By establishing specialised centres for paediatric emergency situation care, Tamil Nadu has actually substantially enhanced kid survival rates recently. The State’s Paediatric Resuscitation and Emergency Medicine (PREM) effort has actually reinforced paediatric emergency situation care in federal government secondary care organizations– district head office healthcare facilities and taluk medical facilities– through committed procedures and proper facilities.
PREM is among the 6 pillars of the Tamil Nadu Accident and Emergency Care Initiative (TAEI).
There are 116 PREM centres throughout federal government tertiary and secondary care organizations– 41 Directorate of Medical Education and Research organizations (36 medical colleges and 5 allied organizations) and 75 Directorate of Medical and Rural Health Services organizations (district head office and taluk healthcare facilities), stated M. Vijayakumar, Deputy Director-Team Lead, TAEI Commissionerate, Tamil Nadu Health Systems Project.
Information reveals a constant increase in survival rates amongst kids dealt with at PREM centres– from 93.44% in 2021 to 96.26% in 2024. In the present year (approximately August 2025), the survival rate is 94.34%. Admissions have actually likewise risen dramatically, increasing from 21,586 in 2021 to 80,907 this year.
The idea was developed on a design created by the Institute of Child Health (ICH) and Hospital for Children in Egmore, stated Indumathy Santhanam, Project Coordinator, Regional Collaborative Center, PREM Skills Laboratory, ICH, Madras Medical College.
‘Guidelines established’
“The Paediatric Emergency Medical Course was begun at ICH. We established standards to deal with paediatric emergency situations. This consisted of training postgraduates to perform a 60-second analysis of ill kids, and make independent choices. These efforts lowered medical facility death. The lessons discovered formed the basis for PREM standards, and systems were gone for 28 medical facilities (22 district head office and 6 sub-district head office health centers) in 2017,” she stated.
This was originated by the National Health Mission, Tamil Nadu, as a technique to lower post-neonatal under-five death.
PREM has actually conserved the lives of many kids generated vital condition. “Earlier, it utilized to be a ‘scoop-and-run’ technique, as paediatric emergency situation services were not available in taluk and sub-district medical facilities. A a great deal of kids were required to these secondary care healthcare facilities, and rapidly described tertiary care centres. This altered in 2017, when PREM systems were very first developed in secondary care medical facilities, and later on restored post-COVID. We established 2 books for PREM, that include medical diagnosis and treatment procedures for typical paediatric emergency situations such as asthma, sepsis, dengue, snake bites and foreign body intake,” she stated.
SOPs for centres
A significant emphasize is Standard Operating Procedures (SOPs) for PREM centres. “PREM has actually put in location uniform requirements for managing paediatric emergency situations. It has a skilled group, devices, and drugs important for emergency situation resuscitation. We have the ability to offer instant care throughout the golden hour,” Dr. Vijayakumar included.
Dr. Indumathy mentioned a current example. The EM group at Government Headquarters Hospital, Kancheepuram, got a two-year-old kid from Ranipet, who experienced a left temporoparietal injury after a tv fell on her head. Physicians stabilised her, started treatment to decrease cerebral edema, and carried out CT brain and CT facial bones with 3D restoration. Subdural hematoma and subarachnoid haemorrhage were developed. She was intubated in anticipation of decreasing sensorium and described an ICH in a 108 ambulance. She was dealt with, recuperated and released.
“Early resuscitation at the PREM system in a secondary care medical facility, prior to recommendation, made sure neurologically undamaged survival. Formerly, shifts without resuscitation led to morbidity and death,” she stated. “The brain is still in the establishing phase for kids. Postponed resuscitation can trigger irreversible damage. PREM systems have actually allowed neurological undamaged survival for kids, and has actually minimized the problem on extensive care systems throughout Tamil Nadu,” she included.
Numerous physicians and nurses are trained at the PREM abilities laboratory developed at ICH under the Tamil Nadu Innovative Initiative Fund in 2019.
Released – November 16, 2025 10:49 pm IST