If at all we had protocols – how should it be?

At the end of the conference – Neuro-trauma 2012, I realised that we are having a diverse practice patterns throughout the country. To the best of my knowledge, every neurosurgeon [with the exception of a few] were adjusting and reinventing methods to deliver the very basic of care to the patients who come to them. Whether it be in the high end ICU of AIIMS and NIMHANS or be it in the remote centres like Ratnagiri the purpose is the same – if possible save the patient. Out of my own experience the facility of the internet, I have chosen a format which is practicable in my environment both economically and morally. Since neurosurgery is tech-intensive, one has to choose what is viable.  If we keep the same objective in mind, development of protocols should not be a problem. I therefore suggest 2 levels of protocol formation – Protocol 1 and Protocol 2. Protocol 1 should be the best as per the international standards where as the protocol 2 should be a scientifically logical and basic and economically rational option to be followed by all neurosurgeons through-out the country. In this respect we should take examples from the protocols developed by the Indian Association of Paediatrics [IAP].

Neuro-trauma

Aug 2012

After attending the conference at cochin [ which was nodoubt well organised] the most obvious thing was the complete chaos in the existing neuro-truma system in the country. There was a clear distinction between the institutional segment and the community based neuro-truma management segment. Then there was that obviuos difference between the teaching institutes where the trauma patients are left to the trainees and the corporate sector where the patients are carefully managed by the consultants. Some of the institutional presentation were disappointing when compared to the results delivered by qualified neurosurgeons operating from extremely low resource areas. Cost of treatment appeared to much lower on the peripheral units. Research presentations were poorly selected and hopefully in the future such presentations will not be allowed. Every body talked of a neuro-truma registry but none had any ideas about how to go about it. I am sure most of us will convienently forgeet the issue as soon as we reach home.