yes sadly this is because we don't have a National Incident Command System, this is instrumental in emergency operations. The NDMA is working on a draft, but it has been in the pipelines since 2009.
I am impressed by your knowledge, the problem is tiered and not linear. There is a huge disparity between pre-hospital care and in hospital care levels in Pakistan.
For example in developed countries you have people with basic knowledge relating to C Spine Injuries and basic airway management, so they know not to move someone who has had a car crash or fall form height and keep the airway open of someone unconscious. In Pakistan the average bystander will never have such knowledge and this compromises the Golden Hour
Golden hour (medicine) - Wikipedia, the free encyclopedia, not only does this compromise the golden hour but also has an impact on the Platinum 10 mins (ambulatory care time)
Battlefield Medicine: The Golden Hour and the Platinum Ten | Britannica Blog.
Secondly when trained responders arrive, we are trained to use a system called START: Simple Triage and Rapid Treatment, in addition to doing a Rapid Trauma Assessment or Medical assessment of the patient, the starting the relevant intervention (Load and Go: Serious Trauma to be treated in hospital, or Stay and Play: Basic First Aid provision, non life threatening).
In Rescue 1122, CARES and Aman Foundation ambulances carry basic and intermediate care equipment including Patient Monitoring, AED, O2, Suction, burns kit, IVs, Airway Management etc... The problem really starts when the patient leaves the bubble of care of the ambulance and is received at the A&E dept of a hospital.
When the ambulance arrives at the hospital the crew will do a handover with doctors, this handover will include a PRF: Patient Report Form, which is filled in by the paramedics when they are transporting the patient and includes data important to the Doctor such as SAMPLE: S:Signs & Symptoms, A:Allergies, M: Medications, P: Past Medical History, L: Last meal/oral intake, E: Events leading upto along with a GCS: Glasgow Coma Scale and other vital patient statistics.
As i said, there is a huge disparity in the levels of care provided at Pre-Hospital and in-hospital. Some hospitals do not have doctors or nurses trained in BLS or ALS, let alone trauma care skills, these hospitals are very understaffed and ill equipped. Sadly it is here that the patients start to suffer, as the chain of survival and golden hour becomes compromised.
There is an emphasis on improving hospital response and training for in hosptial staff on International Standars, for example the lifesavers foundation has been providing ALS: Advanced Life Support & BTLS: Basic Trauma Life Support training to doctors and nurses since 2005:
Lifesavers Foundation - Home
Furthermore PEER: Program for Enhancement of Emergency Response ( A joint project of NSET and USAID) has been working on improving hospital surge capacity and response capacity for MCI: mass casualty incidents.
http://www.ndma.gov.pk/Docs/BooksAndPublications/PEER/Pakistan_PEER_Complete_Database.pdf
Still a lot needs to be done, but Pakistan is limited because of red tape and lack of funds/interest. Did you know that we started free Basic Life Support training in Rawalpindi and Islamabad and only managed to train 400 volunteers from 2005 to 2010, because a lack of interest, Whereas private trainers charge 2500 to 5000 rupees per person for this training
A lot more needs to be done.
he wants to collect all the animals of zoo that McDonalds Happy Meal gives
