The Supreme Court directed that a uniform trauma care policy be adopted across the country within three months with states and union territories mandated to adopt a common helpline for trauma victims, roll out protection for good Samaritans who report an accident, and roll out emergency medical rescue protocol.
A bench of Justices JK Maheshwari and AS Chandorkar said in a May 26 order: “What is needed is systematic intervention, creation of a unified framework for trauma care, building public awareness, standardization of first aid skills and appropriate Good Samaritan laws as the right of citizens to trauma care is an integral part of the right to life enshrined in Article 21 of the Constitution of India.”
These directions came in a Public Interest Litigation (PIL) filed by Savelife Foundation which cited National Crime Records Bureau (NCRB) figures to show how trauma is the main killer. NCRB 2024 data stated that of the 467,000 people who experienced traumatic or accidental deaths, 177,000 of them were attributable to road traffic deaths.
“A unified and robust trauma care system, steps towards its gradual realization, and increased public awareness are well intentioned and may prove to be very crucial in reducing preventable deaths,” the bench said, as it directed all states and union territories to merge police, fire, ambulance services and other joint helpline mechanisms into a joint helpline number ‘112’. ,
This universal access number was proposed by the Ministry of Home Affairs (MHA), under the Emergency Response Support System (ERSS) project, as the single emergency response number for emergency assistance from the police, fire department, health and other services. However, since public health, hospitals, ambulance services, police and public order fall under the State List and not the Union List in the Constitution of India, only a direction from the court can ensure uniform implementation of these measures.
“Sustained and concerted efforts by both the Union and States/Union Territories working in unison can certainly lead to a unified system of trauma care across the country that is efficient and effective,” the bench said, publishing the order four months later for the states, union territories and the Center to report on compliance.
Once the common helpline is implemented, bystanders who witness an accident will not need to remember multiple helplines for police, ambulance or other services, thus preventing delays in providing immediate assistance to road accident victims.
Time is of the essence in such situations, the bench acknowledged, with senior advocate Siddharth Luthra, appearing with advocate Malvika Kapila for the petitioners’ organization, stating that reports submitted by legal authorities showed that 50% of road accident deaths could be prevented through immediate medical attention.
“When someone is involved in an accident or any similar incident that requires urgent trauma care, they are usually so shocked, confused, and so helpless that they have to hope that those around them can somehow help them get the care they need. In such a situation, every minute spent without medical intervention or urgent care dramatically narrows their scope of survival,” the order read. “Speed is, in the literal sense, like medicine.”
Passers-by should take the victim to the hospital. Although Section 134A of the Motor Vehicles Act was brought in to protect these “good Samaritans”, the court noted the hesitation in the minds of the common man who suffers from “paralysis of reaction” due to fear of court proceedings, police harassment, or simply due to the psychological heaviness of the situation.
“Therefore, a robust trauma care mechanism must take a bottom-up approach, taking into account various stakeholders,” the court said and directed the states and union territories to set up functional grievance redressal systems (physical and digital) with designated nodal authorities at the state and district levels within three months.
The court noted that the next step in the “bottom-up” approach is the role of ambulances, hospitals and medical care professionals. When the States and Union Territories informed the Court of their desire to implement any uniform protocol, the Union Government was directed to issue a “Trauma Medical Rescue Protocol” within three months, with a further direction to all States/Union Territories to operationalize it in the next three months.
To ensure that ambulances arrive on time and reach the best possible hospital at the earliest, states and union territories have been told to ensure that all registered ambulances (public and private) have mandatory Global Positioning System (GPS), Vehicle Location Tracking Device (VLTD) and real-time integration with the 112 helpline.
The National Commission for Allied Health and Care Professionals (NCAHP) informed the court that emergency medical training has been integrated into its curriculum. The court granted three months to integrate this curriculum into all training institutions and accredited employees.
Attorney General R Venkataramani, who assisted in the matter on behalf of the Centre, pointed out various cashless treatment schemes of the central government that could benefit road accident victims, provided the states adopt them. One such scheme is the PM-RAHAT scheme, which is yet to be operationalized by some state governments, Venkataramani said. The court granted eight weeks to activate this scheme throughout the country.
The State and UT Governments have been directed to disseminate these directions to ensure awareness of citizens to avail these facilities in case of any emergency. In addition, the guidance issued also includes a common data format for recording a trauma registry. It will be linked to a coordinated trauma registry within four months, and classification of hospitals and medical institutions to ensure that patients receive the best possible medical assistance in the presence of certified and well-trained emergency medicine specialists.
