The role of online medical direction in emergency medical services in India


  • Abhinav Dileep Wankar Department of Hospital Administration, Yashoda Hospital, Hyderabad, Andhra Pradesh


EMT - Emergency medical technician, PCR - Pre hospital care record, ERCP - Emergency response center physician, OLMD - On line medical direction


Medical direction is a system of physician-directed quality assurance that provides professional and public accountability for medical care provided in the prehospital setting. In an Emergency Medical Services (EMS) system, medical direction provides the operational framework and authorization for EMTs and others to provide emergency treatment outside the hospital. While attending and transporting critical patients to a definitive care setting, there is a need for advanced interventions and administration of drugs to the patients, this will alleviate patient suffering and ultimately allow the patient to be delivered to a receiving hospital in an already improved clinical state whenever possible. The Emergency Medical Technician (EMT) in the ambulance is not licensed to administer drugs to the patient on his own. As EMTs are not aware of administering drugs to the patients in critical situation, there is an urgent need to increase the percentage of critical cases with ERCP advice handled by EMT. The current descriptive study has been conducted to identify the hurdles and gaps preventing communication among the EMT and ERCP among a sample of 40 Emergency Medicine staff through a structured questionnaire. The study showed that there are substantial hurdles when the EMT wants to talk to the emergency physician, which can be removed by a few changes like adopting a new method of enhancing skills and training activities, revision of policies and protocols and a few managerial activities.


Peterson T. The role of state medical direction in the comprehensive EMS system. Prehosp Emerg Care. 2004;8:98.

San Francisco Emergency Medical Services Agency. Quality assurance plan. Report No.: policy ref No. 2000, 1991. Available at:

Ministry of Health, Jamaica. National health policy. In: Ministry of Health Policy. Jamaica: Ministry of Health, Jamaica; 1991: 124.

Segree W. Pre hospital emergency medical services. Review of services in twelve Caribbean countries. Prepared for the Pan American Health Organization. 2003. Report No.:PAHO/CAR/61.2/04.02

US Department of Transportation, National Highway Traffic Safety Administration. EMS agenda for the future. In: Technology Transfer Series No. 134. Washington DC: NHTSA; 1996: 1-2.

Hickling F, Kahwa I, Munroe T, Shepherd V, Wint A. Strategic challenges confronting UWI Mona: an analysis and response. In: Hickling F, Kahwa I, Munroe T, Shepherd V, Wint A, eds. Book Whole. Kingston, Jamaica: University of the West Indies Press; 2003: 4-52.

Segree W. Situational analysis of the pre hospital emergency services in Jamaica at the turn of the century, 2000 - 2001. In: Segree W, eds. Department of Community Health and Psychiatry, University of the West Indies. Mona, Kingston 7, Jamaica: West Indies Press; 2002: 2-60.

Department of Community Health & Psychiatry to the Ministry of Health. Final report, 1996. Available at:

Judith E. Tintinalli. Pre hospital care: The American college of emergency physicians. In: Judith E. Tintinalli, Gabor D. Kelen, J. Stephan Stapczynski, O. John Ma, David M. Cline, eds. Tintinalli’s Emergency Medicine. A Comprehensive Study Guide. 6th ed. New York, NY: McGraw Hill Professional; 2009: 1-26.

American Heart Association. Advanced cardiovascular life support provider manual, 2007. Available at:




How to Cite

Wankar, A. D. (2017). The role of online medical direction in emergency medical services in India. International Journal of Research in Medical Sciences, 2(3), 1003–1010. Retrieved from



Original Research Articles