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      PRINCIPAL INVESTIGATOR    :    MR.OBBU CHAITANYA SAI                        GUIDE                      :   DR. HARI PRASAD V              Assistant professor                    Department of forensic medicine                     PESIMSR, Kuppam               Reference ID: 2018-03087TITLE: A Study Regarding “Necessity of a Medical College in remote Rural Area in Emergency Care”, India.Introduction:Emergency medical services (EMS) providers care for individuals who have had a sudden or serious injury or illness, or who have suffered major trauma. Access to EMS is critical for rural citizens, but providing services is often challenging in rural areas5Given that 50% of the world’s population lives in rural areas1.But unfortunately emergency care in rural areas was poor when compared to urban area, especially in INDIA. Rural location was associated with a higher baseline hazard; a 50% reduction in rural prehospital time would theoretically reduce 4-h mortality by about 7%2.  The distribution of pre-hospital trauma care facilities does not reflect the needs in terms of Road traffic accident Mortality and Road traffic injuries for different regions3. The practice of emergency medicine presents many challenges in rural areas. Rural hospital emergency departments (EDs) must be staffed to handle a wide range of emergency situations, but other demands on rural physicians’ time and limited EDpatient volume may complicate ED staffing.4.To get high quality emergency care there is a need of Multi-Specialty unit attached with Emergency Medicine, because most of the emergency cases are related to the involvement in multiple vital organs of the body at the same time. In India the rural health care in most parts of the country are governed by primary health care Centre’s which donot have emergency care staff, infrastructure to handle emergency cases. Since India is a developing country, within 10-15 years later also, there may be a remote possibity of having highly equipped emergency department in primary health care. Private hospitals are unable to build Multi -Specialty Emergency Care Hospitals in rural areas because of low profits and low paying capacity of rural people. But if a Medical College is established in rural areas, there is a possibility of establishment of high quality Multispecialty Emergency Department with surplus staff, so that the rural people may get emergency care in time at affordable price or free.   Objectives:1. To find out whether an establishment of a Medical College in remote rural area would improve the emergency care, when compared to Primary Health Centre.2. To find out whether establishment of Medical College in remote rural area would improve transport facility from the Scene of incident to Medical College Hospital.Methodology:Study design: Retrospective study Study setting: PES Institute of Medical Sciences & Research (PESIMSR), Kuppam, Andhra Pradesh -517425 (a remote Medical College in India).Study period: 2 MonthsStudy population: Patients admitted in Emergency Medicine Department, PESIMSR,  Kuppam.Sampling method: Purposive sampling.Sample size & inclusion criteria: Case records (which involves neurology, CT-surgery, Cardiologist interventions, involvement of investigations like CT, MRI.)in Emergency Medicine Department during Jan -2017 to Dec 2017 in PESIMSR, Kuppam. Data Collection and Analyzation:· Data is collected from case records of Emergency Medicine Department.· Case records which involves Neurology, CT-surgery, Cardiologist interventions, involvement of investigations like CT, MRI are only taken In Emergency Medicine Department during Jan -2017 to Dec 2017 in PESIMSR, Kuppam.· Analyzing the case records regarding Age, sex, type of cases, treatment, investigations, completely Cured cases, disabled cases, duration of treatment and mortality rates.· Analyzing whether the patient was referred from primary or other health care or brought directly from the scene of incident etc and time duration during such transit.· All the data collected are arranged in tables, bar diagrams and pie diagrams using appropriate software.· A hypothetical analysis done by comparing what happen to a patient, if the same patient was admitted in Primary Health Centre or similar health care system with limited time , and if he was referred to higher Centre far away from the scene of incident.·  Conclusions will be drawn from the above research and represented in tables , bar and pie diagrams and discussed    Implications:If my study shows that establishment of Medical College in remote rural area would improve emergency care in India by many folds, then I can publish my research work so that it will bring awareness among people regarding importance of a Medical College in remote rural areas and I can send a supportive proposal to higher authorities like MCI or relevant authorities to establish more number of Medical Colleges in remote rural areas in INDIA.  References: 1. Emergency care facility access in rural areas within the golden hour? Western Cape case study Marianne and Duncan McKune2. Estimating the effect of emergency care on early survival after traffic crashes. Clark1, Winchell RJ, Betensky RA.3. Pre-hospital trauma care resources for road traffic injuries in a middle-income country–a province based study on need and access in Iran.Haghparast Bidgoli H1, Bogg L, Hasselberg M.4. Rural Emergency Department Staffing: Potential Implications for the Quality of Emergency Care Provided in Rural Areas Upper Midwest Rural Health Research Center.5. Rural Emergency Medical Services (EMS) and Trauma. Rural health information hub (RHI hub)      

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