'Swiftness is like medicine': SC calls trauma care part of right to life, orders integration of emergency helpline numbers

The Supreme Court on Tuesday said that the right to trauma care is an integral part of the right to life guaranteed under Article 21 of the Constitution, and directed all states and Union Territories to integrate emergency and ambulance helpline numbers such as 100, 101, 102, 1033, 108 and 1091 into the single emergency number 112 within three months.

“A uniform and robust system of trauma care, steps towards its progressive realisation, and increasing public awareness are well-intentioned and may turn out to be absolutely critical in reducing preventable deaths,” a bench of Justices J. K. Maheshwari and Atul S. Chandurkar observed.

“Sustained and concerted efforts by both the Union and the States/UTs working in unison can certainly result in a uniform trauma care system throughout the country which is both efficient and effective,” the court added.

The directions came while hearing a petition filed by SaveLIFE Foundation, a Delhi-based road safety organisation, which sought the creation of a uniform trauma care system across states and time-bound implementation of road safety and emergency response mechanisms.

The court noted that India continues to witness an alarming number of road accident fatalities. According to the Ministry of Road Transport and Highways, India recorded more than 1.77 lakh road accident deaths in 2024, translating to nearly 485 deaths every day.

The urgency behind the court’s intervention is also reflected in a 2024 study examining ambulance accessibility and trauma response on Indian highways. The study, based on surveys involving 225 participants, found that while nearly 90% of people successfully contacted ambulance services, only around 75% reported that ambulances actually reached accident sites in time.

The study highlighted that on core highways, ambulances often took 25–35 minutes to reach the scene, while transportation to hospitals took an additional 15–25 minutes. In several cases, victims had to be referred again to specialised hospitals located much farther away, pushing total emergency response time beyond the “golden hour” considered crucial for saving lives.

The researchers concluded that “the total time for emergency care accessibility is nearly 60 minutes or greater,” leaving “very meagre time” for effective emergency intervention and underscoring the urgent need for reforms backed by technology to make highways “emergency rescuable highways”.

Against this backdrop, the Supreme Court’s order could become a significant step toward creating a coordinated national trauma response system aimed at reducing preventable deaths and improving emergency medical accessibility across India.

‘Swiftness is quite literally like medicine’

In its detailed order, the Supreme Court recognised trauma care as a constitutional issue linked directly to the right to life under Article 21. The bench stressed that delays in emergency medical response can mean the difference between life and death.

“When a person suffers an accident or any such similar incident which requires urgent trauma care, they usually feel shock and disorientation, a sense of helplessness, where they have to hope that those around them would somehow help them get the care that they need,” the court observed.

“In such a situation, every minute spent without medical intervention or urgent care significantly narrows the scope for survival. Swiftness, is quite literally, like medicine,” the bench added.

The court emphasised that trauma care is not limited to hospitals alone but begins from the moment an accident occurs. It highlighted the importance of first responders, bystanders, ambulance services, paramedics and trauma-equipped healthcare facilities.

The bench observed that a robust trauma care mechanism must take a “bottom-up approach” involving multiple stakeholders. It noted that bystanders often hesitate to help accident victims due to fear of police procedures or legal complications.

“The common man who is a bystander to such an incident has the responsibility to call emergency services and give them accurate descriptions, make an attempt to control bleeding, keep the victim still, calm and warm,” the order stated.

However, the court acknowledged that despite the urge to help, many people experience “reactive paralysis” because of fear of being summoned to police stations or becoming witnesses in legal proceedings.

“To address these barriers, what is required is a systemic intervention, creation of a uniform framework for trauma care, building public awareness, standardisation of first aid skills and proper Good Samaritan laws,” the bench said.

The court referred to its earlier judgment in the SaveLIFE Foundation case of 2016, through which Good Samaritan protections were recognised and later incorporated under Section 134A of the Motor Vehicles Act after the 2019 amendment.

The judges also observed that while the Union government has framed several schemes and frameworks such as ERSS-112, PM RAHAT, Good Samaritan Rules and the National Ambulance Code, implementation across states remains fragmented.

The Attorney General informed the court that public health, ambulance services and hospitals fall largely within the State List, making coordination between the Centre and states essential for implementation. The court agreed that despite existing policies, uniformity in trauma care was lacking across states and UTs.

“A uniform and robust system of trauma care, steps towards its progressive realisation and increasing public awareness are well-intentioned and may turn out to be absolutely critical in reducing preventable deaths,” the order stated.

The push for standardised emergency response across India

To improve emergency response systems nationwide, the Supreme Court issued a series of interim directions to all states and Union Territories with strict timelines for compliance.

The most significant direction was the integration of all emergency helplines into the universal emergency number 112 within three months. The court directed states to ensure both technical and operational integration and simultaneously conduct mass-media campaigns publicising the number.

The bench also ordered states and UTs to establish physical and digital grievance redressal systems for Good Samaritans within three months. Dedicated nodal officers at district and state levels are to be appointed, while monthly review meetings and compliance reports must be uploaded online.

Recognising the need for standardised rescue systems, the court permitted the Union government to frame a medical rescue protocol for trauma cases within three months. States have been directed to operationalise these protocols once issued.

The court further directed all states and UTs to ensure compliance with Automotive Industry Standard-125 across all ambulances, both public and private. GPS or Vehicle Location Tracking Devices are to be installed and integrated in real time with helpline 112. States must also conduct structured audits assessing ambulance response times, quality of care, equipment and patient outcomes.

In another important direction, the court said states must adopt the National Commission for Allied and Healthcare Professionals’ notified EMT curriculum and align training institutions and certification systems within three months.

The Ministry of Health and Family Welfare was also directed to issue guidelines prescribing data formats for a national Trauma Registry within eight weeks. Based on these guidelines, states and UTs must establish state trauma registries linked to a coordinated national registry within four months.

The bench additionally ordered states to grade both public and private medical facilities according to trauma care capacity guidelines. Importantly, this grading exercise will not remain limited to National Highways but extend to State Highways, major district roads and urban and peri-urban areas as well.

The Supreme Court also pushed for implementation of the PM RAHAT cashless treatment scheme for road accident victims. States were directed to designate hospitals, onboard State Health Agencies onto the Transaction Management System and operationalise electronic accident reporting systems. The court clarified that failure to implement the scheme would amount to violation of the Motor Vehicles Act.

The bench directed both the Centre and states to undertake “sustained, structured, multi-lingual mass-media campaigns” on helpline 112, Good Samaritan protections and the PM RAHAT scheme within one month.

To ensure accountability, copies of the order have been sent to Chief Secretaries of all states and UTs. The court has sought action taken reports and said the matter will be listed again after four months for further directions.

The judges acknowledged the role played by SaveLIFE Foundation and the legal teams involved, describing the petition as a “pro bono cause which has massive public interest implications”.

Expert backs Supreme Court’s push

Dr Ashray V, Consultant – Emergency Medicine at Aster Whitefield Hospital, said trauma remains one of the leading causes of death globally among otherwise healthy individuals and can affect anyone irrespective of age, gender or background.

Highlighting the importance of timely intervention, he said the survival and long-term recovery of trauma patients depend heavily on how quickly they are transported to a hospital equipped to provide definitive emergency care.

“In trauma care, time is critical. The survival and long-term recovery of a trauma patient largely depend on how quickly they can be transported to the nearest hospital equipped to provide definitive emergency and trauma care,” he said.

According to Dr Ashray, the Supreme Court’s emphasis on coordinated emergency response systems is important because delays in transportation and fragmented ambulance networks often reduce the chances of survival during the crucial “golden hour”.

He also pointed to international models such as the United Kingdom and Germany, where technology-driven “Green Corridor” systems help ambulances move quickly through congested roads.

“By integrating ambulance GPS tracking with traffic signal networks, traffic lights along the route can be synchronised to provide uninterrupted passage for emergency vehicles,” he explained.

He noted that such systems significantly reduce transportation delays and ensure critically injured patients reach appropriate healthcare facilities in the shortest possible time.

“The implementation of similar technology-driven emergency response mechanisms can significantly strengthen trauma response systems in India,” he added.

This story is done in collaboration with First Check, which is the health journalism vertical of DataLEADS