Background:Due to lack of training in emergency care, basic emergency care in India is still in its infancy. We designed All India Institute of Medical Sciences basic emergency care course (AIIMS BECC) to address the issue.Aim:To improve the knowledge and skill of healthcare workers and laypersons in basic emergency care and to identify impact of the course.Materials and Methods:Prospective study conducted over a period of 4 years. The target groups were medical and nonmedical personnel. Provider AIIMS BECC is of 1 day duration including lectures on cardio-pulmonary resuscitation, choking, and special scenarios. Course was disseminated via lectures, audio-visual aids, and mannequin training. For analysis, the participants were categorized on the basis of their education and profession. A pre- and a post-course evaluation were done and individual scores were given out of 20 and compared among all the groups and P value was calculated.Results:A total of 1283 subjects were trained. 99.81% became providers and 2.0% were trained as instructors. There was a significant improvement in knowledge among all the participants irrespective of their education level including medicos/nonmedicos. However, participants who had higher education (graduates and postgraduates) and/or belonged to medical field had better knowledge gain as compared to those who had low level of education (≤12th standard) and were nonmedicos.Conclusion:BECC is an excellent community initiative to improve knowledge and skill of healthcare and laypersons in providing basic emergency care.

Trauma is a major cause of morbidity and mortality throughout the world. Alarmingly the mortality rate, owing to multiple causes with or without sepsis, is now reported to cross the value of 50%. The preliminary study was conducted in humans to investigate the 1) safety of estrogen therapy following trauma hemorrhage 2) Does estrogen reduced the inflammatory storms caused due to trauma 3) Does estrogen affects the survival of THS patients and prevent the advancement of sepsis-associated problems. 40, THS patients and 20 healthy controls were recruited. THS patients were divided into experimental groups and placebo controls based on the estrogen administration in the ED. Serum level of cytokines and immune cells were measured at different time points on days 0, 3, 7, and 14 in both groups of THS patients. Patients receiving intravenous estrogen beside standard of care as per ATLS guidelines did not develop any major or minor adverse events and showed favorable clinical outcomes during their course of stay in the ED and ICU. The levels of T regulatory cells, monocytes, and systemic cytokines were significantly reduced in THS patients who received estrogen. Again, THS patients who received estrogen recovered early, do not have side effects and showed a balanced inflammatory response. In conclusion, this preliminary study showed that intravenous estrogen therapy is safe and overcame the problem of inflammatory insults caused due to trauma hemorrhagic shock. It may protect from sepsis-associated complications among THS patients.

In view of COVID 19 surge, the construction of Burns & Plastic Surgery Block at AIIMS New Delhi was expedited at war footing level and convert it into a COVID 19 Emergency response Centre (ERC). Engineering works were completed in a speedy manner and various patient care areas were equipped as deemed necessary for providing tertiary care to COVID 19 patients. Highly spirited team comprised of Emergency Medicine Specialists, Anesthesia & Critical Care specialist, Hospital Administrators and Nursing Officers. Effective segregation of patient care areas into clean, contaminated, and intermediate zone was done using physical barriers and air conditioning modifications. Screening area for COVID 19 suspect patients was created and was a two-step process i.e., Triage 1 & Triage 2. Thereafter, patients requiring admission would be referred to emergency area. An inhouse designed and fabricated sampling booth was created to bring down use of PPEs and for better infection control. ERC has general ward and state of the art intensive care units. Mobilizing resources (machinery, manpower, consumables etc.) during the lockdown required commitment from top leadership, motivated team, expeditious procurement, coordination with multiple agencies working on site, expediting statutory clearances, coordination with police services, transportation of labor etc.

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