Emergencies on the train and railway stations managed at a railway station emergency care center

With the increasing focus on setting up emergency care centers in railway stations across India by the government, there are no baseline data in India, or the world, about the profile of patients presenting with emergencies on the trains and at the railway stations.

This retrospective study included all people who presented with any medical emergency to the Emergency Care Center (ECC), Katpadi Railway Station in South India, between January 2017 and December 2017. Details were obtained from the register maintained by the emergency nurses stationed at the ECC.

Among 1076 patients who presented to the ECC during the study period, the mean age was 37 years (standard deviation: 19.01) with two-thirds (66.1%) being males. A quarter (23.4%) were trauma-related and 76.6% were medical emergencies. Sharp force injuries [58.8% (151/252)] was the predominant mode of trauma, while laceration [57.1%] (144/252) was the predominant type of injury sustained. Common nontrauma presenting complaints included fever (27.5%), headache (17.9%), nausea/vomiting (17.9%), and abdominal pain (15%). The maximum number of cases was in the summer months of May-June with heat-related symptoms, while the maximum number of fever cases was recorded during the monsoon season. The majority (905/1076; 84.1%) were able to continue their journey further, and 13.9% required referral to a nearby hospital. During the 1-year study period, 2 patients with trauma and 18 with various medical conditions died at the railway station or at a hospital after resuscitation at the ECC.

Trauma, fever, headache, and vomiting are the most common emergencies among patients traveling by rail and at the railway stations. Establishing well-equipped ECCs across the country to handle trauma and other medical emergencies during travel is part of primary care provided and is the need of the hour.