Investigating emergency rescue readiness on Indian national highways: A case study of Jaipur-Jodhpur Highways (India) using a geospatial approach

Abstract

Background: Highways represent the most significant capital asset that any country's public sector holds. A system of national highways with easy access to ambulance and trauma centers is termed emergency rescue ready and helps reduce the mortality due to road accidents. Given the rich impetus for road infrastructure development by the government of India, there is a need to consider emergency rescue readiness on highways. Previous research suggests that on typical Indian highways, an ambulance can reach the accident scene within 30 minutes; the remaining 30 minutes of golden hour is essential for saving the life of the injured by admitting to a healthcare facility with a trauma unit.

Objective: To investigate the emergency rescue readiness for a stretch of highway between two cities in India. The main objective is to determine the possibility of transporting the injured due to the accident on the highway to the nearest available trauma center within 30 minutes.

Methods: A Geographic Information System (GIS)-based network analysis method has been adopted to find the possibility of transporting the injured anywhere on the circuit of a national highway to the nearest healthcare unit within 30 minutes.

Results: A map representing the status of emergency rescue readiness has been presented for the study area. For a circuit of national highway with a length of 805 km, in a stretch of 89.5% (718.5 km), the injured can be transported to the healthcare unit within 30 minutes. In the remaining 10.5% of the highway, the healthcare units are significantly far from the highways and may hamper the post-crash rescue operations.

Conclusion: There exists a wide disparity in trauma care delivery in the study area. Currently, the healthcare units established to serve the areas with dense populations also serve as emergency rescues during accidents on the national highways. Using GIS techniques for highway stretches with difficulty reaching the trauma centers, a national-level assessment is highly recommended.

Keywords: Emergency rescue; national highways; road accidents; trauma care.

Figure 1

The extent of the study area to investigate the emergency rescue readiness. The maps show the circuit of national highways between Jaipur and Jodhpur via various densely populated towns/cities, healthcare units with trauma facilities, and minor roads that connect national highways and villages. The distribution of trauma care centers is highly concentrated within urban agglomerates and near densely populated cities/towns. For a circuit of 805 km of national highways, ~82% of the healthcare units are concentrated pockets near urban settlements

Figure 2

A GIS-based network analysis method to find the possibility of transporting the injured anywhere on the circuit of a national highway to the nearest healthcare unit within 30 minutes. (a) Every 500 m on the national highway circuit, a point is assumed to be a crash scene from which the injured is proposed to be transported to the nearest healthcare unit (for example – points P1, P2, and P3). (b) GIS-based search for the nearest servable healthcare unit. (c) GIS-based evaluation of time that needs to reach the nearest healthcare unit from the crash site

Figure 3

Map prepared using the GIS-based network analysis methods highlighting the emergency rescue readiness in the study area. Highways marked with green are the stretches from where the injured can be transported to the nearest trauma facility within 30 minutes, whereas the orange and red zones are the stretches where considerable time will be taken for transporting the injured for post-crash rescue

Figure 4

Maps showing the extent of the stretches on various highways where transporting the injured to the nearest healthcare units takes significant time. (a) The stretch of highway NH62 between Baori and Kherapa villages. (b) The stretch of highway NH62 between Soila and Guriya villages. (c) The stretch of highway NH58 between Burdi and Khabariyana villages. (d) The stretch of highway NH58 between the villages Manglooona and BHUMA Bada villages. Notably, for these stretches of the road network, the location of the healthcare unit is more than 40 km. Thus, ambulance transporting the injured may take significant time