Transport time to trauma facilities in Karachi: an exploratory study

BACKGROUND Rapid urban growth in developing countries has outpaced the development of health infrastructure, including trauma centers, leading to potential delays in trauma care. This study was conducted in Karachi, a city of 16 million people in Pakistan. AIMS Our aim was to determine the time taken to reach the nearest 24-h emergency care facility (ECF) and the government-designated trauma center (TC). We also sought to determine the availability of supplies and equipment required for "basic" trauma care at these centers. METHODS We selected five towns in Karachi that had the highest number of road traffic injuries (RTIs) (as identified through medicolegal records). We then measured the time taken to reach the nearest ECF and the government-designated TC from four compass points within each town. We also asked about the equipment and supplies used in basic trauma care. RESULTS All three TCs in Karachi were located in the selected towns and were within 5.0-10.5 km of each other. The transport times to the 3 TCs were an average of 13.3 min (+/- 7.1) and to the 16 ECFs an average of 4.7 min (+/- 2.4) (p value < 0.00). Most ECFs did not have all equipment and supplies necessary for basic trauma care; 90% had the basic equipment for management of airway, oxygen, and IV fluids, 70% had morphine, and 45% had C-spine collars. CONCLUSIONS Vital time is lost in reaching a government-designated TC. ECFs might be an alternative option, but are not fully equipped and funded to provide adequate trauma care to all.