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Management of emergencies is of serious concern to the state of Kerala specially in the light of increasing road accidents, health related problems, outbreak of diseases and unexpected natural disasters etc. While 45% of emergencies are owing to road accidents 55% is health related emergencies. Cardiac problems, pregnancy problems, suicides, asthma attacks, snake bites etc are medical emergencies needing immediate intervention. It is an established fact that effective emergency response will significantly reduce deaths, disabilities suffering from length of hospital stay etc. The critical concept in trauma is “golden hour”, which means to say, more than 50% of all accident mortality takes place within the 1st hour. It is highly significant, in this context, to establish emergency response services in the state of Kerala on a large scale.

So far in the State of Kerala no concentrated effort has ever been put in to meet emergency management requirements. Number of Emergency Services that have been either in existence or worked sometime in the past, have been mainly serving single dimensional interests be it corporate hospital or limited context interest interests of social organization which run them. Though the State made some efforts to make available Emergency Medical Services to people under various schemes the desired results could not be achieved.

Therefore a project titled KEMP has been initiated in the state hiring the service of an expert organization under the notion of Public Private Partnership. KEMP is an Emergency Management System which is established scientifically through a network of sophisticated ambulances connected and controlled with an Emergency Response Center having single seamless solution including Computer Technology Integration, Voice Logger system, Geographic Information System maps, Geographic positioning System, Automatic Vehicle Tracking and Mobile Communication technology. The project has been conceived by the Engineering division of the State chapter of NRHM. Police help, ambulance help and Medical assistance is provided under one roof to make the venture successful.

This Emergency Medical Service can be availed by any person through a toll free number 108. The project is being launched initially in the district of Thiruvananthapuram on 19th May 2010 and will be introduced soon in Alappuzha district.

A fleet of twenty five Advance Life Support Ambulances will be parked in different strategic locations in the district to provide 24x7 pre-hospital Emergency response ambulance service accessible to all. The ambulance will have sophisticated equipments to tackle all kinds of Emergencies, medicines and consumable required for stabilizing the life of the patient including oxygen. All the ambulances will be monitored and controlled through a 24x7 Emergency Response Center (Control room) with the help of GPS and GPRS network. This pre-hospital Emergency Service is accessible to all the people of Thiruvananthapuram through a toll free number 108. When a call is received the nearest ambulance will be located by the control room and will be dispatched immediately to the location with the help of the information provided by the caller and with Geographic Information System. In case of road traffic accidents the patient will be taken to the nearest Government hospital to stabilize the patient depending upon the condition of the patient. In case of other emergencies the patient will be admitted to any hospital of their choice and may be charged only if they opt for a private hospital. This rate for transport to a private hospital will be finalized later. The service under KEMP will be available for only pre-hospital Emergency and not for shifting the patient from the hospitals. This service will also be not available for transferring dead bodies.

M/s Ziqitza Health Care, Mumbai, who was qualified as the successful bidder through a tender process has been awarded the contract for operating the KEMP project in Thiruvananthapuram district. The control room for KEMP has been established in Technopark.

The KEMP Advance Life Support Ambulance is designed to handle all types of emergencies including Trauma, cardiac, labour emergencies, etc. Equipments were also provided for handling such emergencies. The trauma and life saving medical equipments meets the CEN 1789 European safety standards for medical transportation vehicles. This European standard specifies requirements for the design, testing, performance and equipping of road ambulances used for the transport and care of patients. The ALS ambulances also have extraction tools which is very important in emergency ambulances, because in many a time the mangled debris had to be cut open to save the life of people.

The interior of the ambulances are made of seamless medical grade Fiber Reinforced Polymer (FRP) panels and joint less medical grade polyurethane anti-abrasive epoxy flooring which is anti static, anti bacterial, anti fungal, anti skid and anti fire. This type of interiors is easy to clean and maintain sterile and hygienic.

The Major medical equipments on board are Defibrillator and patient monitor with Automated External Defibrillation and telemetry facility, Ventilator which is driven pneumatically and easy to transfer along with patient, Foetal monitor, Syringe pump, pulse oxymeter, battery operated suction apparatus, nebulizer, needle destroyer, glucometer, BP apparatus, etc.

The trauma equipments available in the ambulances are auto loading patient trolley which can be loaded in the ambulance effortlessly with a single person, Scoop stretcher which is useful in shifting patients with multiple injuries and spine injuries and helps in shifting the patient keeping the spine intact, Spine board which helps in providing adequate support to an injured patient during transfer, folding wheel/ stair chair to carry the patient, where the trolley cannot be taken, Splints for immobilizing particular parts especially long bone fractures, Cervical Color to avoid irreparable damage to the patient in the case of cervical fracture and spinal brace to stabilize and immobilize spine during an injury.

Proper storage spaces for medical equipments, medicines and consumables including refrigerated medicine cabinet. Each ambulance has two bulk Oxygen cylinders which is capable of storing more than 12,000 liters of Oxygen. All ambulances are fitted with solar panel to charge the battery when the ambulance remains stationary.

Rescue tools necessary for extrication of a victim in a crash, fire and other situations like Bolt cutter, Crowbar, Axe, Spade, High tensile rope, Hacksaw blade with frame, wrench, screw driver, vise grip pliers, hammer, wrecking bar, folding shovel, mastic knife, pruning saw, spring loaded center punch, double action tin snips, gauntlets, heavy duty shoring cribbing blocks of various sizes, 5kg fire extinguisher, rescue blanket which have been proven in saving lives when victims were stuck up in emergency are available in each ambulances.

The ambulances are also fitted with rhombus shaped light bar with integrated high intensity public address system and exterior reflective stickers prominently indicating Emergency. The doors of all ambulances open 270 degrees enabling quick patient transfer in public places.

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