According to a who estimate, road accidents are expected to become the third largest killer in the world by 2020. Be it an accident or a terrorist attack or any natural disaster, the need for immediate treatment after an event and before hospitalisation is being increasingly felt to reduce the number of casualties. Trauma care centres are needed.

After the terrorist attack at the Indian Institute of Science, Bangalore, last year, the system of trauma care came to light. An ambulance reached the spot within 10 minutes and took the victims to the hospital. The service was provided by Comprehensive Trauma Consortium, an ngo . The ngo renders pre-hospital care to accident and medical emergency victims in and around Bangalore through a network of ambulances and trained paramedics. But not all cities enjoy such facilities.

According to statistics, head and brain injuries constitute almost 70 per cent of the injuries in Bangalore and the average time taken from the time of accident to the initiation of the treatment in the city takes more than three hours.

"The first hour of the accident is critical and medical treatment should be given in those hours to save life,' says A K Banerjee, director of Vidyasagar Institute of Mental Health and Neuroscience, New Delhi. Such fatalities can be drastically reduced through the establishment of a comprehensive and effective system of trauma care.

More than half of the cerebral injuries that occur can also be taken care of with adequate pre-hospital trauma care systems. "Although road accidents are one of the largest killers, the casualty need not be that high,' says M K Joshipura, trauma surgeon in Ahmedabad and director of Academy of Traumatology. The burden of road traffic injuries amounts to Rs 55,000 crore or 3 per cent of our gdp. India accounts for 10 per cent of road accident fatalities in the world