Fast growing speciality ....in Kerala

https://www.facebook.com/venucreative/posts/769223619871744
In 2006, when I was leaving anesthesia and initiated Emergency Medicine program in Kerala with the support of GWU and IIEMS in Calicut Mims and Dr.Ashish Nandi in Kims Trivandrum, we had only one PG program in Kerala at AIMS Kochi under Dr.Gireesh Kumar.The unconditioned support from Dr.Bobby Kapoor, Dr.George Abraham, Dr. Tamorish Kole and Dr.Azad Moopen in initiating and experimenting a new concept and training program have to be mentioned. The growth of EM in Kerala is tremendous and grass route level. Nine years created history. More than 50 hospitals are holding proper EM in Kerala. More than 100 qualified Emergency physicians are working in Kerala. More than 300 residents and more than 700 ems staff are working in this small state. More than 40 percent DNB Emergency Medicine seats of national average are in Kerala. 352 Asap emct trainees and 150 Angels emct trained volunteers are available here. Asian Ems award, AAEMI award, and Aiims entrepreneurship award have reached to angels community ems network. The sparkling touch of a very vibrant district magistrate of Calicut Dr.PB Salim IAS helped EM Kerala to cross the boundaries of hospitals. IIEMS Kottayam is a pre-hospital training initiative of Dr.George Abraham has bagged platinum status of AHA in 2014 and 2015.The highest number of life support providers in Kerala. India's biggest community-based ems network with 500 ambulances is running in Kerala. Five medical colleges in Kerala state are running PG program in EM.More than 300 EMS paramedics who have been trained from Kerala, are now placed safely and high level in various parts of Globe. EM veteran Prof.Suresh David moved from Vellore to Kerala recently and enriched EM Kerala. EM pioneer Dr.Babu Palatty moved from Bangalore to Trichur and enforcing em training in Kerala. More than 7 AHA ITC are operating in Kerala. India first rural Emergency Medicine center has been launched at Omasseri. India first community-based rural Emergency medical care task force has been launched in last week at Kondothpalam village. India's first community-based bike rescue team with 150 higher ends trained volunteers launched in 2014 in Calicut. Emcon 13, the biggest em conference was hosted at Waynad in November 2013 with a theme of caring people. .bridging gap was the unique medical conference with its public participation. When we organized emcon 13 in Kerala, our aim was to sensitize entire state to em concept and to bring quality em care here. Honorable Chief Minister of Kerala Sri. Ommen Chandy was the chief patron of Emcon 13.We did India's biggest Emergency Medicine road show in connection with Emcon 13 which covered 14 districts with 102 shows that attracted thousands of people in Kerala.This amazing growth of EM has happened in a small state with a population of 3/123 cr of India.Kerala Government health services are the only area where em penetration is relatively less paced. The most popular hill station pilgrimage destination of Kerala, now moving from the concept of cardiology center to Emergency Medical care centers with trained volunteers. The death rate in Sabarimala was very high ( average 1.5 deaths per day in the season ) due to the lack of primary life support care. This year Government has taken it very seriously and trying to establish proper EM care. Proudly observing the life-saving mission in Kerala. ...when looking back, l myself jumped out of a well established and safe specialty to an area that was not known to anybody in the locality and nobody like to move to Indian casualty in a decade back. Honestly, Em is the most wanted glamorous specialty in the region.

M Mohan movie

https://m.facebook.com/story.php?story_fbid=765816730212433&id=416577328469710

Angels BLS

https://m.facebook.com/story.php?story_fbid=764738400320266&id=416577328469710

Belief and Believers

https://drvenu.wordpress.com/2015/11/06/belief-and-believers-a-fwd-message-from-social-media/

Prof.Ian Stell in MRCEM preparatory course at Aster Medcity kochi. Wonderful session. Excellent feedback.

Emergency medical care an urgent need in Kerala

Emergency medical care is the priority ONE in Kerala
One important news today but people took it very lightly or casually ...three people died due to sudden collapse and incidental cardiac arrest during polling. Kerala is the state where the highest number of diabetics, coronary artery diseases, kidney disease, etc. These diseases are the forerunners of sudden collapse. 2015 AHA guidelines recommend bystander CPR and early Emergency medical care to save such medical emergencies. Angels trained more than 100000 lay people in Kerala in Basic life support. Angels have more than 300 trainers pool from health care providers and lay public. These activities are continuing. Good thing many organizations are coming forward to receive this training or to provide training. Kerala is the state where Emergency Medicine awareness is maximum when to compare with any other states in India. Now, we are in a position and high time for the Government to launch the massive public program and also to launch dispatchers cell to public support public.
Second news Dr.Aysha reinstated after suspension following the death of a media person. Good news. The fight is not yet over. I don't know how many of did the real cause analysis on the incident. I strongly believe the scenario will repeat in future as well. What we saw in the current situation is a political patch up. The government is responsible for the present incident. The government is not interested in improving the conditions of casualties of hospitals. Scientifically based emergency room and protocol based emergency medicine practice is the one-word answer to preventing such incidents in the future. Proper Emergency Medicine system would help to save more lives and avoid medicolegal complications. This system will triage patients and ensure ultimate resuscitation care for deserved.This approach will convince lay public and media in critical situations. I have worked in both systems. My ten years experience showed that scientific Emergency room management has  proven to save lives and well convincing lay people about the methodology of emergency case management.
I am adding a forwarded message from personal what's app group
മാതൃഭൂമിയുടെ തിരുവനന്തപുരം റിപ്പോർട്ടർ എനിക്ക് പേഴ്സണൽ വാട്ട്സ്ആപ്പ് മെസേജ് അയച്ചത്.

കുറേ ഗീർവാണങ്ങൾ കേട്ടത് കൊണ്ട് കുറിക്കുകയാണ്...

1) പിഴവ്

സർ..

എപ്ടോയിൻ എന്ന ഗുളിക ആളെ കൊല്ലുന്ന മരുന്നല്ലെന്ന് താങ്ങളെ പോലെതന്നെ എല്ലാവർക്കും അറിയാം..മരണകാരണം തലച്ചോറിലുണ്ടാവുന്ന രക്തസ്രാവമാണെന്നും അറിയാം. അങ്ങനെയുണ്ടായാൽ രോഗി ജീവിതത്തിലേക്ക് തിരികെ വരാനുളള സാധ്യതയും കുറവാണെന്നും അറിയാം...ഇനി കാര്യത്തിലേക്ക് വരുന്നു..

സർ,

മുപ്പത് കഴിഞ്ഞ ഒരാൾക്ക് ആദ്യമായി ജന്നി(അപസ്മാരം)ഉണ്ടാകുന്നു .അത് വീണ്ടും ആവർത്തിക്കുന്നു. അയാളുടെ ബി പി 170/110 ആണ് .
അയാൾതന്നെ തനിക്ക് മുൻപ് ഇങ്ങനെ ജന്നി വന്നിട്ടില്ലെന്ന് ഡോക്ടറോട് പറയുന്നു.

അയാൾക്ക് നൽകുന്ന ചികിത്സ 103 mg% ആയ ഷുഗറിനുള്ല ചികിത്സയായ 25% Dextrose DRIP പ്പും ജന്നി വന്നതിനുളള എപ് ടോയിനുമാണ്..

ഇപ്പോൾ റിപ്പോര്‍ട്ടറാണ്‌ എങ്കിലും ഒരു പഴയ നഴ്സിന്റെ അനുഭവ പരിചയത്തിൽ നിന്നും ഇനി ചിലത് കുറിക്കുന്നു.

ഇങ്ങനെ ജന്നിവന്നാൽ ആദ്യം സിറ്റി സ്കാൻ എടുക്കും. കാരണം
തലച്ചോറിൽ ഉണ്ടാകുന്ന പ്രശ്നങ്ങൾ മൂലമാണ് ജന്നി ഉണ്ടാകുന്നത് അത് കൊണ്ട് തന്നെ തലച്ചോറിലെ രക്തസ്രാവമൊ മറ്റൊ ഉണ്ടാകാൻ ഇടയുണ്ട്. അങ്ങനെയാണെങ്കിൽ അത് കൈകാര്യം ചെയ്യാൻ ജനറൽ ആശുപത്രിയിൽ സൗകര്യമില്ല.മണിക്കൂറുകൾ നീണ്ട് നിൽക്കുന്ന ഓപ്പറേഷനടക്കം ആവശ്യമായി വരും.

എന്നാൽ നമ്മുടെ ഡോക്ടർ എന്താണ് ചെയ്ത്..

1 സിറ്റി സ്കാൻ എടുത്തോ..
2 ബി പി കൂടിയത് ശ്രദ്ധയിൽ പെട്ടോ
3 അടുത്ത ദിവസം ന്യൂറോ വിഭാഗത്തിൽ കാണിച്ചാൽ മതിയെന്ന് ഡോക്ടർ പറഞ്ഞില്ലെ..
4 ജന്നിക്കപ്പുറം ..എന്ത് കൊണ്ട് ജന്നി വന്നു എന്ന് നിങ്ങൾ പരിശോധിച്ചോ..
5 അവന് ജീവിതത്തിലേക്ക് തിരികെ വരാൻ സാധ്യതയുണ്ടായിരുന്ന രണ്ട് മണിക്കൂർ നിങ്ങൾ നശിപ്പിച്ചില്ലേ ...

ഇല്ല.. ഇല്ല... ഇല്ല...ഇല്ല.....

സിറ്റി എടുത്ത് റെജിമോന് തലയ്ക്ക് രക്തസ്രാവമാണെന്ന് മനസിലാക്കി എവിടേക്കെങ്കിലും റെഫർ ചെയ്തിരുന്നെങ്കിൽ അവനെ രക്ഷിക്കാൻ കഴിയുമായിരുന്നില്ലേ?

അവിടെയാണ് ചികിത്സാ പിഴവ് എന്ന് പറഞ്ഞത്. നിങ്ങളുടെ അശ്രദ്ധ.. എല്ലാം നിങ്ങൾ നിസാരവത്കരിച്ചു....

അവന്റെ വിധി ...

2 ) വിധി..

സർ ,
നമുക്കൊപ്പം ക്യാമറ ചലിപ്പിച്ചവൻ പെട്ടന്ന് മരിച്ചെന്ന് പറഞ്ഞപ്പോൾ ഞങ്ങൾ തകർന്ന് പോയി ..അതു കൊണ്ട്
ഞങ്ങൾ ഡോക്ടറോട് മരണ കാരണം ചോദിച്ചു..

പക്ഷെ ഡോക്ടർക്ക് മരണ കാരണം അറിയില്ല.. എങ്ങനെ അറിയും
ഡോക്ടര്‍ മാഡം ജന്നിക്കല്ലേ പരിശോധിച്ചുളളൂ. അതിന്റെ കാരണം തിരക്കിയില്ലലൊ..അതുകൊണ്ട് ഡോക്ടർക്ക് ഉത്തരം മുട്ടി.

അവിടെ വന്നവർ നാട്ടുകാരുടെ പൈസക്ക് MBBS പഠിച്ച്‌ നാട്ടുകാരുടെ പണം ശമ്പളമായി വാങ്ങുന്ന KGMOAയുടെ അംഗങ്ങൾ അല്ലാത്തതിനാല്‍ ഡോക്റുടെ ഉരുണ്ട് കളിയിൽ സംശയം തോന്നി..

ചോദ്യമേറിയപ്പോൾ "' മരണ കാരണമൊക്കെ ഇതിലുണ്ട്, അതില്‍ നോക്കിയാല്‍ മതി""പറഞ്ഞ്
OP ടിക്കറ്റ് വിലിച്ചെറിഞ്ഞു . ഇത് നിരസിക്കാൻ അവർക്കാകുമൊ..

അതോടെ സംഭവം കൂടുതൽ വഷളായി ..തുടർന്ന് DHS ഉം DMOയും ഒക്കെ സ്ഥലത്തെത്തി...DHS ന്റെ പ്രാഥമിക വിവരത്തിന്റെ അടിസ്ഥാനത്തിൽ ഡോക്ടറെഅന്വേഷണവിധേയമായി സസ്പെന്റ് ചെയ്യാൻ മന്ത്രി നിർദേശം നൽകി

പക്ഷെ അവിടെ വില പേശിയത് ഡോക്ടർമാരാണ്, ഞങ്ങളല്ല.

സസ്പെൻഷനാണെങ്കിൽ ഞങ്ങൾ സമരം ചെയ്യുമെന്ന് പറഞ്ഞത്
KGMOAയുടെ സംസ്ഥാന പ്രസിഡന്റ് ഡോ. പ്രമീളയാണ് .

.

3 ) ടാം റേറ്റിങ്ങ്
(ഇപ്പോൾ ടാമൊക്കെ മാറി പുതിയത് ബാർക്കാണ്).

ഇതുപോലത്തെ സംഭവം പലപ്പോഴും ആശുപത്രികളിൽ ഉണ്ടാകും
എന്നാൽ DHS നേയും DMO യേയും മന്ത്രിയേയും അറിയാത്തതു
കൊണ്ടും മാധ്യമങ്ങള്‍ അറിയാത്തത് കൊണ്ടും പുറം ലോകമറിയുന്നില്ല . (പക്ഷെ ഇനി അതെല്ലാം പുറം ലോകം അറിയും )

സർ, കൂടപ്പിറപ്പിന്റെ മരണ വാർത്ത നൽകി ബാർക്ക് റേറ്റിങ്ങ് കൂട്ടാമെന്ന് ഞങ്ങൾ കരുതുന്നില്ല. അതിനായി മരുന്ന് കമ്പനികളിൽ നിന്നും ലാബുകാരിൽ നിന്നും ഡോക്ടർ കമ്മീഷൻ വാങ്ങുന്നതും,
സർക്കാർ ആശുപത്രികളിലെ ഓപ്പറേഷന് വീട്ടിൽ പണം വാങ്ങുന്നതും , (അനസ്തേഷ്യ ഉൾപ്പടെ) മൊക്കെ വാർത്തയാക്കിയാൽ മതി .. സാറേ..

അല്ലാതെ ഒരാൾ മരിച്ച് കിടക്കുമ്പോൾ സമരം കൊണ്ട് വിലപേശുന്ന പിതൃശൂന്യ സംസ്കാരം ഞങ്ങൾക്കില്ല .

4 ) ഒണക്ക KGMOA യും കുറേ പുളുന്താൻ സമരങ്ങളും

1966 ൽ രൂപം കൊണ്ട ശേഷം ശമ്പളം കൂടാനും ജോലി സമയം കുറക്കാനും വേണ്ടിയിട്ടല്ലാതെ ഡോക്ടർമാർ സമരം ചെയ്തിട്ടുണ്ടോ..

നിങ്ങളുടെ ഓരോ സമരത്തിലും എത്ര രോഗികളാണ് ബുദ്ധിമുട്ടുന്നത്. സമൂഹത്തിനോട് ഒരു പ്രതിബദ്ധയും ഇല്ലാത്ത ഒരു സംഘടന .

2007 ൽ ഡോക്ടർമാർ സമരം ചെയ്യാൻ പാടില്ലെന്ന് ഹൈകോടതി വിധിയുണ്ട് . അഹമ്മദ് കുട്ടി v/s സറ്റേറ്റ് ഓഫ് കേരള
എന്ന കേസിലാണ് ആ വിധി . അതിന്റെ ഭാഗങ്ങള്‌ ചുവടെ

We may also observe that the services by doctors are essential services and if, therefore, the doctors of the State may strike, the Government would be well in its right to invoke the provisions of the Essential Services Maintenance Act and take action against them accordingly. We may also mention that in a noble profession which is totally service oriented, strike cannot be possibly resorted to. The members of the noble profession who are expected to serve the people cannot leave in lurch the patients at the time of their extreme difficulty, pain and suffering.

ഇത് പ്രകാരം സർക്കാർ എസ്മ പ്രയോഗിക്കാൻ പോയപ്പോഴല്ലെ കഴിഞ്ഞ രാപ്പകൽ സമരം ഒരു ആവശ്യവും അംഗീകരിക്കാതെ നിങ്ങൾ തലയിൽ മുണ്ടുമിട്ട് രാക്ക് രാമാനം അവസാനിപ്പിച്ചത്.

എന്ത് കോടതി വിധി. നമ്മൾ നോട്ടീസ് പോലും നൽകില്ലല്ലോ....

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Helmet controversies

http://epaper.deccanchronicle.com/epaper_main.aspx

New malayalam hit songs 2015-2014

Love 24 x 7 @ home theatre

The DVD on this movie was released this week. I missed this movie in the theater. It is a beautiful movie.But it was a failure in the box office show. Probably it may be due to the effect of box office hit "Premam".
However, in word, love 24 x 7 a movie worth to watch. It is the clean movie with a message. The movie is telling a story inside the life in visual media and giving a subtle comparison with the busy life of doctors. When critical decisions in life collide with professional priority will lead us entirely different directions. Moreover, when looking back, we came to know that we have not reached anywhere. Moreover, when deciding something in a right way, the time may lapse. We lose the game altogether.
New actress, Nikhila did extremely well in the movie.

She is highly talented and promising. Dileep as usual good but controlled acting. The core characters are Rupesh nambiar[Dileep] and Kabani [Nikhila] .However, Dr.Sarayu [Suhasini] and Dr.Suresh [ SashiKumar] the two characters will touch your heart deeply and follow you even after the movie.
This movie has been written, and Directed by Sreebala K Menon.

Yes, we have got another female director like Anjali. We can feel the smoothening touch of directorship in the entire movie.  Good movies like this are not get accepted by people. That is the sad side of Malayalam film industry 

For our sisters, daughters ,mothers and lovers ...for children

Meghamalhar (7) - Oru naru pushpamay

Parayaan Maranna Paribhavangal

Neermizhi peeliyil neermani thulumpi .vachanam HD

Oru chembaneer pooviruthu njaanomane.......(STHITHI,2003)

‘Kanaka Mylanchi’ - Loham | Official Music Video HD | Mohanlal, Andrea J...

Emagency in AMC

https://youtu.be/ZvbaRdDFcho

Excellence in Emergency Medicine award 2015 at Pace , TN

Special Lecture on Cardiac Troponins

Times of India

'Angels' set for statewide expansion http://timesofindia.indiatimes.com/city/kozhikode/Angels-set-for-statewide-expansion/articleshow/48182100.cms via@timesofindia

Deccan Chronicle wrote

Criya Kottakkal ... anniversary

My home

Honour

Honour

GWU MEM @ DM Health Care

GWU MEM Convocation at Mims Calicut

New Ems batch 2015

My students are my wealth

Doctors Day

Trauma aftermath

വളരെ ഇമോഷണൽ ആയ ഒരു രംഗം - കഴിഞ്ഞ ദിവസം സജീവൻ, മറ്റു രണ്ടു സുഹൃത്തുക്കൾ , ഞാനും മുക്കത്തിന്നടത്തു ഒരു ക്വാറി പണിക്കാര നായ സുഹൃത്തിനെ കാണാൻ പോയി. പുനർജ്ജനിയുടെ ഭാഗമായ , അപകടത്തിൽപ്പെട്ടവർക്കുള്ള ഒരു ചെറിയ സഹായം നൽക ന്നതിന്ന് - 2009 ൽ പതിനഞ്ച് അടി മുകളിൽ നിന്ന് വീണ് നട്ടെല്ലിനും സുഷു മന ശീർഷത്തിനും പരിക്കേറ്റ ഈ ആന്ധ്രക്കാരന്റെ കഥ വളരെ വേദനാജനകമാണ്: ചൂഷക പൂർണ്ണവും. ആദ്ദേഹത്തിന്റെ ആ കൈയ്യിലെ സ്പർശത്തിന് ഒരു പാട് അർത്ഥങ്ങൾ ഉണ്ട്

Reading New Indian Express epaper http://www.readwhere.com/read/525636/#page/3/1 -- powered by readwhere.com https://play.google.com/store/apps/details?id=com.readwhere.app

For our Father

https://youtu.be/AQ2e_WUy6KU

Panarjeny

Take a look at this medical image on Figure 1. "Approx. 60y/o m s/p MVC, crushed between two vehicles at slow speed. Gross deformity on arrival. 10/10 pain with good pedal pulse. Tx by EMS to local trauma center. Closed tib/fib fx.": https://app.figure1.com/rd/image?imageid=5557fcf031f3b9e94863ecba&sb=5558b15eccf63be615b02fbe&st=s&utm_source=ishare&utm_medium=ImageLink

Proud .... be a doctor

I enjoy being a doctor. My businessmen, engineer and software friends might earn more than me, bankers may have more benefits than me. But I still enjoy being a doctor because I can make someone better, because I can save a family , because I am a part of a miracle many a times and because I am symbol of hope in despair.

People save a life by accident and feel proud for the rest of their lives. I do it for a living. Is there any better way of living than this?

My profession has given me enough. Being doctor I have more than enough money to raise my kids, have a decent house, enjoy little hobbies, needs are met. I am also amongst the most intelligent and the top elite professionals in the world . In the current scenario still the toppers of high schools , SAT exams and other entrance tests in India and abroad want to take medicine as a career.

I am grateful to all those people who invested in me to make me doctor. I am thankful to all my patients who waited for hours, so that I can present the case for teaching. I am thankful to God that he helped me to gain skills that now I can contribute and can have a meaningful life. Thankful to my patients who put their trust and faith in me and I wouldn't let them down .

Yes, it is stressful. I agree I worked very hard, without a doubt I had many sleepless nights. I have worked days together without holidays , vacations or weekends .

End of the day, it is my choice. I am leading a much easier life than those soldiers , army men , officers who stay in tents in snow, deserts and jungles and die every day for us, and what a shame they die unknown . They are doing a tremendous job as well . All professions have challenges but not all have such returns as this one .
My profession has given a meaning to my life, it is my turn to justify that. I love being a doctor , actually I feel blessed being one !!!
This one is dedicated to all my doctor colleagues and friends who are doing a great job wherever they are and whatever might be the circumstances, they are making a difference in someone's life !

Radio Talk on AIR - Socio medical aspects of Road accidents

ROAD TRAFFIC ACCIDENT

Road traffic accidents are the major killers in Kerala , which causes huge number of minor and major disabilities.  Presently road accidents created an unsafe feeling while we are moving out of home.  It created a situation that no guarantee for human life.

I remember the great words of M T Vasudevan Nair in novel Manju - “Death is a comedian who doesn't have any sense of scene”.  Nowadays, it is more appropriate in accident scenarios.

The statistics on road traffic accidents given by Government agencies like NATPAK is quite alarming.  It shows that more than 5000 people killed in the road in last year, more that 6 fold of this number disabled and huge number became bed ridden due to severe head injuries and spinal cord injuries.  More than that, statistics showed that 80% of the victims were between 20 – 50 years of age, out of this figure 90% were either two wheeler riders or pedestrians.  Across India, 80 people are dying in every minute.  In general, Kerala has the highest rates of accidents when compare to other states.

One interesting observation – as we know, in Kerala in 2015 January Kerala Police and Kerala Road Safety authority celebrated road safety week in very high pace.  Incidentally I came to face many accident cases during this period.  Out of curiosity I did  goggling to get some figures and found that we had more than 800 accident deaths in January alone.  This information from 'Kerala Police' face book page.  This figures really questioning the meaning of our great celebrations.
Why such accidents -  reasons are many; like road conditions, vehicle conditions, driver related issues, pedestrian related issues and some other unavoidable situations.

Contributory factors like alcohol and illicit drugs, using mobile phones are to worse the situation.  More than 80% incidents showed that violation of road traffic rules are single factor which lead to accidents.

I would say the 'Golden' period in Kerala road safety was the tenure when Mr Rishiraj Singh IPS was the Road Safety Commissioner.    Personally I felt that, there was 40 – 50% reduction in accident cases presentations in emergency rooms in the hospitals where I worked or supervised.  This reflection was  evident in Government Hospitals and Medical College accident registry as well.

What the Commission was trying to do that he tried to implement the rules little more strictly and did adequate monitoring, its implementation with passion.  It reflected on the road.  This tells a lesson to us, Kerala people are educated, can accept the rule.  But somebody should insist.

One major issue in our roads are, 80% people are not following any traffic rules or doesn't have any road culture.  It needs a huge awareness campaign on road safety to educate this major road users and in the authority should insist the road rules more strictly.

We already rejected express highway and other major road widening proposals.  It may not be possible to build international road standards  in Kerala with immediate effect, due to our special political, population related and land related issues.  Later, we may think about the projects like express high way through sea shore etc.  But we can't loss lives till such innovations to happen.

Two things that we can do immediately -
very strict and rigorous implementation of traffic rules with bold political will.  In our state, people have belief that, what ever crime you did, top most political leadership or some influenced people will save you.  People are considered that road traffic accident killings are not a big crime.
Huge awareness campaign on road culture and which should be inculcated in our mind and make it part of our children eduction.  School can be the huge platform for such activities

Few words about seat belt and helmet
Seat belts are just the part of safety of the passenger, just like brakes and head light etc.  A basic science that we learned in out school day, Newtons law which will be applied in all accidents.  In case a vehicle involved in an accidents, it is very obvious that all unrestrained objects and passenger will  moving forward and throw out of vehicle, at a speed rate at which the vehicle was traveled at the time to incident.

So naturally the people inside vehicle, who not worn seat belt will throw out or hit on dash board or steering wheel, will be injured badly and presented with life threatening injuries like head injury, chest injury, lung injury, bone injury and end up into very disaster our poly trauma situations.  This risks are equal for front seat and back seat passengers.  The risks are very high for the children inside the car, they are prone to throw out of car and instant death.

Two wheeler are more prone accidents and bad injuries.  Two organs in our body – Brain and Spinal cord are irreparable, if once damaged.  That is the reason why road safety rules insist helmet.  Good quality helmet can prevent 90% of major head injuries.  But the helmet should cover your whole head and face up to lower jaw and should be strapped properly.  An unhooked helmet has no value, in protecting head injury.  Because in the event of accident helmet will be thrown out of your head.  The head injury risk are equal for both front and back passengers.  Rather back seat riders are more prone for severe injuries.  I observe that, presently 75% of two wheeler drivers are wearing helmets.  But 95% are not used to put buckles.  100% back seat riders in Kerala are not using helmet.  Very interestingly, majority of back seat riders are females or children.  I surprise that, why we are not caring out better half and children in terms   of safely and love.

What is next once an accident occurs & How you care the accident victim -
All accident victim should get urgent medical care, need higher end life saving care within golden hour or platinum 10minutes

Accident cares are in three levels
on site cares
care during transport
care at hospital
At least two things should be taken care in all trauma victims on site
C-spine protection
Bleeding control
Victim should be transported to nearest healthcare facility in a Ambulance with back spine board protection.  In Kerala, we have health care facilities in every 15km, and this healthcare facilities should also equipped to manage at least primary level trauma care.

Destination care should be manged by trauma team, which involved Trauma Surgeon, Emergency Physician, Anesthetist, Ortho, Vascular, Neuro and Faciomaxillary surgeon.
Trauma facility include X ray, radiology, blood bank, operation theaters, post mortum facility rehabilitation centre.

Finally -
we don't know, who is going to be a trauma victim, it can happen any time to any body.  Once an accident occurred, if you unconscious, if you are not identified by somebody, you will become a destitute, you will continue in the destitute state till somebody recognize your identity.
I believe it is the right of a citizen to get quality trauma care at free or affordable cost, that come from site of accident, en route to hospital and then in the critical hours in the hospital emergency medical care system.

Grand function at Skin diseases hospital Chevayoor

Today  ...it  was a great and disturbing day for me. I attended a function at Skin diseases  hospital Chevayoor which was previously called Government leprosy hospital .SYS Sahayi group renovated two wards with modern amenities and the function was it's submission to the user's.  Usthad  AP Aboobacker Musliyar was the chief  guest.Dr.Ajith Kumar VT and other dignitaries  attended the function. The function was simple and elegant.
In my mbbs days 1981to  87 , I used to visit Chevayoor leprosy center very regularly. My senior Dr.Roy pulickan introduced my to the inmates in those days. We used to collect dresses and other useful items for them and used to spend time with them .There were more than 100 inmates there . All inmates were completely  cured victims of leprosy . But the social stigma and disfigured  facies and hands made them miserable and they were out casted from families. They forced to spend their whole life in the sanitarium.
I lost connection with this place and people ...may be my ignorance or changed my priority. The place was so cool and calm ,old and nostalgic. It is inside the city. .a 100 cents land with greens ..evening blessed with breeze and chirping of birds ...it is Devine too. But for the inmstes with cursed life may not feel it.
Very interestingly  in last 40 years Calicut city has been changed a lot. Now Calicut look like a well developed forgien city. But this leprosy sanitarium has no change. Old building ...poor facilities and few of the inmates are the same people that I met 40 years ago. Only change the center name changed to "Govt.Skin disease center "
We claimed that we are educated with 100 percent  literacy rate. But I believe that we are not . We are keeping the same stigma ...At least their on families don't want them. Leprosy is like TB .100 percent curable.
The day is disturbing when I am leaving the center.
SALUTE  SYS for the present initiatives.

Road traffic accidents in Kerala

Summer Rain at Calicut

http://metrovaartha.com/2015/04/03/%E0%B4%B1%E0%B5%87%E0%B4%BE%E0%B4%A1%E0%B5%8D-%E0%B4%85%E0%B4%AA%E0%B4%95%E0%B4%9F%E0%B4%99%E0%B5%8D%E0%B4%99%E0%B4%B3%E0%B4%BF%E0%B4%B2%E0%B5%8D%E2%80%8D-%E0%B4%AE%E0%B4%B0%E0%B4%BF%E0%B4%95/

Sun burs and related issues

Cricoid pressure Yes or No :Presentation at Gamet 15 Chennai

http://m.authorstream.com/presentation/drvenugopalpp-2438440-cricoid-pressure-yes-or-no/

Metro vartha wrote

Procedural Sedation in ED , Presentation given at SEMIC ON 2015 at Chennai in February 2015

http://www.authorstream.com/Presentation/drvenugopalpp-2406839-chennai-procedural-sedation-emergency-medicine/

Emergency Medicine : The most wanted speciality in India - presenation which has been viewed by more than 2000 people within 24 hours of upload

http://www.authorstream.com/Presentation/drvenugopalpp-2423823-emergency-medicine-wanted-medical-speciality-india/

Fast exam : Save lives in acute care setting ; Presentation on Fast approach

http://www.authorstream.com/Presentation/drvenugopalpp-2435215-fast-exam-save-lives-critical-situations-trauma-settings/

Cricoid pressure : Yes or No

http://www.authorstream.com/Presentation/drvenugopalpp-2438440-cricoid-pressure-yes-or-no/

PK Full Movie 2014 Aamir Khan HD

Amir Khan's Movie PK released across nation with large scale controversies which have been discussed widely. I screened PK in my home theatre recently. PK DVD released last week. Full HD movie available in You tube .[http://www.drvenu.net/2015/03/pk-full-movie-2014-aamir-khan-hd.html]. I postponed my PK viewer ship to home theatre mainly because of my poor Hindi knowledge . Special advantage in home theatre is that we can get the privilege of subtitles and any time we can rewind and re look.

In one word -PK is a awesome movie ...only Amir Khan do it. The movie exposes Indian mind ask us several questions . We ourselves exposed to our many pseudo...in terms of love , worships , customs , relations , sex  and many ....Movie ask us to think "who you are ? " Craft is simple . But the movie conveyed the wrong numbers very powerfully. The issue raised in the movie is much more relevant in Kerala. We proudly say we are educated and having 100 percent literacy . But I believe that Kerala is the state in which maximum wrong numbers...we the biggest pseudo s when compare with any other states ....Movie is giving the biggest message of pure love. Being a doctor and as the member of the  biggest professional organization in India [IMA] , I don't know why IMA raised protest against PK. I received form messages against PK through social media . I don't know it was prank call through a PK wrong number .....
https://www.facebook.com/venucreative?fref=nf