HEAD INJURY LEADS TO SEIZURES

1. HEAD INJURY LEADS TO SEIZURES Two wheeler on a highway can be dangerous when it is involved in an accident. On 9th April 2014, at 19:54 hrs CHC Thakurdwara ambulance was assigned to a road traffic accident. Rider of the bike was rescued by the 108 team who responded immediately with all first aid equipment. Shahnawaj 22/M who is travelling from suraj nagar to sharif nagar in Moradabad district in late night met with an accident on sharif nagar highway which lead to head injury. EMT Miss. Deepa performed rapid trauma assessment which revealed the victim had a head injury which was bleeding heavily from his scalp and his right lower leg appeared to be fractured with multiple abrasions all over the body. He was responding to verbal stimulus. Victim was complaining of severely leg and neck pain.EMT immediately controlled the major bleeding and splinted the fractured leg. EMT suspected neck injury as he was complaining of neck pain so she applied C-Collar to the victim with the help of Pilot. Then with all spinal precautions victim was shifted to ambulance on spine board. In ambulance EMT took initial vital signs of the patient and the vital signs were BP-100/80 mm of Hg, Pulse- 84 bpm, RR-16 bpm,SPO2-92 % and the Pupils- right pupil was normal, round and reacting to light where as left pupil was constricted and non reacting to light.EMT was trying to contact ERCP but suddenly patient started seizing ,which lasted for some seconds.EMT cleared patients airway by suctioning and recovery position was given to the patient. EMT contacted ERCP Dr. Praveen for further guidance. Under ERCPs advice EMT gave oxygen by using non rebreather mask, EMT administered required medication and fluid support and monitored his vitals along with the seizure episodes and the time it lasts.  Enroute EMT performed ongoing assessment and she found his status was improving and the SPO2 reached to 100% on oxygen. EMT shifted patient to CHC thakurdwara where he was referred to district hospital Moradabad by MO of CHC.  Patient was handed over to casualty medical officer of district hospital; he appreciated the work done by Miss. Deepa who saved the patient with prompt treatment under the advice of ERCP.  After 48 Hrs follow up patient found to be alive and improved. AMBULANCE LOCATION: CHC Thakurdwara MORADABAD CASE ID: 4202785 ERO: SUNIL KUMAR PATEL DATE: 09-04-2014 CALL TIME: 19:54 HRS ERCP: DR. Praveen RECEVING HOSPITAL: DISTRICT HOSPITAL, MORADABAD.

2. journey turned to tragedy As we all know buses are fairly safe mode of transportation but just because there may be fewer traffic accidents involving buses, compared with car & motorcycles.  In Early morning hours, Emergency Response Center got a call for a case of Volvo bus roll over (travelling from Barabanki to Delhi) where nearly 110 people were travelling. The team of police from police station fathgegunj reached the accident site and started extricating people after activating emergency response system 108.ERO immediately dispatched the case to CHC fareedapur, EMT-Vinod kumar and Pilot-Pankaj kumar rushed to the scene.   Upon arrival at the scene, once the EMT confirmed the scene safety approached the patients where he found two people were trapped in bus with the help of pilot and police EMT extricated two people by using extricating tools.   Then EMT found nearly 50 people were injured.EMT immediately informed ERC for the additional help required for him to handle all the patients.EMT immediately started triaging 50 patients where he found 12 were dead (Black category), 15 people need immediate interventions (Red category) and 23 people were having minor injuries (Yellow & Green category) like abrasions all over the body, avulsions and small lacerations which could be managed by additional help provided.  EMT approached the severely injured patients who were profusely bleeding from hands and legs due to open fractures, it was managed by bleeding control, wound care and splinting. Head injury patient was shifted to ambulance with all spinal immobilsation.Open wounds were managed by dressing and bandaging and shifted all the 15 patients to CHC Faridabad which is nearly 5 kms from accident site for stabilizing the critical patients. Initial vitals were monitored by EMT immediately contacted ERC Physician,Dr. Ashish Awasthi for further management. As per the Physicians advice EMT placed an Intravenous line and administered Normal saline for required patients.  In the mean time 3 more 108 ambulances reached the accident site where other 23 people were shifted to CHC Faridabad for further medical assistance. Enroute EMT reassessed the patients’ condition and Pilot was able to reach CHC Faridabad within minutes. Patients were handed over to medical officer of CHC Faridabad, who appreciated the process of triaging and the pre hospital care provided by ambulance team and handing over of head injury patient with all spinal precautions were commended. After 48 Hrs follow up patients found to be alive and improved, some were discharged and some were shifted in ICU under observation. AMBULANCE LOCATION: CHC FAREEDPUR BAREILLY. CASE ID: 6366344 ERO: ASHUTOSH KUMAR DATE: 28/5/2014 CALL TIME: 4:19 HRS ERCP: DR.ASHISH AWASTHI RECEVING HOSPITAL: CHC FAREEDPUR BAREILLY.

3. TRAUMA leads to shock During the evening hours of May 29th, 108 emergency response center got a call seeking an ambulance and police help. Informer was a train passenger who saw a man slither from train. 108 team was dispatched and police team was intimated about the incident. EMT Pooja and Pilot Kishan pal collected information from the caller about the incident reached scene within minutes.EMT and pilot heard faint cries of a man coming from a very distant place. The landscape where cries were heard was near to railway track which was surrounded with bushes.EMT and Pilot could not spend much time waiting for police and started in the direction of cries, through the bushes. Finally EMT and pilot found old man in reverie, lying in a pool of blood, in the middle of railway track. It was shocking to EMT and pilot when they realized the victim’s both feat were amputated at ankle level.EMT immediately controlled the bleeding at scene itself with pressure bandage, pilot started searching for the amputated feat, he able to find the both amputated feat which was cleansed in normal saline and preserved in a sterile plastic bag. EMT and Pilot shifted victim on spinal board after applying cervical collar from scene to ambulance, where EMT suspected a cervical spine injury due to fall from train. After shifting the patient in the ambulance EMT carried out detailed physical exam and monitored the vital signs. Patient’s systolic blood pressure was 80 mm of Hg because of profuse bleeding and pulse was thready, at 52 beats/min with tachypnea with low oxygen saturation of 82%.Immediately EMT connected oxygen with non rebreather mask at 15 lit/min and established an IV line on both the hands, IV fluid Ringer’s Lactate 500 ML was connected on both hands to combat shock. In ambulance the wounds were cleansed in normal saline and pressure bandage was done to prevent bleeding. After stabilizing the patient enroute EMT reassessed the patient’s condition and vitals monitored for every 5 minutes. Pilot was able to reach district hospital Moradabad within few minutes. Patient was handed over to Moradabad district hospital team of surgeons, who appreciated the pre hospital given by ambulance team and handing over the amputated feat were commended. After 48 hrs follow up patient was found alive after great efforts kept by our ambulance staff .Patient and his family members expressed their immense gratitude towards the effort of our team. AMBULANCE LOCATION: KOTWALI MORADABAD CASE ID: 4991648 ERO: VIVEK SINGH DATE: 29/05/2013 CALL TIME: 20:11 HRS HOSPITAL: DISTRICT HOSPITAL MORADABAD.

4. DRIVE SLOW, ACCIDENT HURTS On 30-01-2012 at 07:37, Sonapur ambulance got a call of Road Traffic Accident. Immediately ambulance was rushed to the scene, with all the preparation enroute to scene. On scene, EMT found the two patients on the roadside with bleeding and shouting with pain. As the scene was safe, EMT approached the patients who were in distress. EMT and PILOT immediately shifted the patients into the ambulance with all spinal precautions and covered the open wounds with sterile gauze pads. When shifting the patients in to the ambulance, EMT and pilots found 3,80,00 rupees along with 15 kgs silver. So, EMT and Pilot took the money and silver into the ambulance along with patients. On physical examination EMT found that Ravi soni, having severe bleeding from left hand and from Right leg which was an open Fracture.EMT found multiple abrasions all over the body. The second patient was Rajesh , having abrasions all over the body. EMT Pushpendra immediately controlled bleeding from both the limbs by covering the exposed bone with sterile gauze pads and splinting was done. Wound care was given to rajesh.Ambulance swiftly rushed to hospital, enroute vitals were monitored. Patients condition was improved after pre hospital care. Enroute EMT performed ongoing assessment with continuous monitoring, patients showed improvement in condition. Patients were shifted to PHC Hospital, chitrakoot for further management and care. Ambulance team handed over the 3, 80,000 rupees along with 15 kg silver to the patient’s attendant. Receiving hospital staff and patient’s attendant appreciated the team work in managing patient. After 48 hrs follow up patient was alive .Patient visited ambulance location to thank the crew after recovery and the Ambulance crew was so glad to see the result of their hard work. AMBULANCE LOCATION: DISTRICT HOSPITAL SONA PUR CASE ID: 748683 ERO: IRFAN AHMAD DATE: 30-01-2012 CALL TIME: 07:37 HRS RECEVING HOSPITAL: PRIMARY HEALTH CENTER CHITRAKOOT

5. HONESTY ON CARING WHEELS On 11th November 2012, at 13:10 Circuit house ambulance was assigned for an RTA case. EMT and pilot rushed to scene to attend that Road Traffic Accident immediately. As the EMT & PILOT entered the scene, they found 2 patients who were injured. After Triage EMT found one of them was injured & unconscious and other patient was conscious with minor injuries. The unresponsive patients are shifted into the ambulance with all spinal precautions. While shifting EMT and pilot found 4, 10,000 (four lakh ten thousand rupees) along with patients. No attendee is available with them. EMT really had a hard time in managing two patients at a time. Govind, who was unresponsive, was Profusely bleeding from mouth and nose. Immediately EMT had given left lateral position to avoid aspiration.EMT performed bleeding control, wound care and administered intravenous fluid Normal Saline with vital monitoring. Second patient with minor injuries received wound care and monitoring. On Physical examination EMT found abrasions all over the body of Govind .It was really a challenging situation to any EMT to manage two injured patients at a time. Enroute to the hospital govind’s level of consciousness was improved. Patients were shifted to the Casualty of S.B.D hospital for the further management. They had handed over 4, 10,000 rupees to their relative. Patients relative thanked our EMT and PILOT for their honesty and determination towards their work. After 48 Hrs follow up patient was found to be alive and improved. • ATTENDER RECEIVING MONEY FROM EMT AMBULANCE LOCATION: CIRCUIT HOUSE CASE ID: 631332 ERO: AJAY KUMAR PATEL DATE: 11-11-2012 CALL TIME: 13:10 HRS RECEVING HOSPITAL: S.B.D HOSPITAL SAHARANPUR

6. Retrieved life from shock Jhoosi police station ambulance received a call from ERC, at 14:44 hours of 14 August’13, case of Road Traffic Accident. Scene was 12 km distance from ambulance location. EMT Santosh, with all BSI precautions reached the scene, where he found a bike and car which was damaged due to head on collision, which is a resultant of brake failure. Beside the bike, victim was lying in a pool of blood and his both ankle joints were badly injured. A young 16 years male was driving the car, who escaped with minor injuries. Car was evidently damaged and the scene was a total mess. Once the EMT confirmed the scene safety, approached the patient who was profusely bleeding from the head and legs. EMT immediately controlled the bleeding and checked the response. Patient was semiconscious, shivering, anxious and thirsty. On rapid physical examination EMT found a laceration on left parietal region with severe bleeding, Left Ankle and Right Ankle had deep laceration which increases pain on movement and abrasions all over the body. Once the bleeding was controlled by direct pressure, EMT covered all open wounds with sterile gauze, splinted both the lower limbs along with ankle joints and shifted patient into the ambulance by scoop stretcher. Vitals were monitored by EMT, His initial vitals were Pulse 132 beats/min, Blood Pressure 90/60 mmHg and Oxygen saturation 96% on room air, Respiratory Rate 32 breaths/min which states patient was in shock with tachypnea and hypotension. EMT immediately applied high flow oxygen, and did Trauma assessment and contacted ERC Physician, Dr. Praveen for further management. As per the Physicians advice EMT placed an Intravenous line and administered Normal saline Intravenous fluid bolus and covered patient with a blanket and Inj. Diclofenac and Inj. Perinorm was administered and other warming measures were taken. Patient history was taken and continuous ongoing assessment was done till patient was admitted in T.B Sapru hospital, at the time of handing over patient was conscious and oriented at hospital and his Blood pressure was 100/70mm of Hg. On 48 hrs follow up, Patient was found alive and recovering steadily. AMBULANCE LOCATION: JHUSI POLICE STATION CASE ID: 8031920 ERO: KRIPA SHANKAR DATE: 14/08/2013 ERCP: dr. PRAVEEN CALL TIME: 14:44 HRS HOSPITAL: T.B SAPRU HOSPITAL, ALLAHABAD.

7. CASE OF ELECTROCUTION On 29th March 2013, 108 Moradabad team comprising of EMT and Pilot got a call of electrocution at 12:13. Ambulance team rushed the scene with in 5 min.EMT found Devendra who was 13 years old wincing in unbearable pain with severe shock from a non insulated wire.EMT taken history from the family members, then EMT came to know that he got electric shock which leads to fall. EMT immediately shifted patient into the ambulance with spinal precautions. When the EMT assessed the patient and found that patient was having severe burns on the chest, stomach and on both upper and lower limbs, EMT immediately sprayed the cooler spray on burnt area and covered EMT with blanket to avoid hypothermia. EMT provided pre hospital care in the ambulance .EMT removed the tight clothing which is covering the burnt area. Vital signs were monitored, provided high flow oxygen. Patient was kept under observation with intermittent ongoing examination. Patient was stabilized and shifted to hospital. They reached Hospital. Patient was handed over at casualty for definitive care. After seeing the patient’s condition medical officer appreciated the EMT and Pilot for the medical care given to patient. After 48 hrs follow–up the patient was improved and discharged .With gratitude, patient‘s parents visited ambulance location to thank the staff after discharge of Devendra. Patient’s parents feel that without the prompt assistance and appropriate pre hospital care in the ambulance, he would not have survived from the incident. AMBULANCE LOCATION: POLICE STATION MORADABAD CASE ID: 2724113 ERO: POONAM YADAV DATE: 29/03/2013 CALL TIME: 12:13 HRS HOSPITAL: DISTRICT HOSPITAL MORADABAD.

8. CRITICAL DELIVERY Subha Devi was pregnant for the third time. As she started having strong contractions on 21st Nov ’13 at 8:56 AM her husband called 108 and she had been experiencing pain since early morning. The ambulance based at District Hospital was dispatched for the case. After taking patient in to the ambulance, EMT monitored the vitals. Within minutes through their journey to hospital, she started to have stronger contractions and was bearing down. At that time, EMT prepared himself to conduct the delivery in ambulance itself. EMT asked the pilot to park the ambulance in a safe place on the way.EMT reassured the patient and started conducting delivery. Once the head was out EMT checked for cord around the neck, as he found baby neck was surrounded by cord due to which baby had turned blue. So EMT relieved the pressure of cord around the neck and clamped and cut the cord.EMT contacted ERCP Dr.Prashant who advised him to give Oxygen by BVM. EMT found that the first Apgar score of the baby was 4 and with immediate resuscitation measures taken on the neonate, the baby’s APGAR score improved to 8. EMT then wrapped the baby in a clean and sterile towel and handed over him to the mother to keep him warm and avoid hypothermia. Intravenous fluid was administered for the mother and oxygen was given to the baby. Few minutes later ambulance reached the hospital. EMT handed over the mother along with the baby for placental delivery and further management to the medical officer on the duty. After 48 Hrs follow up, this gave immense pleasure to the ambulance crew for having saved a llife. AMBULANCE LOCATION: district hospital NOIDA CASE ID: 12436885 ERO: PRIYANAKA VERMA DATE: 21/11/2013 CALL TIME: 8:56 HRS ERCP: DR.PRASHANT HOSPITAL: DISTRICT HOSPITAL NOIDA.

9. AMBULANCE LOCATION: ARNIYA BULANDSAHAR CASE ID: 1394856 ERO: POONAM LATHA DATE: 23/12/2012 CALL TIME: 13:34 HRS RECEVING HOSPITAL: CHC KHURJA. TRAIGE SAVED 9 PATIENT’S LIVES On 28th December 2012, at 13:34 kurjha ambulance was assigned to a road traffic accident.108 team reached the scene, ambulance was blocked by a mob and they saw a truck was roll overed. As the EMT & PILOT entered the scene, they found 9 patients who were extricated by the bystanders from truck. It was a multi casualty Of the 9 causalities, after triage EMT found 9 patients were having major injuries with severe bleeding. EMT’s really had a hard time in managing all the patients at a time. Mr. Anil who was having right leg fracture with a laceration on his head which was bleeding profusely, EMT controlled the bleeding by direct pressure and patient was shifted into the ambulance after splinting stretcher with all precautions. Mr.Indar who was having right hand fracture with laceration on left ear was managed by splinting, received wound care from EMT and was shifted into the ambulance. Mr.Alim who was having open left leg fracture and laceration on head which was bleeding profusely was managed by splinting, received wound care from EMT and was shifted in to the ambulance. Mr.Ralim who was having right fore arm fracture and a deep laceration on chest was managed by EMT by covering the open chest wound by him on oxygen. Mr.Pappu Yadav who was having laceration on face which was bleeding and a fracture on left leg, was managed by splinting and received wound care from EMT and was shifted to ambulance.  Mr. Omkar who was having a laceration on temporal region of head which was bleeding profusely was controlled by EMT by direct pressure; wound care was given and shifted to ambulance. Mr.Raju who was having laceration on fore head received wound care from EMT and was shifted to ambulance. Mr. Bantu Yadav who was having laceration on face and head received wound care from EMT and was shifted to ambulance. Mr.Sonu who was having abrasions all over the body and an open fracture of left hand which was managed by our EMT by splinting and shifted the patient to the ambulance. After shifting all 9 patients in to ambulances EMT’s conducted Physical examination to all the patients. Enroute, EMT’s were continuously monitoring the patients, condition of the patient was improved. It’s really a challenging situation to any EMT to manage an MCI with limited resources. Patients were shifted to the khurja CHC hospital for the further management. After shifting patients to khurja CHC hospital, medical officer referred two patients to district hospital by IFT (inter facility transfer) for further management by the same ambulances.  After 48 Hrs follow up patients found to be alive and improved.

10. AMBULANCE LOCATION: CHC MAHOLI CASE ID: 1744822 ERO: BALDEV SINGH GILL DATE: 3/03/2013 CALL TIME: 17:31 ERCP: DR.ABBAS RECEVING HOSPITAL: DISTRICT HOSPITAL SITAPUR SUICIDE, NOT ONLY THE SOLUTION A call was made to 108 in the evening hours of 3rd of March 2013, from the residence of Ms.Soni in maholi. Maholi ambulance was assigned; EMT Santosh and PILOT Lal bahadur were on the shift. They rushed to the scene immediately. EMT was shocked to find patient Ms. Soni aged 14 years in a pool of vomitus. Patient was consistently vomiting and was in a restless state. Her family members were unable to provide any medical history. Patient was shifted aside and unsoiled; vitals were recorded on the scene which were stable. Patient was instantly shifted into the ambulance to provide further care and provided high flow Oxygen. Obtaining permission from Dr.Abbas, EMT administered inj.Hydrocort and took Intravenous line and administered Inj. Rantac and Intravenous Fluid for maintenance. Patient was still vomiting; left lateral position was given to avoid aspiration. Patient was very uncooperative and acting erratically. EMT alone tried to manage the patient and enroute condition was improved. EMT was continuously attempting to take proper history from the patient enroute to hospital. Finally she disclosed that she has consumed herbal pesticide. Then EMT realized the cause of vomitus. By the time ambulance reached the hospital, patient became oriented. Enroute EMT had a challenging situation of securing IV line and controlling agitated & uncooperative patient all the way to hospital safely. Patient was shifted into casualty of District Hospital and handed over to CMO for further management and showed improvement in her vital stats. Ms. Soni recovered from a life threatening condition due to prompt & proper pre-hospital care which saved her life.

11. CASE OF BURNS On 06-03-2013, Azamgarh ambulance got a call of burns which consists of EMT Ajit kumar and Pilot Rajesh Singh. Immediately ambulance was rushed to the scene, with all the preparation enroute to scene. On scene, EMT found the patient with burns and shouting with pain. As the scene is safe, EMT approached the patient who is in distress. EMT and PILOT immediately shifted patient into the ambulance and covered the patient with sterile blanket to avoid hypothermia. After shifting the patient in to the ambulance. On physical examination EMT found that patient having second degree burns on face, arm and both legs including anterior part of the chest. Due to facial burns patient was having difficulty in breathing. Immediately EMT connected him on oxygen. In ERCP conference, Dr.Nitin Dwivedi advised him to administer an inj.Diclofenac 3ml, prevent hypothermia by covering patient with blanket, cold spray and rapid transport. As per ERCP advice, EMT Ajit kumar pandey administered inj.Diclo and cold spray given. Ambulance swiftly rushed to hospital, enroute vitals were monitored. Patients condition was improved after pre hospital care. Enroute EMT performed ongoing assessment with continuous monitoring, patient showed improvement in condition. Patient was shifted to Hospital, for further management and care. Receiving hospital staff and patient’s attendant appreciated the team work in managing patient. After 48 hrs follow up patient was alive. AMBULANCE LOCATION: AZAMGHAR CASE ID: 1832968 ERO: ANUP SINGH DATE: 06/03/2013 CALL TIME: 8:57 AM RECEVING HOSPITAL: CHC MOHAMADPUR AZAMGHAR

12. AMBULANCE LOCATION: DISTRICT HOSPITAL CASE ID: 2249143 ERO: VISHAL GAUR DATE: 17-03-2013 CALL TIME: 2:13 HRS RECEVING HOSPITAL: S.R.N HOSPITAL ALLAHABAD PROMPT RESPONSE SAVED GUN SHOT PATIENT Kaushambi ambulance received a call from ERC, at 02:13 hrs of 17 March, case of gun shot. Enroute EMT kapil Sharma, with all BSI precautions reached the scene, where EMT found a 17 years male patient with gunshot wound on right side of the chest .Patient was lying in a pool of blood, which was resultant of some past retribution. Once the EMT confirmed the scene safety, approached the patient who is profusely bleeding from the chest. EMT immediately controlled the bleeding and checked the response. Patient was responding with pain stimuli. On examination EMT observed patient had difficulty in breathing. Once the bleeding stopped, EMT did occlusive dressing to open chest wound to avoid pneumothorax. Patient was shifted into the ambulance on spine board.EMT gave semi fowler’s position and connected patient on oxygen. Vitals were monitored by EMT, which states patient was in breathlessness and hypotension with Blood Pressure of 90/60 mmHg. EMT immediately placed an Intravenous line and administered Normal Saline Intravenous fluid bolus. Patient history was taken and continuous ongoing assessment was done till patient was admitted in S.R.N hospital, Allahabad. Patient was conscious and oriented at hospital with the blood pressure of 100/70 mm of Hg. Patient was found alive and recovering steadily after 48 hour follow up.

13. AMBULANCE LOCATION: BHADORA, GHAZIPUR. CASE ID: 5210006 ERO: MOHD SHARIF SIDDIQUI ERCP: DR.SAIMA DATE: 04/06/2013 CALL TIME: 17:39 HRS HOSPITAL: PHC ZAMANIA. ATROPINE –THE ANTIDOTE Mr. Sonu, a young boy of 17 years residing in a remote village of a Ghazipur district who was dependent on the agriculture produces of their fields. Some quarrel took place between him and his father on some financial matter. Accordingly on the fateful day of 4th June 2013 when he was alone at home, he consumed copious amount of pesticide(Turantu).Gradually he started to experience increased salivation, lacrimation and many episodes of vomiting a blood tinged fluid and was in a restless state. His condition was fortunately noticed by his mother who came from fields, subsequently she called for help one of the neighbors’ dialed 108 and mentioned that Mr.sonu had consumed some unknown poison. A call was made to 108 in the evening hours of 4th of June 2013, Ambulance was assigned. EMT Aditya singh and PILOT Pawan Sharma were on the shift. They rushed to the scene immediately within 5 minutes. EMT was shocked to find patient in a pool of vomitus.EMT and PILOT started searching for any evidence of poison which Sonu had consumed and finally EMT succeeded in finding the empty bottle of Pesticide and packed it in a carry bag. Patient was shifted aside and unsoiled; vitals were recorded on the scene which were unstable as Blood Pressure was 80/50 mmHg, Respiratory Rate of 26/min and SpO2 88%. On further examination EMT Aditya noticed profuse secretions pouring out from the patient’s mouth. Patient was instantly shifted along with the empty bottle (which will be useful for the receiving hospital to give antidote) into the ambulance to provide further care and suctioned the mouth and started giving positive ventilations by BVM till the SPO2 comes to 95 % and placed him in left lateral position. Obtaining permission from Dr. Saima, EMT took Intravenous line and administered Inj. Atropine and Intravenous Fluid NS 500 ml to increase blood pressure and then connect DNS for maintenance. Patient was still vomiting; suctioning was done to clear the airway by monitoring vital signs continuously. Enroute EMT had a challenging situation of maintaining airway by suctioning, securing IV line and controlling restless patient all the way to hospital safely. Patient was shifted into casualty of PHC Zamania and handed over to CMO for further management and showed improvement in level of consciousness and his vital signs. After 48 hrs follow up Mr. Sonu recovered from a life threatening condition due to prompt & proper pre-hospital care which saved his life and his family members expressed their immense gratitude towards the effort of our team.

14. PELVIC BINDER SAVED A LIFE In the morning hours of 20th December, district hospital Ambulance team consisting of EMT & Pilot got a call for a Fall Victim case. They immediately rushed to the scene without delay, where they found Mrs. Usha Devi ,50 years female patient fallen from a two story building around 40 feet height. EMT immediately triaged and conducted a rapid physical examination, where he found patient was with altered sensorium and severely injured. Patient has a closed pelvic fracture and bilateral femur fracture with numerous lacerations and abrasions all over the body. Patient was literally crying with severe pain and also possibility of internal bleeding. EMT stabilized the Pelvis with binder and took spinal immobilization precautions while shifting the patient into the ambulance using the scoop board, Help was provided by bystanders. EMT Pradeep immediately controlled the bleeding and performed wound care. Vitals were monitored which was Pulse Rate of 110 beats/min, Blood Pressure at 90/70mmHg, SpO2 at 95% and normal skin condition. He administered oxygen, as per Emergency Physician Dr. Prashant advice, he administered Intravenous Fluid NS on both hands by two IV lines, Injection Diclofenac (IM) & Injection Rantac (IV) with close monitoring of GCS and shifted the patient to the nearest District Hospital. Throughout the journey it was EMT Pradeep consistent efforts that ensured Mrs. Usha Devi was stabilized well by maintaining adequate perfusion. Finally the patient was handed over to district Hospital of Agra Casualty. After essential surgical interventions Mrs. Usha Devi recovered steadily. After 48 hrs follow-up patient was found to be alive and stable. AMBULANCE LOCATION: DISTRICT HOSPITAL AGRA CASE ID: 13449052 ERO: RASHMI DIXIT DATE: 18/12/2013 CALL TIME: 11:24 HRS ERCP: DR.PRASHANT HOSPITAL: DISTRICT HOSPITAL AGRA.

15. Thank you