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Most ambulances ill-equipped

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KATHMANDU, Jan 28: Almost all the ambulances operating in the capital are ill-equipped; as they do not meet requirements set by the government, according to the Nepal Ambulance Service (NAS), a non-profit initiative dedicated to establishing an emergency medical response system in Kathmandu and Lalitpur municipalities.



A total of 125 ambulances operated by various hospitals and social organizations in the capital are registered with NAS. However, many hospitals and organizations have not registered their ambulances with NAS. [break]



Most of the ambulances registered with NAS are of C category as they are running without the basic life support system. Only three ambulances registered with NAS meet the requirements mentioned for B category, while none meet the A category requirements.



"Only Bir hospital, Tribhuwan University Teaching Hospital (TUTH) and NAS are operating B category ambulances in the capital," Bishoram Shrestha the coordinator of the NAS said. The remaining ambulances fall under the C category.



"Most of the ambulances are in poor condition and ill-equipped, and they don´t have trained staff for pre-hospital care," Shrestha said.



Pre-hospital emergency care is a critical component of ambulance service. It is a minimum requirement regardless of the category of the ambulance. The adverse health consequences of not having pre-hospital care are extensive and contribute to high mortality rates even in cases of common medical emergencies.



According to the requirements set by the Ministry of Health, to qualify in the A category, ambulances should have an ECG, cardio monitor, defibrillator, ventilator, nebulizer, head immobilization facility, catheterization set, length and weight-based chest for pediatrics. Along with these, the A category ambulance should have a doctor and staff nurse. And it should also have all the facilities of the B category ambulance.



"An A category ambulance should have facilities of the emergency ward of the hospital," Shrestha said.



Similarly the B category ambulance should have suction machine, fracture splint, cervical collar, airway, patient restraint strap and a trained paramedic.



The C category ambulance is required to have first aid medicine, oxygen cylinder, flow meter, mask, tools required for intravenous injection, stethoscope, B P set torch light and stretcher-cum-bed.



The list of ambulances registered with the NAS is not exhaustive, though.



The ambulances of the Norvic International Hospital, and Shahid Gangalal Heart Center, among others have yet to be registered with the NAS.



A Norvic staff, who preferred to remain unnamed, claimed that it has a fully equipped ambulance service, while a staff at the Shahid Gangalal Heart Center expressed ignorance about the standard set by the government.



Shrestha said that NAS is working to list all the ambulances and make sure that the standards set by the government are followed by ambulances operating in the capital.


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