7 months ago
2
By mounting up specialised centres for paediatric exigency care, Tamil Nadu has importantly improved kid endurance rates successful caller years. The State’s Paediatric Resuscitation and Emergency Medicine (PREM) inaugural has strengthened paediatric exigency attraction successful authorities secondary attraction institutions — territory office hospitals and taluk hospitals — done dedicated protocols and due infrastructure.
PREM is 1 of the six pillars of the Tamil Nadu Accident and Emergency Care Initiative (TAEI).
There are 116 PREM centres crossed authorities tertiary and secondary attraction institutions — 41 Directorate of Medical Education and Research institutions (36 aesculapian colleges and 5 allied institutions) and 75 Directorate of Medical and Rural Health Services institutions (district office and taluk hospitals), said M. Vijayakumar, Deputy Director-Team Lead, TAEI Commissionerate, Tamil Nadu Health Systems Project.
Data shows a dependable emergence successful endurance rates among children treated astatine PREM centres — from 93.44% successful 2021 to 96.26% successful 2024. In the existent twelvemonth (up to August 2025), the endurance complaint is 94.34%. Admissions person besides surged sharply, rising from 21,586 successful 2021 to 80,907 this year.
The conception was built connected a exemplary formulated by the Institute of Child Health (ICH) and Hospital for Children successful Egmore, said Indumathy Santhanam, Project Coordinator, Regional Collaborative Center, PREM Skills Laboratory, ICH, Madras Medical College.
‘Guidelines developed’
“The Paediatric Emergency Medical Course was started astatine ICH. We developed guidelines to dainty paediatric emergencies. This included grooming postgraduates to behaviour a 60-second investigation of sick children, and marque autarkic decisions. These efforts reduced infirmary mortality. The lessons learned formed the ground for PREM guidelines, and units were launched astatine 28 hospitals (22 territory office and six sub-district office hospitals) successful 2017,” she said.
This was pioneered by the National Health Mission, Tamil Nadu, arsenic a strategy to trim post-neonatal under-five mortality.
PREM has saved the lives of galore children brought successful captious condition. “Earlier, it utilized to beryllium a ‘scoop-and-run’ approach, arsenic paediatric exigency services were unavailable successful taluk and sub-district hospitals. A ample fig of children were taken to these secondary attraction hospitals, and rapidly referred to tertiary attraction centres. This changed successful 2017, erstwhile PREM units were archetypal established successful secondary attraction hospitals, and aboriginal revived post-COVID. We developed 2 books for PREM, which see diagnosis and attraction protocols for communal paediatric emergencies specified arsenic asthma, sepsis, dengue, snake bites and overseas assemblage ingestion,” she said.
SOPs for centres
A large item is Standard Operating Procedures (SOPs) for PREM centres. ”PREM has enactment successful spot azygous standards for handling paediatric emergencies. It has a trained team, equipment, and drugs indispensable for exigency resuscitation. We are capable to supply contiguous attraction during the aureate hour,” Dr. Vijayakumar added.
Dr. Indumathy cited a caller example. The EM squad astatine Government Headquarters Hospital, Kancheepuram, received a two-year-old kid from Ranipet, who suffered from a near temporoparietal wounded aft a tv fell connected her head. Doctors stabilised her, initiated attraction to trim cerebral edema, and performed CT encephalon and CT facial bones with 3D reconstruction. Subdural hematoma and subarachnoid haemorrhage were established. She was intubated successful anticipation of declining sensorium and referred to an ICH successful a 108 ambulance. She was treated, recovered and discharged.
“Early resuscitation astatine the PREM portion successful a secondary attraction hospital, anterior to referral, ensured neurologically intact survival. Previously, shifts without resuscitation resulted successful morbidity and mortality,” she said. “The encephalon is inactive successful the processing signifier for children. Delayed resuscitation tin origin imperishable damage. PREM units person enabled neurological intact endurance for children, and has reduced the load connected intensive attraction units crossed Tamil Nadu,” she added.
Hundreds of doctors and nurses are trained astatine the PREM skills laboratory established astatine ICH nether the Tamil Nadu Innovative Initiative Fund successful 2019.
