Transport time to trauma facilities in Karachi: an exploratory study

Area of Science:

• Public Health
• Trauma Care
• Urban Health Infrastructure

Background:

• Rapid urbanization in developing nations often outpaces healthcare infrastructure development.
• This study addresses trauma care challenges in Karachi, Pakistan, a megacity of 16 million.
• Inequitable access to trauma care is a critical public health concern.

Purpose of the Study:

• To assess travel times to emergency care facilities (ECFs) and government-designated trauma centers (TCs).
• To evaluate the availability of essential supplies for basic trauma care at ECFs.
• To inform strategies for improving trauma care accessibility and effectiveness in urban settings.

Main Methods:

• Study conducted in five Karachi towns with high road traffic injury (RTI) rates.
• Transport times to nearest ECF and TC measured from multiple points within towns.
• Surveys assessed availability of critical trauma care equipment and supplies.

Main Results:

• Average transport time to TCs was 13.3 minutes; to ECFs, 4.7 minutes (p < 0.00).
• Most ECFs lacked comprehensive supplies: 90% had airway/oxygen/IV equipment, 70% had morphine, 45% had C-spine collars.
• All three TCs were located within a 5.0-10.5 km radius in selected towns.

Conclusions:

• Significant time is lost reaching designated trauma centers.
• ECFs present a closer alternative but are inadequately equipped for comprehensive trauma care.
• Enhancing ECF capabilities and resources is crucial for improving trauma patient outcomes.