notice or information from AIIMS about Yuvraj who was brought to Lok Nayak Hospital on January 5. It’s a matter of great concern that SC guidelines are being violated, according to which hospitals will have to ensure that any patient requiring emergency medical care will be provided with the same,” said Dr Ritu.
According to Dr Ritu, the existing policy is universal and applies to all hospitals but on an everyday basis, patients are shunted which leads to a large number of deaths. Dinesh Gora, a senior resident doctor deployed at the Trauma Centre agreed with Dr Ritu and said that there should be a referral policy within the central institutes where patients can be referred in an official capacity.
The duty officer at the institute’s trauma care told that he had no information about Yuvraj and said the patient must have been told about the recent shifting of the trauma care to the old OPD building.AIIMS administration last month converted Jai Prakash Narayan Apex Trauma Centre into a Covid ward since the first wave of the pandemic.