Why Is India’s Emergency Healthcare System Not Able to Tap On the 5-Minute Window or Golden Hour? | Health

Medical emergencies are most impacted by delays within the ‘golden hour,’ or the five minutes

Life-threatening conditions like cardiac arrest, stroke, and acute respiratory failure are desperately time sensitive. With each of these conditions, the first five minutes, or the “golden hour”, literally becomes a deciding factor for survival versus long-term outcome. Regrettably, in most Indian cities, a response within five minutes is rare.

Medical emergencies are most impacted by delays within the “golden hour”, or the five minutes that include trauma and accidents, heart attacks, and strokes, as swift intervention in these conditions significantly improves outcomes and can prevent severe complications or death.

Experts believe India’s prehospital emergency system faces gaps in ambulance availability, response times, and trained staff. “Much of this problem stems from a lack of well-trained emergency medical technicians. High vehicle density delays ambulance transit times. Multiple emergencies occurring simultaneously can strain resources,” Dr K. S. Harshith, Consultant – Internal Medicine, Aster RV Hospital, told Times Now.

According to Dr Harshith, other infrastructure issues like the bad condition of roads and maintenance affect travel times. “Delays in paperwork and approvals for emergency services are another important issue,” he said.

While basic life support ambulances focus on immediate aid, advanced ambulance vehicles have been designed to mimic a hospital ICU on wheels, which enables critical interventions for conditions like severe head injuries or cardiac emergencies en route to a hospital.

How to reduce response delays?

Experts believe that to reduce first response delays, private hospitals and government institutions can improve coordination through inclusive partnerships, robust structural coordination mechanisms, adequate capacity building, and strong political leadership.

This involves bringing together diverse stakeholders who can establish clear communication channels and defined roles, ensure sufficient resources and foster collaboration at all levels of governance and healthcare delivery. “More robust public-private partnerships are essential. Hospital ambulances integrated into government-run dispatch systems, coordinated training programmes, standardisation of the equipment used on ambulances, and co-developed joint emergency response apps can all go a long way toward coordination and reduced response times,” said Dr Tejas Shinde, Associate Consultant in the Emergency Department, K J Somaiya Hospital and Research Centre.

According to Dr Shine, there is also a lack of training and insufficient awareness of helpline numbers for emergencies, which only adds to the problems. “Hospitals can lead by example by spending money on well-equipped ambulances, first-responder training, public CPR classes, and coordinating with civic governments. Through ER data-driven policy advocacy and organising community awareness drives, they can establish new emergency preparedness norms,” he added.

Doctors also stress the fact that hospitals should lead the transformation of the country’s emergency care narrative by: