Delays and Chaos Define Kashmir’s Emergency Care

By Dr. Fiaz Maqbool Fazili

When sudden sickness strikes, families in Kashmir enter emergency departments hoping for timely, dependable care, knowing every moment matters.

These moments expose the pressures on hospitals and doctors and reveal the gaps in systems that are supposed to protect lives.

Questions rise immediately in every emergency: where will help arrive first, who will guide treatment, and how will decisions happen when time does not wait?

Recent tragic events in local hospitals make these questions real for everyone, highlighting the difference between care that responds effectively and care that depends on chance.

Kashmir hospitals face overwhelming numbers of patients, with halls crowded beyond their capacity and staff stretched across multiple roles and responsibilities. Weak referral networks push critical cases straight to tertiary centers, and social factors funnel patients toward emergency rooms with little preparation.

These pressures explain the intensity, but they cannot excuse delays or variations in care.

Heart attacks, strokes, severe trauma, and sepsis demand immediate attention, and every minute affects outcomes. Emergency care must remain consistent, responsive, and effective regardless of the number of patients.

Emergency medicine relies on structure as much as skill.

Triage, clear protocols, step-by-step pathways, and senior oversight combine to create a system where care does not depend on luck or memory.

In many hospitals, triage is weak or superficial, leaving patients treated in order of arrival while critical symptoms go unrecognized. Junior doctors face the burden of prioritizing care without guidance.

Triage that is conducted by trained personnel, with clear categories, rapid escalation of high-acuity cases, and careful documentation, ensures patients receive attention when it matters most and provides support for doctors under pressure.

Protocols and algorithms prevent errors and standardize responses to emergencies. Delays in ECGs, overlooked warning signs, treatments given without diagnosis, and prolonged observation without action all result from absent or inconsistent guidance.

Standard operating procedures for chest pain, stroke, trauma, sepsis, and abdominal emergencies ensure that doctors act decisively and safely, reducing variability while allowing judgment and experience to guide care.

Algorithms serve as support, helping teams work effectively under pressure.

Junior doctors bring energy and commitment, but complex emergencies require early senior involvement. Structured escalation, shared responsibility, and a culture that encourages consultation protect patients and build learning.

Emergency medicine cannot rely on isolated decisions, and supervision at every critical stage strengthens outcomes while relieving pressure from less experienced clinicians.

Time defines success in emergencies.

International benchmarks measure intervals from door-to-doctor, doctor-to-decision, and decision-to-destination.

However, delays occur at every stage in Kashmir, with patients waiting for assessment, decisions, or transfer.

Hospitals that implement clear, time-bound care pathways can act promptly, even under constraints, ensuring that patients experience competent, reliable care.

Emergency response systems for cardiac arrest or sudden collapse remain unclear in many hospitals. Confusion arises about who should respond, how alarms operate, and who leads the resuscitation.

Teams must train rigorously, alarms need to work effectively, and post-event review should examine lessons for improvement.

Hospitals that systematize responses reduce risk and save lives.

Learning from events strengthens the entire system. Structured audits, morbidity and mortality reviews, and feedback loops ensure that each emergency becomes an opportunity for improvement rather than repetition of avoidable mistakes.

Families sense unpredictability when care depends on personal influence, staff presence, or random chance.

Clear procedures, trained personnel, and accountable leadership transform fear into confidence, giving patients and their families certainty when every second matters.

Restoring trust in emergency care calls for strong commitment to structure, oversight, and protocol-driven responses.

Hospitals must operate predictably, with staff trained and systems clear, ensuring every patient receives timely and effective care.

When someone enters an emergency room at their most vulnerable, the first impression must reflect competence, clarity, and assurance.

Standards, documentation, supervision, and organized processes form the foundation of confidence, replacing anxiety with the certainty that lives can be saved.