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Government of Tamilnadu Tamil Nadu Health Systems Project

108 Emergency Management Services Performance Report

Month: Apr Year: 2015

Financial Year 2015 -2016

Page 1 of 35

Table of Contents Page No

1. Sense - Activities of the Emergency Response Center (ERC) ……...... 3

2. Reach – Ambulance Trip Data…………………………………………………...... 3

3. Life saved Data...... 3

4. Care - Emergencies Handled……………………………………………………...... 3 - 4

5. AN Mother & Neo-natal cases Data ...... 4

6. Financial Performance ...... 5 -6 Annexure:

Annexure A: Ambulance Details………………………………………………………... 7

Annexure B: District Wise Distribution of Ambulances…………………….... 8

Annexure C: District Wise Trip Details……………………………………………….. 9

Annexure D: Hospital Case Admission Details ...... 10

Annexure E: District Wise Emergency Cases Handled………………………... 11 - 13

Annexure F: District Wise Kilometre Run & Kilometre / Litre Details... 14

Annexure G: Human Resources Details…………………………………………….. 15

Annexure H: District Wise Hospital MoU Details………………………………. 16

Annexure I: Call and Dispatch Average Handle Time...... 16-18

Annexure J: Interesting Emergency Cases………………………………………... 19-21

Annexure K: Important Events & Photographs…………………………………. 22

Annexure L: AN Cases Monthly report..……………………………………………. 23

Annexure M: Neonatal ambulance cases...... 24 -34

Annexure N : Issues to be sorted out...... 35

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GOVERNMENT OF TAMIL NADU TAMIL NADU HEALTH SYSTEMS PROJECT 108 - EMERGENCY AMBULANCE SERVICES Monthly performance report (FORM A) Month : Apr 2015 FY- Year :2015-'16 During the Month - During the Month - SL. During the Month - Apr'15 Details Mar'15 Apr'15 No. Performance % Performance % Performance % 1 Sense - Activities of the Emergency Response Center 1.1 Details of the Calls 1.1.1 Number of Calls Landed 516557 100.00 533442 100.00 533442 100.00 1.1.2 Number of Unattended Calls (UAC) 3118 0.60 4329 0.81 4329 0.81 1.1.3 Number of calls answered 513439 99.40% 529113 99.19% 529113 99.19% 1.2 Types of Calls 1.2.1 Emergency Calls 106090 20.66 102598 19.39 102598 19.39 1.2.2 Non Emergency Calls 81382 15.85 78739 14.88 78739 14.88 1.2.3 Ineffective Calls * 325967 63.49 347776 65.73 347776 65.73 1.2.4 Total Number of Calls (Ref.1.1.3) 513439 100.00% 529113 100.00% 529113 100.00% 1.3 Classification of Emergency Calls 1.3.1 Number of Medical Emergency Calls 103980 98.01 100938 98.38 100938 98.38 1.3.2 Number Police Emergency Calls 936 0.88% 747 0.73% 747 0.73% 1.3.3 Number fire Emergency Calls 1174 1.11% 913 0.89% 913 0.89% 1.3.4 Total Emergency Calls (Ref. 1.2.1) 106090 100.00% 102598 100.00% 102598 100.00% 1.4 Classification of Medical Emergency Calls 1.4.1 Number of Medical Emergency calls 80117 77.05% 78656 77.93% 78656 77.93% 1.4.2 Number of repeated Emergency calls 23863 22.95% 22282 22.07% 22282 22.07% 1.4.3 Total Medical Emergency Calls (Ref. 1.3.1) 103980 100.00% 100938 100.00% 100938 100.00% 1.5 Call Handling Data 1.5.1 Percentage of calls attended within 1st Ring NA 94.58% NA 93.70% NA 93.70% 1.5.2 Percentage of calls attended within 2nd Ring NA 2.97% NA 3.15% NA 3.15% 1.5.3 Percentage of calls attended within or above 3rd Ring NA 2.45% NA 3.15% NA 3.15% 2 Reach - Ambulance Service utilized 2.1 Number of Medical Emergency Dispatch requests (Ref.1.4.1) 80117 NA 78656 NA 78656 NA 2.2 Total Number of Ambulance Trips 80052 NA 78549 NA 78549 NA 2.3 Number of Ambulance Services utilized 76450 95.42% 74892 95.21% 74892 95.21% 2.4 Number of Ambulance Services not utilized 3602 4.50% 3657 4.65% 3657 4.65% 2.5 Number of Ambulance Services busy ** 65 0.08% 107 0.14% 107 0.14% 2.6 Number of Trips per ambulance 113.71 NA 110.79 NA 110.79 NA 2.7 Number of Trips per ambulance/day 3.67 NA 3.69 NA 3.69 NA 3 Care 3.1 Total number of cases transported (Ref. 2.3) 76450 NA 74892 NA 74892 NA 3.2 Total number cases transported per ambulances 108.59 NA 105.63 NA 105.63 NA 3.3 Total number cases transported per ambulances per day 3.50 NA 3.52 NA 3.52 NA Note: Total Lives Saved from 15th Sep 2008 to 30th Apr 2015 = 2, 48,123 Page 3 of 35

Month : Apr 2015 FY- Year :2015-'16 During the Month - During the Month - SL. During the Month - Apr'15 Details Mar'15 Apr'15 No. Performance % Performance % Performance % 4 Types of Emergencies handled 4.1 Accidental Poisoning 4103 5.37% 4055 5.41% 4055 5.41% 4.2 Acute Abdomen 6583 8.61% 6544 8.74% 6544 8.74% 4.3 Allergic Reactions 78 0.10% 79 0.11% 79 0.11% 4.4 Animal Attack 1823 2.38% 2063 2.75% 2063 2.75% 4.5 Assault 2962 3.87% 3168 4.23% 3168 4.23% 4.6 Behavioral 15 0.02% 12 0.02% 12 0.02% 4.7 Cardiac/Cardio Vascular 4924 6.44% 4559 6.09% 4559 6.09% 4.8 Diabetes 747 0.98% 698 0.93% 698 0.93% 4.9 Disasters due to Natural elements 26 0.03% 22 0.03% 22 0.03% 4.10 Epilepsy 2072 2.71% 2093 2.79% 2093 2.79% 4.11 Fevers / Infections 2576 3.37% 1734 2.32% 1734 2.32% 4.12 Fire/Burns 718 0.94% 657 0.88% 657 0.88% 4.13 Hazmat (Hazardous Material) 7 0.01% 2 0.00% 2 0.00% 4.14 Industrial 11 0.01% 12 0.02% 12 0.02% 4.15 Neonatal(upto 1 month) 1488 1.95% 1535 2.05% 1535 2.05% 4.16 Paediatric(1-12years) 107 0.14% 97 0.13% 97 0.13% 4.17 Pregnancy related 18855 24.66% 18691 24.96% 18691 24.96% 4.18 Respiratory 3603 4.71% 3179 4.24% 3179 4.24% 4.19 Road Traffic Accident - Trauma 16388 21.44% 16529 22.07% 16529 22.07% 4.20 Stroke/Cerebro Vascular Accidents 2308 3.02% 2238 2.99% 2238 2.99% 4.21 Suicide attempt 403 0.53% 422 0.56% 422 0.56% 4.22 Trauma 3602 4.71% 3849 5.14% 3849 5.14% 4.23 Unconscious 1964 2.57% 1782 2.38% 1782 2.38% 4.24 Others 1087 1.42% 872 1.16% 872 1.16% Total Medical Emergencies (1.4.1/2.3) 76450 100.00% 74892 100.00% 74892 100.00% 5 AN Mother and Neonatal – Emergencies Care 5.1 Inter Facility Transfer of AN Mothers 5.1.1 Number of cases lifted thro’ ERC to Hospital 8179 43.38% 7964 42.61% 7964 42.61% 5.1.2 Number of cases lifted from Hospital 10676 56.62% 10727 57.39% 10727 57.39% 5.1.3 Number of cases re-referred by Hospital to Higher Level 3 0.02% 5 0.03% 5 0.03% 5.1.4 Number of cases re-referred by referred institutions 0 0.00% 1 0.01% 1 0.01% 5.1.5 Total Number of Re-referred cases (5.1.3+5.1.4) 3 0.02% 6 0.03% 6 0.03% 5.1.6 Total Number of AN Cases 18855 100.00% 18691 100.00% 18691 100.00% 5.2 IFT others 19193 64.26% 19261 64.23% 19261 64.23% 5.2.1 Neonatal (upto 1 month) 1342 4.49% 1400 4.67% 1400 4.67% 5.2.2 Road Traffic Accident - Trauma 3797 12.71% 3903 13.02% 3903 13.02% 5.2.3 Accidental Poisoning 1983 6.64% 1984 6.62% 1984 6.62% 5.2.4 Cardiac/Cardio Vascular 1881 6.30% 1836 6.12% 1836 6.12% 5.2.5 Others 10190 34.12% 10138 33.81% 10138 33.81% 5.2.6 Total number of IFTs (5.1.2+5.2) 29869 100.00% 29988 100.00% 29988 100.00% 5.3 AN Mother/Infant Mother - Follow-Up Data 5.3.1 Number of Maternal Mortality at Hospital 6 0.03% 6 0.03% 6 0.03% 5.3.2 Number of Infant Mortality at Hospital 2 0.01% 3 0.01% 3 0.01% 5.4 Neo-natal transport Data 5.4.1 Neonatal cases transported in Neo-natal ambulances 1335 89.72% 1323 86.19% 1323 86.19% 5.4.2 Total Neonatal cases transported (Ref. 4.15) 1488 100.00% 1535 100.00% 1535 100.00% 6 Availed Tribal case count 6.1 Total number of cases taken from Tribal areas 2587 NA 2672 NA 2672 NA 7 Critical Life Saved 7.1 Total Number of Lives Saved*** 3018 NA 3346 NA 3346 NA 8 Death En-route Case Details 8.1 Total number of cases where victims “Vitals were not recordable” 84 NA 55 NA 55 NA *** Based on 48 hr follow up done in that year only

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Financial Performance (Apr’15)

Planned Achieved Difference Upto 10 Financial Performance Savings During Remarks During Month Upto Month During Month Excess During Month Savings Upto Month Excess Upto Month Month Month 10.1 108 Call center Salary Expenditure 25.79 25.79 21.28 21.28 4.51 - 4.51 - 10.2 Ambulance Personnel Cost 424.26 424.26 388.02 388.02 36.24 - 36.24 - 10.3 Care Personnel Cost 10.28 10.28 5.64 5.64 4.64 - 4.64 - 10.4 Fuel Cost 201.85 201.85 195.10 195.10 6.75 - 6.75 - 10.5 Repairs and Maintenance 42.66 42.66 17.89 17.89 24.77 - 24.77 - 10.6 Medical Consumables 26.91 26.91 20.12 20.12 6.78 - 6.78 - 10.7 Ambulance Mobile Telephone Expenditure 7.08 7.08 3.99 3.99 3.09 - 3.09 - 10.8 Replacement of Tyres 24.35 24.35 20.00 20.00 4.34 - 4.34 - 10.9 Refurbishment of Ambulances 12.61 12.61 2.99 2.99 9.61 - 9.61 - 10.1 Uniform 2.81 2.81 3.55 3.55 - (0.73) - (0.73) Whole year insurance amount 10.11 Vehicle Insurance 6.34 6.34 11.02 11.02 - (4.68) - (4.68) accounted in the month of April'15 , it will control in overll year 10.12 Training Cost 22.92 22.92 4.67 4.67 18.24 - 18.24 - 10.13 Other Insurance ------Whole year Expenses amount 10.14 Annual Maintenance 4.74 4.74 8.98 8.98 - (4.24) - (4.24) accounted in the month of April'15 , it will control in overll year 10.15 Other Salaries- Support Staff 53.27 53.27 36.95 36.95 16.32 - 16.32 - 10.16 Marketing Expenditure 8.33 8.33 0.44 0.44 7.89 - 7.89 - 10.17 Travelling Cost 11.29 11.29 4.72 4.72 6.57 - 6.57 - Administrative Expenditure (Telephone, Electricity, 10.18 39.68 39.68 38.40 38.40 1.28 - 1.28 - house keeping, security, office expenditures)

Sub Total 925.16 925.16 783.77 783.77 151.05 (9.65) 151.05 (9.65)

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Planned Achieved Difference Financial Performance Upto Savings During Remarks During Month Upto Month During Month Excess During Month Savings Upto Month Excess Upto Month Month Month Non Recurrent Cost 1 Sense - Call Center Equipment 5.13 5.13 - - 5.13 - 5.13 - 2 Training Material 0.94 0.94 - - 0.94 - 0.94 - 3 NDME -Medical equipment 43.78 43.78 - - 43.78 - 43.78 - 4 Infrastructure - Emergency Response Center 1.70 1.70 - - 1.70 - 1.70 5 New Building ------6 Ambulance Modification 21.00 21.00 - - 21.00 - Sub Total 72.54 72.54 - - 72.54 - 51.54 - Total 997.70 997.70 783.77 783.77 223.59 (9.65) 202.59 (9.65) ECC 23.62 23.62 7.47 7.47 16.15 - 16.15 - Grand Total 1,021.32 1,021.32 791.23 791.23 239.74 (9.65) 218.74 (9.65)

Note: Budgeted during month : 1,021.32 No. of line items under utilized during month 16 Budget released during month : 755.22 No. of line items over utilized during month 5 Expenditure during month : 791.23 Savings during month : 230.09

Note: Budgeted upto month : 1,021.32 No. of line items under utilized upto month 14 Budget released upto month : 9,264.29 No. of line items over utilized upto month 7 Expenditure upto month : 791.23 Savings upto month : 209.09

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Annexure A – Ambulance Details (Apr’15)

Phase II Ambulance Phase I Ambulance Count and GH S No Ambulance Distribution Data Count and GH Vehicles Total Vehicles(Swaraj (Force Motors) Mazda & Eicher)

1 Number of Ambulances Supplied 687 126 813* 2 Number of Ambulances modified 583 126 709

3 Number of Ambulances Launched during the month 5 0 5

Number of ambulances replaced (Condemned 4 0 0 0 vehicles and Vehicles handed over to IRCS)

Number of ambulances removed from the old 5 12 7 19 replacement/ condemnation lot Number of ambulance replaced for converting BLS to 6 0 0 0 NN

Total number of vehicle replaced for the month 7 12 7 19 from the 100 New BLS ambulances (4+5+6)

8 Number of Ambulances operational for the month 583 126 709

9 Number of Ambulance on road for the month 570 117 687

1-Chennai 1-Coimbatore 1-Kancheepuram 1-Coimbatore 1-Pudukottai 1-Dindigul Number of Ambulance Off road for the month 1-Ramnathapuram 1-Krishnagiri (Down due to breakdown/Accident/FC/ Manpower 22 1-Salem 1-Thanjavur shortage) 2-Thanjavur 2-The Nilgris 10 1-Theni 1-Thiruvanamalai 2-Thiruvallur 2-Vellore 1-Tirupur 1-Villupuram A)Down due to Refurbishment /Accident/Break 18 18 down

B)Down due to Manpower shortage 4 4

1-Ariyalur 1-Ariyalur 2-Chennai 1-Cuddalore 1-Coimbatore 1-Dharmapuri 1-Cuddalore 2-Dindigul 1-Dindigul 2-Erode 4-Kancheepuram 1-Kanyakumari 1-Madurai 1-Karur 4-Pudukkotai 2-Nagapattinam 11 Spare ambulances used in Districts 2-Ramanathapuram 1-Namakkal 54 2-The Nilgris 1-Perambalur 1-Thiruvallur 1-Pudukottai 2-Thiruvarur 1-Salem 2-Tiruchirapalli 2-Sivagangai 2-Tirunelveli 1-Thanjavur 1-Tirupur 1-Thiruvallur 2-Vellore 2-Thoothukudi 2-Villupuram 2-Vellore

* Excluding Trauma care vehicle - 8, Police Vehicle - 3 and PTV vehicles - 4

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Annexure B: District Wise Distribution of Ambulances

Regular Neonatal 4WD Total Districts ambulances ambulances ambulances ambulances (ALS+ BLS) ARIYALUR 12 1 1 14 CHENNAI 33 2 1 36 COIMBATORE 22 1 4 27 CUDDALORE 24 2 2 28 DHARMAPURI 16 1 1 18 DINDIGUL 19 1 3 23 ERODE 18 1 5 24 KANCHEEPURAM 35 2 1 38 KANYAKUMARI 9 1 0 10 KARUR 11 1 1 13 KRISHNAGIRI 14 1 4 19 MADURAI 20 1 1 22 NAGAPATTINAM 17 1 0 18 NAMAKKAL 14 1 3 18 PERAMBALUR 9 1 1 11 PUDUKOTTAI 17 1 1 19 RAMANATHAPURAM 17 1 1 19 SALEM 22 1 5 28 SIVAGANGAI 14 1 0 15 THANJAVUR 17 1 2 20 THE NILGIRIS 10 1 11 22 THENI 11 1 2 14 THIRUVALLUR 30 1 3 34 THIRUVANAMALAI 23 2 4 29 THIRUVARUR 12 1 1 14 THOOTHUKUDI 14 1 0 15 TIRUCHIRAPALLI 17 1 3 21 TIRUNELVELI 21 1 2 24 TIRUPUR 16 1 1 18 VELLORE 38 2 4 44 VILLUPURAM 33 2 3 38 VIRUDHUNAGAR 13 1 2 16

Grand Total 598 38 73 709

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Annexure C: District Wise Trip Details

1st - 30th Apr 2015

No: of Trips Upto the Average no: of Total Kilometre Kilometre/ Average District Ambulances Month trips/amby/day Run Amby/Day Kilometre/Trip

TIRUPUR 18 2544 4.71 98523 182 39 KANCHEEPURAM 38 5250 4.61 218853 192 42 DHARMAPURI 18 2386 4.42 125356 232 53 CUDDALORE 28 3600 4.29 157315 187 44 CHENNAI 36 4592 4.25 89093 82 19 MADURAI 22 2703 4.10 94259 143 35 THENI 14 1694 4.03 79195 189 47 SIVAGANGAI 15 1807 4.02 87884 195 49 THIRUVANNAMALAI 29 3478 4.00 206025 237 59 NAGAPATTINAM 18 2151 3.98 111175 206 52 THANJAVUR 20 2375 3.96 89068 148 38 VILLUPURAM 38 4471 3.92 235466 207 53 TIRUCHIRAPALLI 21 2458 3.90 97086 154 39 COIMBATORE 27 3141 3.88 99156 122 32 THIRUVALLUR 34 3885 3.81 171661 168 44 SALEM 28 3090 3.68 130555 155 42 NAMAKKAL 18 1981 3.67 81663 151 41 THIRUVARUR 14 1503 3.58 70179 167 47 KRISHNAGIRI 19 2028 3.56 100369 176 49 VELLORE 44 4686 3.55 260929 198 56 TIRUNELVELI 24 2533 3.52 139216 193 55 PUDUKKOTAI 19 1971 3.46 100271 176 51 KANYAKUMARI 10 1034 3.45 36787 123 36 ERODE 24 2354 3.27 98381 137 42 VIRUDHUNAGAR 16 1560 3.25 83229 173 53 RAMANATHAPURAM 19 1801 3.16 106475 187 59 THOOTHUKUDI 15 1408 3.13 74792 166 53 ARIYALUR 14 1245 2.96 61820 147 50 DINDIGUL 23 1987 2.88 100492 146 51 KARUR 13 1118 2.87 55339 142 49 PERAMBALUR 11 936 2.84 40060 121 43 THE NILGRIS 22 779 1.18 57791 88 74 TOTAL 709 78549 3.69 3558463 167 45

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Annexure D – Hospital Case Admission Details

During the month Upto the month S No Hospital Case Admission Details Apr’15 (Apr’15) Count % Count % 62,995 84.11% 62,995 84.11% 1 Number of cases admitted in Government Hospitals 2,027 2.71% 2,027 2.71% 2 Number of cases admitted in Private Hospitals

9,870 13.18% 9,870 13.18% 3 Others (Number of cases provided First aid only refused treatment, etc.) TOTAL 74,892 100.00 74,892 100.00

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Annexure E: District Wise Emergency Cases Handled (Apr 2015)

Apr'15 EMERGENCY TYPE ARIYALUR CHENNAI COIMBATORE CUDDALORE DHARMAPURI DINDIGUL ERODE KANCHEEPURAM KANYAKUMARI KARUR KRISHNAGIRI MADURAI NAGAPATTINAM NAMAKKAL PERAMBALUR PUDUKOTTAI RAMANATHAPURAM SALEM Ambulance count 14 36 27 28 18 23 24 38 10 13 19 22 18 18 11 19 19 28 Accidental Poisoning 89 80 155 226 130 120 90 243 30 40 98 140 154 97 68 139 94 173 Acute Abdomen 152 419 197 364 236 115 149 481 79 105 135 198 207 144 110 158 167 184 Allergic Reactions 2 2 6 1 1 1 4 2 1 1 1 2 17 4 Animal Attack 57 19 56 147 72 34 36 130 18 26 47 58 102 56 33 98 57 71 Assault 80 153 100 186 99 92 89 135 88 52 68 99 118 104 43 127 84 117 Behavioral 1 1 3 1 1 Cardiac/Cardio Vascular 66 276 215 227 127 100 130 270 57 83 69 134 144 117 66 123 127 171 Diabetes 11 39 36 32 24 12 19 53 22 10 13 28 24 20 6 15 13 21 Disasters due to Natural elements 1 2 2 1 4 1 1 Environmentals 1 1 1 1 2 Epilepsy 27 240 110 70 47 35 60 147 18 35 35 76 58 58 21 50 44 70 Fevers / Infections 29 128 69 100 54 19 42 113 28 31 27 30 59 41 38 34 37 50 Fire/Burns 8 47 14 39 7 13 23 64 12 10 14 26 14 11 3 16 14 21 Hazmat (Hazardous Material) 1 Industrial 1 2 1 1 Neonatal(upto 1 month) 30 149 43 46 87 62 40 75 18 14 37 67 7 34 14 27 35 61 Others 16 87 44 46 22 12 27 51 17 14 16 20 37 18 16 23 41 27 Paediatric(1-12years) 3 10 2 9 5 4 14 3 2 2 2 1 2 1 2 2 Pregnancy related 330 528 564 775 677 495 471 1110 206 227 708 607 325 412 180 524 379 782 Respiratory 41 332 181 125 68 63 101 215 51 58 42 96 89 85 38 57 67 136 Stroke/CerebroVascular Accidents 33 222 99 95 53 58 70 145 29 44 29 66 77 76 22 40 46 88 Suicide attempt 5 47 14 34 6 5 11 33 1 8 7 17 21 12 4 7 6 12 Trauma (non Vehicular) 40 395 166 136 99 114 125 255 66 66 67 152 141 108 35 81 95 159 Trauma (Vehicular) 162 982 715 693 456 512 665 1266 213 226 490 662 470 454 175 359 378 681 Unconscious 21 243 139 80 36 21 63 139 25 24 21 53 37 51 22 27 31 64 Grand Total 1202 4399 2924 3440 2308 1887 2219 4946 980 1076 1926 2533 2087 1902 897 1908 1736 2896 Number of cases/ambulance 86 122 108 123 128 82 92 130 98 83 101 115 116 106 82 100 91 103

Number of cases/Ambulance/day 2.9 4.1 3.6 4.1 4.3 2.7 3.1 4.3 3.3 2.8 3.4 3.8 3.9 3.5 2.7 3.3 3.0 3.4

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District Wise Emergency Cases Handled...contd (Apr 2015) EMERGENCY TYPE SIVAGANGAI THANJAVUR THE NILGIRIS THENI THIRUVALLUR THIRUVANNAMALAI THIRUVARUR THOOTHUKUDI TIRUCHIRAPPALLI TIRUNELVELI TIRUPUR VELLORE VILLUPURAM VIRUDHUNAGAR Grand Total Ambulance count 15 20 22 14 34 29 14 15 21 24 18 44 38 16 709 Accidental Poisoning 101 157 31 105 182 220 90 60 110 139 135 191 313 55 4055 Acute Abdomen 173 216 76 158 321 265 184 124 189 207 185 344 386 116 6544 Allergic Reactions 2 2 1 4 6 3 1 3 2 3 3 4 79 Animal Attack 47 82 16 41 66 129 50 21 79 61 40 101 162 51 2063 Assault 92 142 41 92 74 138 71 61 132 110 82 116 147 36 3168 Behavioral 1 1 1 1 1 12 Cardiac/Cardio Vascular 108 134 79 118 261 179 133 62 134 164 169 258 197 61 4559 Diabetes 19 12 7 10 31 37 10 14 20 33 17 48 31 11 698 Disasters due to Natural elements 2 4 1 3 22 Environmentals 1 7 Epilepsy 44 58 22 27 136 81 33 48 70 71 82 112 80 28 2093 Fevers / Infections 26 53 25 51 96 72 34 30 77 64 69 84 83 41 1734 Fire/Burns 14 20 6 8 39 28 13 13 15 30 20 36 19 40 657 Hazmat (Hazardous Material) 1 2 Industrial 1 1 1 3 1 12 Neonatal(upto 1 month) 17 44 24 19 46 77 32 36 58 36 39 142 71 48 1535 Others 10 23 5 18 32 25 21 19 22 28 37 39 45 7 865 Paediatric(1-12years) 1 4 2 6 3 2 5 2 3 2 3 97 Pregnancy related 388 568 203 457 948 1012 296 421 638 600 452 1558 1389 461 18691 Respiratory 72 87 33 73 173 111 74 44 90 103 103 186 142 43 3179 Stroke/CerebroVascular Accidents 42 59 31 56 126 77 43 34 68 80 93 91 108 38 2238 Suicide attempt 3 6 3 4 35 29 6 4 9 6 14 24 22 7 422 Trauma (non Vehicular) 114 96 45 66 192 136 67 57 109 97 127 190 181 72 3849 Trauma (Vehicular) 449 446 86 272 828 658 258 263 496 539 661 892 760 362 16529 Unconscious 23 50 16 36 99 57 26 32 57 51 70 68 80 20 1782 Grand Total 1746 2261 749 1615 3695 3343 1448 1347 2382 2421 2401 4491 4226 1501 74892 Number of cases/ambulance 116 113 34 115 109 115 103 90 113 101 133 102 111 94 106

Number of cases/Ambulance/day 3.9 3.8 1.1 3.8 3.6 3.8 3.4 3.0 3.8 3.4 4.4 3.4 3.7 3.1 3.5

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District wise Unavailed and RTA Unavailed cases For the month - Apr'15 District Availed UAD UAD% RTA UAD RTA UAD% ARIYALUR 1202 43 4% 16 1% CHENNAI 4399 193 4% 116 3% COIMBATORE 2924 217 7% 147 5% CUDDALORE 3440 160 5% 69 2% DHARMAPURI 2308 78 3% 38 2% DINDIGUL 1887 100 5% 58 3% ERODE 2219 135 6% 99 4% KANCHEEPURAM 4946 304 6% 209 4% KANYAKUMARI 980 54 6% 38 4% KARUR 1076 42 4% 28 3% KRISHNAGIRI 1926 102 5% 69 4% MADURAI 2533 170 7% 94 4% NAGAPATTINAM 2087 64 3% 38 2% NAMAKKAL 1902 79 4% 54 3% PERAMBALUR 897 39 4% 22 2% PUDUKOTTAI 1908 63 3% 41 2% RAMANATHAPURAM 1736 65 4% 36 2% SALEM 2896 194 7% 138 5% SIVAGANGAI 1746 61 3% 39 2% THANJAVUR 2261 114 5% 59 3% THE NILGIRIS 749 30 4% 16 2% THENI 1615 79 5% 55 3% THIRUVALLUR 3695 190 5% 114 3% THIRUVANNAMALAI 3343 135 4% 61 2% THIRUVARUR 1448 55 4% 29 2% THOOTHUKUDI 1347 61 5% 48 4% TIRUCHIRAPPALLI 2382 76 3% 50 2% TIRUNELVELI 2421 112 5% 71 3% TIRUPUR 2401 143 6% 92 4% VELLORE 4491 195 4% 123 3% VILLUPURAM 4226 245 6% 131 3% VIRUDHUNAGAR 1501 59 4% 42 3%

State 74892 3657 5% 2240 3%

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Annexure F: District Wise Kilometre Run & Kilometre / Litre Details

During the month Ambulance Ambulance Upto the month Sl.No District Apr 2015 Count Count KM Kmpl KM Kmpl 1 ARIYALUR 14 61820 8.98 14 61820 8.98 2 CHENNAI 36 89093 7.78 36 89093 7.78 3 COIMBATORE 27 98925 7.89 27 98925 7.89 4 CUDDALORE 28 157315 9.48 28 157315 9.48 5 DHARMAPURI 18 125356 10.50 18 125356 10.50 6 DINDIGUL 23 100492 8.54 23 100492 8.54 7 ERODE 24 98612 9.26 24 98612 9.26 8 KANCHEEPURAM 38 218853 8.88 38 218853 8.88 9 KANYAKUMARI 10 36787 8.37 10 36787 8.37 10 KARUR 13 55339 9.10 13 55339 9.10 11 KRISHNAGIRI 19 100369 9.68 19 100369 9.68 12 MADURAI 22 94259 9.24 22 94259 9.24 13 NAGAPATTINAM 18 111175 9.40 18 111175 9.40 14 NAMAKKAL 18 81663 9.42 18 81663 9.42 15 PERAMBALUR 11 40060 9.49 11 40060 9.49 16 PUDUKOTTAI 19 100271 9.53 19 100271 9.53 17 RAMANATHAPURAM 19 106475 10.02 19 106475 10.02 18 SALEM 28 130555 9.34 28 130555 9.34 19 SIVAGANGAI 15 87884 10.02 15 87884 10.02 20 THANJAVUR 20 89068 8.13 20 89068 8.13 21 THE NILGIRIS 22 57791 6.52 22 57791 6.52 22 THENI 14 79195 9.61 14 79195 9.61 23 TIRUPUR 18 98523 9.37 18 98523 9.37 24 THIRUVALLUR 34 171661 9.42 34 171661 9.42 25 THIRUVANNAMALAI 29 206025 9.75 29 206025 9.75 26 THIRUVARUR 14 70179 9.88 14 70179 9.88 27 THOOTHUKUDI 15 74792 9.10 15 74792 9.10 28 TIRUCHIRAPPALLI 21 97086 9.87 21 97086 9.87 29 TIRUNELVELI 24 139216 9.95 24 139216 9.95 30 VELLORE 44 260929 9.54 44 260929 9.54 31 VILLUPURAM 38 235466 8.99 38 235466 8.99 32 VIRUDHUNAGAR 16 83229 9.35 16 83229 9.35 709 3558463 9.15 709 3558463 9.15 TOTAL

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Annexure G: Human Resources Details- Manpower count and Attrition Count (Apr’15)

Head Count During the month S. No Associate Classification Upto the month Current month (New joinees) Male Female Total Male Female Total Male Female Total 1 Emergency Response Officers (EROs) 19 18 37 19 18 37 84 99 183 2 ERO (Under Training) 3 Assigned PDOs 4 EMT (Trained) 13 6 19 13 6 19 1 75 6 167 5 EMT (Under Training) 6 Pilot (Trained) 3 30 3 30 1652 16 2 7 Pilot (Under Training) 8 Operations Staff 5 2 7 5 2 7 61 37 98 9 Support Staff 1 1 2 1 1 2 76 76 68 27 9 68 27 9 2948 736 3684 Total

Attrition Count Sl No. Associate Attrition During the month Male Female Total 1 Emergency Response officers (ERO) 6 3 9 2 EMT 7 15 22 3 Pilot 28 28 4 Operations Staff 2 1 3 5 Support Staff 3 3 Total 46 19 65

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Annexure H: District Wise Hospital MoU Details

The number of MoU’s signed with private hospital in Apr 2015 is zero.

Total MoU’s signed with private hospitals from 15th Sep ’08 to 30th Apr 2015 =1806.

Annexure I – Call and Dispatch Average Handle Time

During the Greater Up to the Month than S No Call / Dispatch Time Break-Up Month Time Time Average (HH:MM:SS) (HH:MM:SS) in %

1 Average Call to Dispatch Time 0:03:08 41% 0:03:08 2 Average Time taken from Base to Scene/Incident 0:18:13 43% 0:18:13 3 Average Time taken at the Scene / Incident Location 0:13:32 45% 0:13:32 4 Average Time taken from Scene to Hospital 0:37:24 45% 0:37:24 5 Average Time taken from Call to Hospital 1:03:16 42% 1:03:16

Apr 2015 - Call to scene Split up Call to scene IFT IFT % IFT Rural IFT Urban NON - IFT NON- IFT % Non IFT Rural Non IFT Urban 0- 5 min 6893 23.0 5197 1696 2279 5.1 1666 613 5- 10 min 5899 19.7 4029 1870 7385 16.4 5007 2378 10 - 15 min 2418 8.1 1663 755 7822 17.4 5500 2322 15 - 20 min 2520 8.4 1926 594 7019 15.6 5425 1594 20 - 25 min 2468 8.2 1981 487 5741 12.8 4853 888 25 - 30 min 2250 7.5 1842 408 4404 9.8 3794 610 30 - 35 min 1964 6.5 1646 318 3231 7.2 2883 348 35 - 40 min 1583 5.3 1345 238 2312 5.1 2098 214 40 - 45 min 1071 3.6 935 136 1674 3.7 1532 142 45 - 50 min 836 2.8 702 134 1096 2.4 1005 91 50 - 55 min 536 1.8 438 98 632 1.4 581 51 55 - 60 min 376 1.3 313 63 413 0.9 386 27 > 60 min 1174 3.9 910 264 896 2.0 796 100 Total cases 29988 100.0 22927 7061 44904 100.0 35526 9378 Apr 2015 - Call to hospital Split up Call to hospital IFT IFT % IFT Rural IFT Urban NON IFT NON- IFT % Non IFT Rural Non IFT Urban 0 -10 min 54 0.2 42 12 149 0.4 102 47 10 -20 min 155 0.5 53 102 1517 4.3 1097 420 20 - 30 min 662 2.2 283 379 3414 9.7 2386 1028 30 - 40 min 1535 5.1 909 626 4758 13.6 3483 1275 40 - 50 min 2389 8.0 1726 663 5447 15.5 4275 1172 50 - 60 min 2877 9.6 2250 627 5256 15.0 4395 861 >60 min 22316 74.4 17664 4652 14493 41.4 12776 1717 Total cases 29988 100.0 22927 7061 35034 100.0 28514 6520

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IFT and Non-IFT cases

For the month - Apr'15 District Availed IFT IFT % Non IFT Non IFT % ARIYALUR 1202 405 34% 797 66% CHENNAI 4399 1689 38% 2710 62% COIMBATORE 2924 790 27% 2134 73% CUDDALORE 3440 1122 33% 2318 67% DHARMAPURI 2308 1142 49% 1166 51% DINDIGUL 1887 805 43% 1082 57% ERODE 2219 743 33% 1476 67% KANCHEEPURAM 4946 1931 39% 3015 61% KANYAKUMARI 980 528 54% 452 46% KARUR 1076 340 32% 736 68% KRISHNAGIRI 1926 829 43% 1097 57% MADURAI 2533 994 39% 1539 61% NAGAPATTINAM 2087 969 46% 1118 54% NAMAKKAL 1902 778 41% 1124 59% PERAMBALUR 897 295 33% 602 67% PUDUKOTTAI 1908 728 38% 1180 62% RAMANATHAPURAM 1736 667 38% 1069 62% SALEM 2896 1036 36% 1860 64% SIVAGANGAI 1746 708 41% 1038 59% THANJAVUR 2261 707 31% 1554 69% THE NILGIRIS 749 361 48% 388 52% THENI 1615 747 46% 868 54% THIRUVALLUR 3695 1496 40% 2199 60% THIRUVANNAMALAI 3343 1384 41% 1959 59% THIRUVARUR 1448 603 42% 845 58% THOOTHUKUDI 1347 648 48% 699 52% TIRUCHIRAPPALLI 2382 880 37% 1502 63% TIRUNELVELI 2421 1180 49% 1241 51% TIRUPUR 2401 873 36% 1528 64% VELLORE 4491 2370 53% 2121 47% VILLUPURAM 4226 1623 38% 2603 62% VIRUDHUNAGAR 1501 617 41% 884 59%

State 74892 29988 40% 44904 60%

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Response time – IFT and Non-IFT cases (Apr’15)

IFT Non-IFT District Call - Wheel Base - Scene Call to Scene Call - Wheel Base - Scene Call to Scene ARIYALUR 0:02:43 0:21:43 0:24:26 0:02:58 0:25:32 0:28:30 CHENNAI 0:02:58 0:13:17 0:16:15 0:03:04 0:11:16 0:14:20 COIMBATORE 0:02:35 0:15:47 0:18:22 0:03:04 0:14:42 0:17:47 CUDDALORE 0:02:37 0:15:36 0:18:13 0:03:03 0:20:09 0:23:13 DHARMAPURI 0:02:30 0:17:10 0:19:39 0:02:56 0:18:58 0:21:54 DINDIGUL 0:02:30 0:18:24 0:20:53 0:02:55 0:18:21 0:21:15 ERODE 0:02:41 0:15:16 0:17:57 0:02:54 0:15:10 0:18:03 KANCHEEPURAM 0:02:43 0:17:18 0:20:01 0:03:05 0:16:10 0:19:15 KANYAKUMARI 0:02:27 0:19:38 0:22:05 0:02:55 0:16:06 0:19:01 KARUR 0:02:39 0:14:53 0:17:31 0:02:57 0:19:26 0:22:23 KRISHNAGIRI 0:02:32 0:16:05 0:18:37 0:02:55 0:22:41 0:25:36 MADURAI 0:02:41 0:19:17 0:21:57 0:03:04 0:16:26 0:19:30 NAGAPATTINAM 0:02:36 0:17:29 0:20:05 0:03:02 0:20:45 0:23:48 NAMAKKAL 0:02:28 0:12:42 0:15:10 0:02:54 0:14:48 0:17:42 PERAMBALUR 0:02:34 0:21:59 0:24:33 0:02:55 0:20:34 0:23:30 PUDUKOTTAI 0:02:34 0:17:52 0:20:26 0:02:58 0:21:37 0:24:36 RAMANATHAPURAM 0:02:30 0:17:55 0:20:25 0:02:51 0:22:46 0:25:37 SALEM 0:02:33 0:16:37 0:19:10 0:02:54 0:16:59 0:19:53 SIVAGANGAI 0:02:30 0:17:46 0:20:15 0:02:59 0:21:14 0:24:13 THANJAVUR 0:02:45 0:20:39 0:23:24 0:03:05 0:20:12 0:23:17 THE NILGIRIS 0:02:51 0:22:10 0:25:01 0:03:05 0:25:31 0:28:36 THENI 0:02:31 0:17:22 0:19:53 0:02:53 0:18:01 0:20:54 THIRUVALLUR 0:02:37 0:19:16 0:21:53 0:03:08 0:19:31 0:22:39 THIRUVANNAMALAI 0:02:42 0:21:56 0:24:38 0:03:03 0:22:58 0:26:01 THIRUVARUR 0:02:42 0:21:35 0:24:18 0:03:11 0:20:59 0:24:10 THOOTHUKUDI 0:02:39 0:23:21 0:26:01 0:02:52 0:21:09 0:24:01 TIRUCHIRAPPALLI 0:02:41 0:20:34 0:23:14 0:03:02 0:20:37 0:23:40 TIRUNELVELI 0:02:31 0:18:10 0:20:41 0:02:53 0:17:51 0:20:44 TIRUPUR 0:02:38 0:15:33 0:18:11 0:03:00 0:15:34 0:18:34 VELLORE 0:02:31 0:15:49 0:18:20 0:02:53 0:18:20 0:21:13 VILLUPURAM 0:02:43 0:17:40 0:20:23 0:03:05 0:22:33 0:25:37 VIRUDHUNAGAR 0:02:28 0:21:21 0:23:50 0:02:48 0:21:28 0:24:16 State Average 0:02:37 0:17:44 0:20:21 0:03:00 0:18:43 0:21:43

For the month - For the month - Response Time Call to Hospital Apr'15 Apr'15 C-S Metro (hh:mm:ss) 00:13:04 C-H Metro (hh:mm:ss) 00:34:44 C-S Rural (hh:mm:ss) 00:22:06 C-H Rural (hh:mm:ss) 01:04:12 C-S Tribal (hh:mm:ss) 00:25:17 C-H Tribal (hh:mm:ss) 01:21:01 C-S Urban (hh:mm:ss) 00:18:15 C-H Urban (hh:mm:ss) 01:04:47 C-S Total (hh:mm:ss) C-H Total (hh:mm:ss) 00:21:05 01:03:16

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Annexure J: Interesting Emergency Case

Emergency case 1

Case Details Format Case ID 1807075 Date 20-Apr-15 Assign Time 20:18hrs Ambulance Location Dharmapuri MCH Neonatal Ambulance District Dharmapuri

Name of EMT Mr. Rajagopal R ID Number 30009 Name of Pilot Mr. Govintharasu ID Number 39133

Patient details Baby of Kalyani - Twins Age 1day Gender Twins- Male Gestational Age Preterm Birth Weight 1.9kg and 2kg Emergency Type Respiratory Distress Syndrome Level of Consciousness Active On 23rd April at 20:18 hrs , Dharmapruri Medical College and hospital Neonatal ambulance received a call from ERO at 20:18hrs stating that IFT case was from Panjapalli PHC to Dharmapuri MCH. Baby of Kalyani - Twins, 1 day old male babies with birth weight of 1.9kg and 2kg respectively, Gestation age- Preterm. Babies was referred to level III hospital with the complaints of Preterm, Respiratory distress and Low Birth weight. Our NEMT reached the PHC. Babies in Oxygen 3liters /min and Dextrose 10% IV was on flow.NEMT assess vitals of Twins ,Skin Condition - Pink and Warm, CRT- <3seconds, Temp- 98 F, HR- 144/min, Poor Cry and Movement present, RR- 58/min, SPO2- 92% (with Oxygen) , Grunting- Present, CBG - 48mg/dl. DOWNES score - 5/10. After the Pre referral stabilization baby was transffered to Ambulance. Case Details (Description) In ambulance sniffing position was maintained and warmth was maintained.Oxygen administgered through nasal cannula 3liters/min of oxygen. ERCP Dr. Dinesh advice taken. For both babies Intra venous fluid administered Dextrose 10% 2ml/kg fluid administered for managing the hypoglycemia. Enroute to the hospital tactile stimulation and umbilical cord care given. Airway was cleared with frequent suction. Vitals were monitored and TABC was maintained. Then the Neonate was safely shifted to Dharmapuri MCH with the stable vitals. With effective prehospital care blood glucose level improved as 110mg/dl. After two weeks of hospitalization both babies got discharged to home safely.

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Emergency Case – 2

Case Details Format Case ID 1889733 Date 28-04-2015 Assign Time 13:43hrs Ambulance Location Karur GH District Karur

Name of EMT Ms. Jayalakshmi ID Number 36549 Name of Pilot Mr. Thangaraj ID Number 48031

Patient details B/O Kalishwari Age 3days Gender Male Gestational Age Term Birth Weight 2.5kg Emergency Type Respiratory Distress Syndrome, Persistant Pulmonary Hypertension Level of Consciousness Lethargic On 28th April, Karur neonatal ambulance was assigned for IFT case at 13:43hrs from Palani GH to Govenment Rajaji hospital madurai. Baby of Kalishwari, 3 days old male, gestational age- preterm, birth weight of 2.5kg was referred to Level III hospital for the complaints of Persistant Pulmonary Hypertesion with Severe Respiratory distress. At birth baby had sever respiratory distress and under treatment at Palani GHsince birth. Baby was in ventilator support for 2days. On arrival at the scene, baby had complaints of respiratory distress. NEMT assess vitals, Skin color- Pink and warm, CRT- <3sec, Temperature- 36.5 c, HR- 140beats/minutes,RR- >80breaths/min, SpO2- 82%(without O2), SpO2- 94% (with O2) , CBG-75mg/dl. Intavenous fluid ISO-P and Injection dopamine 10mcgs was on flow. Case Details (Description) After the prereferral stabilization baby transferred to Ambulance. Endotracheal tube position checked.Warmth was maintained. Nasogastric tube was inserted. ERCP Dr. Lavanya advice taken. As per Airway was cleared with frequent suction. Continuous ventilation given through BVM. Enroute to the hospital vital were stable. TABC was maintained. Then the Neonate was safely shifted to Madurai GRH with the stable vitals. With more than 3 hours manual bag valve mask ventilation and proper prehospital care by NEMT saved the baby's lives. After two week of hospitalization baby got discharged to home safely.

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Emergency Case – 3

Case Details Format Case ID 1531597 Date 8-Apr-15 Assign Time 03:35 Ambulance Location Karimangalam phc District Dharmapuri

Name of EMT Ms.K.Amuthavalli ID Number 61878 Name of Pilot Mr. Kumaravel ID Number 35514 Patient details Age 55 years Gender Female Name Kalaiselvi Contact Number (Patient / informer) 8098975986 Emergency Type RTA Level of Consciousness Semi Concious ROAD ACCIDENT VICTIM SAVED WITH IN GOLDEN HOUR On 08.04.2015 Karimangalam PHC ambulance received a dispatch call at 3:35hrs stating that it is a case of Road traffic accident, four wheeler falls down by upside down. Pilot immediately started the ambulance & reached the scene in next 6 minutes the EMT prepared required dressing materials, stretcher for the case and reached the scene safely with personal protective equipments. After reached the scene EMT triaging the mass causality & rendered pre-hospital care. The details as follows First victim - Mrs.Kalaiselvi had head injury, multiple severe laceration.EMT taken ERCP advice. Based on ERCP Dr.Dhinesh advise pre hospital care such as bleeding control measures, Inj.Tramodol 2cc, I.V fluid 500 ml NS given to the client. On scene vitals monitored HR: 82bpm, BP: 130/90mmHg, RR: 22 Case Details Breaths/mint, Spo2:99%. Second victim - Mrs.Rajeswari 40 years female had open injury on left leg & multiple laceration all over the body, on scene vitals are Pulse:88beats/m, Respiratory Rate:24 breaths/Mints, Blood Pressure:120/90mmHg,SPO2:98%. Splint applied, wound care given,. As per ERCP advice EMT administered Inj.Tramadol 2cc & 500 ml IV fluid Normal Saline. Third victim - Master kumaran 2 years 6 month male Baby conscious, oriented, multiple laceration all over the body. As per the ERCP advice EMT provide the wound care & Administered paracetamol syrup -4ml, vitals of the three victim were continuously monitored and Pre-hospital care was continued by the EMT till all the victims admitted into hospital. After 48 hrs follow up, found that the life of the victim was saved

For First Victim :Mrs.Kalaiselvi: Enroute Bleeding control measures, Inj.Tramodol 2cc, I.V fluid 500 ml NS given to the client. For Second Victim Rajeswari : Splint applied, wound care given, IVF Normal saline started & monitored victims vitals ie HR:88Bpm,RR:24/Mins,BP:120/90mmhg,SPO2:98%. inj. Prehospital Care Provided Tramadol 2cc administered as per ERCP advise. For Third victim: Master kumaran As per ERCP advice EMT provide the wound care & Administered paracetamol syrup -4ml, Three victims are shifted to Dharmapuri medical college hospital.

Stabilizing the three victim at a time with out going into the shock, On the spot management Additional Challenges Photographs**

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Annexure K – Important Events & Photographs

Event: EMT Day celebrated across the state on 2nd Apr 2015. Officials from HO went to the districts and the Best EMT’s were felicitated during the event. Various Govt officials including JDHS, DDHS, DPMU Coordinators, Police personnel honoured our associated during their speech and felicitated the best EMT’s.

Other Events:

- Demo’s at Various PHC across the state

- Demo’s carried out in Hilly terrain for improving utilisation of 4 Wheel drive

- Awareness of Neonatal ambulances created in all PHC/GH

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Annexure L: AN – Cases Monthly Report (Apr ’15)

AN - Cases Monthly Report For the month of Apr 2015

Number of cases Number of cases Number of cases Number of cases Number of cases Number of cases Number of cases Number of cases Total Pregnancy re-referred by re-referred by Total Cases Re- S No District Name lifted thro’ ERC lifted thro’ ERC lifted thro’ ERC referred by referred by referred by PHC Cases FRU to Higher referred referred to PHC to GH/MC to Others GH/MC Others Level Institutions institutions

1 ARIYALUR 51 98 23 92 65 1 330 - - - 2 CHENNAI 0 96 28 58 45 301 528 - - - 3 COIMBATORE 73 152 29 191 83 36 564 - - - 4 CUDDALORE 133 255 62 213 112 0 775 4 1 5 5 DHARMAPURI 145 68 48 372 41 3 677 - - - 6 DINDIGUL 65 84 34 253 59 0 495 - - - 7 ERODE 106 62 23 220 55 5 471 - - - 8 KANCHEEPURAM 161 180 63 576 116 14 1110 - - - 9 KANYAKUMARI 12 23 14 136 21 0 206 - - - 10 KARUR 35 56 14 82 39 1 227 - - - 11 KRISHNAGIRI 196 102 52 310 40 8 708 - - - 12 MADURAI 76 82 37 327 73 12 607 - - - 13 NAGAPATTINAM 14 101 19 116 74 1 325 - - - 14 NAMAKKAL 81 64 24 203 36 4 412 - - - 15 THE NILGIRIS 34 22 25 53 64 5 203 1 - 1 16 PERAMBALUR 34 39 7 94 6 0 180 - - - 17 PUDUKOTTAI 110 186 20 140 67 1 524 - - - 18 RAMANATHAPURAM 67 95 17 149 51 0 379 - - - 19 SALEM 184 68 66 387 77 0 782 - - - 20 SIVAGANGAI 66 104 17 161 38 2 388 - - - 21 THANJAVUR 62 237 39 178 51 1 568 - - - 22 THENI 39 133 19 190 76 0 457 - - - 23 THIRUVALLUR 131 116 79 478 128 16 948 - - - 24 THIRUVANNAMALAI 272 147 70 455 64 4 1012 - - - 25 THIRUVARUR 12 100 14 100 70 0 296 - - - 26 THOOTHUKUDI 29 89 31 195 75 2 421 - - - 27 TIRUCHIRAPPALLI 135 139 35 243 77 9 638 - - - 28 TIRUNELVELI 27 99 30 292 150 2 600 - - - 29 TIRUPUR 82 100 19 204 45 2 452 - - - 30 VELLORE 298 124 120 722 288 6 1558 - - - 31 VILLUPURAM 423 195 110 533 126 2 1389 - - - 32 VIRUDHUNAGAR 106 77 24 184 67 3 461 - - - Total 3259 3493 1212 7907 2379 441 18691 5 1 6

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Annexure M: Neonatal ambulance cases (Apr’15)

Neonatal Cases Admission- April'15 S.No District Location Referral Hospital No. Cases Destination Hospitals ALANGANALLUR PHC 2 ARUPUKOTTAI GH 1 DINDIGUL GH 10 KALLUPATTI PHC 2 KANJARAMPETTAI PHC 1 KARUNGALAKUDI PHC 1 KATCHAKATTI PHC 1 KEERTHI PVT HOSPITAL 1 KOILPAPPAKUDI PHC 1 MELUR GH 1 NILAIYUR PHC 3 PALAMEDU PHC 1 RAJAKOOR PHC 1 MADURAI GRH SAMAYANALLUR PHC 1 SANTHANKUDI PHC 2 SEKKIMANGALAM PHC 2 SIFAI HOSPITAL 1 GOVERNMENT RAJAJI MEDICAL THIRUMANGALAM GH 7 1 MADURAI COLLEGE HOSPITAL(GRH) SRIVILLIPUTUR GH 1 USILAMPATTI GH 4 THONDAMANAPATTI (Pt residence) 1 THIRUPARANKUNDRAM PHC 1 VATHIPATTY PHC 1 VELLALORE PHC 1 VIRUDHUNAGAR GH 1 VIRUTHANUR PHC 2 RAMANATHAPURAM.T PHC 1 USILAMPATTI GH KOODAKOIL PHC 1 THIRUMANGALAM GH CUMBUM GH 1 THENI MEDICAL COLLEGE HOSPITAL THIRUMANGALAM GH 1 ALANGANALLUR PHC 1 VIRUDHUNAGAR GH 2 Not an Emergency KOTTAMPATTI PHC 1 PALANI GH 1 THUMBAIPATTI PHC 1 Total Number of cases 61 ANNAI PVT CLINIC 1 BARUR PHC 1 ADIKARAPATTY(Pt residence) 1 HARUR GH 4 ERIYUR PHC 2 BOOTHANATHAM PHC 1 INDUR PHC 1 HOSUR GH 2 JEKKASAMUDRAM PHC 2 K.N.PUDUR PHC 1 MORAPPUR PHC 2 DHARMAPURI MEDICAL COLLEGE LALIGAM PHC 1 NULAHALLI PHC 2 NAGADASAMPATTY PHC 4 PANCHAPALLI PHC 4 2 DHARMAPURI DHARMAPURI MEDICAL COLLEGE PALACODE GH 1 PENNAGARAM GH 3 PAPPARAPATTI PHC 2 PERUMPALAI PHC 3 PULIKARAI PHC 2 THURINJIPATTI PHC 4 THOPPUR PHC 2 DHARMAPURI MEDICAL COLLEGE HOSPITAL 2 HARUR GH 2 SALEM MEDICAL COLLEGE HOSPITAL KADAYAMPATTI PHC 1 HOSUR GH 1 DENKANIKOTTAI GH 1 HOSUR GH ILAMKUNNI PHC 1 HARUR GH MARANDAHALLI PHC 1 Not an Emergency NAGATHASANPETTAI PHC 1 Total Number of cases 56 MELPATTAMPAKKAM PHC 1 THOOKANAMPAKKAM PHC 1 THEERTHANGIRI PHC 1 CUDDALORE GH NADUVEERAPATTU PHC 1 RMMCH CHIDAMBARAM 1 RAMPAKKAM PHC 1 MUNDIAMBAKKAM MCH, VILLUPURAM 1 CUDDALORE GH, CUDDALORE 5 JIPMER, PONDY VRIDHACHALAM GH 2 3 CUDDALORE CUDDALORE GH NEONATAL CUDDALORE GH, CUDDALORE 1 RAJIV GANDHI GH FOR W&C KADAMPULIYUR PHC 1 MUNDIAMBAKKAM MCH CUDDALORE GH 1 ICH MUNDIAMBAKKAM MCH, VILLUPURAM 2 MUTLUR B PHC 1 CHIDAMBARAM MCH KOMARATCHI PHC 1 MUNDIAMBAKKAM MCH, VILLUPURAM 1 CHENGALPET MCH THUKKANAMBAKKAM(Pt residence) 1 Not an Emergency Total Number of cases 23 MUNDIAMBAKKAM MCH 1 ICH 4 KANCHIPURAM KANCHIPURAM - NEONATAL Total Number of cases 1 Page 24 of 35

Neonatal Cases Admission- April'15 S.No District Location Referral Hospital No. Cases Destination Hospitals ALANDHUR CORPORATION HOSPITAL 1 ADYAR CHC 2 108 ECC CHROMPET 1 ARAKONAM GH 1 AVADI PHC 1 AYANAVARAM PHC 1 EGUVARPALAYAM PHC 1 ESI HOSP. AYANAVARAM 2 ELICHUR PHC 1 GOSHA 2 IOG EGMORE 3 KAVARAPETTAI PHC 2 KADUVUR PHC 1 KANCHIPURAM GH 1 KODAMBAKKAM CHC 1 KUNDRATHUR PHC 3 KILPAUK MCH 3 MADARAPAKKAM PHC 1 MANALI PHC 2 MINJUR PHC 1 NARAVARIKUPPAM PHC 1 MOOVARASAMPATTU PHC 1 MOLACHUR PHC 1 PADIANALLUR PHC 1 ICH NR MEDICAL HOME 1 NEW LIFE CHILDREN PVT HOSP 1 PAZHAVARKADU GH 1 PANCHATTI PHC 3 PAMMAL(Pt residence) 1 PERIYAR NAGAR PHC 1 PONNERI GH 5 PERAMBUR RAILWAY HOSPITAL 2 PURASAVAKKAM CORP HOSP 1 PULIYANTHOPE CHC 3 PULIYUR PHC 1 5 CHENNAI ICH SAIDAPET GH 3 RSRM 1 SANJEEVARAYANPET CHC(SOLAIYAPPAN STREET) 2 SHENOY NAGAR CHC 3 SOMANGALAM PHC 1 STEDFORD HOSPITAL 1 STANLEY MCH 1 THIRUNINDRAVUR PHC 1 TAMBARAM GH 2 VEE CARE HOSPITAL 1 THIRUVALLUR GH 5 VELLORE MCH (ADUKKAMPARAI) 2 VENKAT RATHNA NURSING HOME 1 ICH 2 IOG EGMORE KILPAUK MCH 1 ICH 2 KILPAUK MCH IOG EGMORE 1 ICH 1 MULTI SUPER SPECIALITY GOVT HOSP OMANDURAR MADARAPAKKAM PHC 3 MANGADU PHC 1 MINJUR PHC 1 STANLEY MCH SANJEEVARAYANPET CHC(SOLAIYAPPAN STREET) 3 THIRUVALLUR GH 2 SHENOY NAGAR CHC 1 PERIYAPALAYAM PHC 1 PERAMBAKKAM PHC 1 ARANI PHC 1 THIRUVALLUR GH ULUNDAI PHC 1 TIRUTANI GH 1 KALYANI HOSPITAL 1 GOSHA KELAMBAKKAM PHC 1 CHENGALPET MCH LIFE CARE HOSPITAL, VILLIVAKKAM 1 AVADI GH 1 Not an Emergency PADI CORPORATION HOSPITAL 1 Total Number of cases 107 ALANGAYAM PHC 3 KAKANAMPALAYAM PHC 1 ARANGALDURGAM PHC 2 KORATTI PHC 1 NATRAMPALLI PHC 3 KARAPATTU PHC 1 PACHUR PHC 2 NIMMIAMPETTI PHC 2 PERAMPATTU PHC 2 THIRUPATHUR GH PUDUPETTAI PHC 8 RAMANAICKENPETTAI PHC 1 SINGARAPETTAI PHC 2 PUDURNADU PHC 2 SOMANAICKANPATTI(Pt residence) 1 A.K.MOTTUR(Pt residence) 1 UTHANGARAI GH 2 VANIYAMPADI GH 6 TIRUPATHUR GH - NEONATAL 6 VELLORE KAPPALVADI PHC 1 KRISHNAGIRI GH AMBULANCE ARUNKUNDRAM PHC 1 AMBUR GH 1 ANAICUT PHC 1 KAKANAMPALAYAM PHC 1 MUSIRI PHC 1 GUDIYATTAM GH 1 VELLORE MCH (ADUKKAMPARAI) PERAMPATTU PHC 1 ODUGATHUR PHC 1 PERNAMPATTU URBAN PHC 1 THIRUVANNAMALAI MCH 1 TIRUPATTUR GH 3 VANIYAMPADI GH 1 PANAPAKKAM PHC 1 KANCHIPURAM GH THIRUPATHUR GH 4 VELLORE MCH (ADUKKAMPARAI) 2 ICH TIRUPATTUR GH 2 DHARMAPURI MEDICAL COLLEGE HOSPITAL Total Number of cases 64 Page 25 of 35

Neonatal Cases Admission- April'15 S.No District Location Referral Hospital No. Cases Destination Hospitals BARGUR PHC 1 JAGADEVI PHC 1 KAPPALVADI PHC 2 KAVERIPATTINAM CHC 2 NAGAMANGALAM PHC 1 KRISHNAGIRI GH NEDUNGAL PHC 1 MEKALACHINNAMPALLI PHC 1 PERUGOPANAPALLI PHC 3 SINTHAGAPALLI PHC 1 RAYAKOTTAI PHC 1 DEVAGI NAYAK PVT HOSP 1 GUNAM PVT HOSP 1 HOSUR GH 7 KRISHNAGIRI KRISHNAGIRI GH -NEO BAGALUR PHC 2 NAGAMANGALAM PHC 1 PANCHAPALLI PHC 1 KRISHNAPURAM GH 1 SHOLAKOTTAI PHC 1 BARGUR PHC 1 DHARMAPURI MEDICAL COLLEGE HOSPITAL HANUMANTHAPURAM PHC 1 KRISHNAGIRI GH 1 KARIMANGALAM PHC 1 NATRAMPALLI PHC 2 TIRUPATTUR GH KAVERIPATTINAM PHC 1 Nota an Emergency PAPPARAPATTI PHC 1 Total Number of cases 30 ANDAKULAM PHC 2 ALANGUDI GH 1 KEELANILAI PHC 1 PUDUKOTTAI GH MELSIVAPURI PHC 1 VISALIKOIL PHC 1 VADAKADU PHC 1 RANIS MATERNITY GH, PUDUKKOTTAI 3 VELLALAVIDUTHI PHC 1 RAJA MIRASDAR GH PUDUKOTTAI GH, PUDUKOTTAI 2 VARAPPUR PHC 1 KEELANILAI PHC 1 PANAYAPATTI PHC 1 RANIS MATERNITY GH, PUDUKKOTTAI 8 PUDUKOTTAI RANI'S GH ANDAKULAM PHC 1 ARANTHANGI GH 2 MANAPPARAI GH 1 TRICHY GH MUKKANNAMALAIPATTI PHC 1 ARANTHANGI GH ATTANI PHC 1 SEVINIPATTI PHC 1 KARAIKUDI NEW GH BABA HOSPITAL, TIRUPATTUR 1 ARANTHANGI GH 1 KARAIKUDI NEW GH 1 MADURAI GRH PUDUKOTTAI GH 1 Not an Emergency GANDARVAKOTTAI GH 1 Total Number of cases 28 ADI ANNAMALAI PHC 1 ANANANTHAL PHC 3 ARCADU PHC 1 ARIYUR PHC 1 ATHAMANGALAMPUDUR PHC 5 AVALURPETTAI PHC 3 CHENGAM GH 1 CHETPET PHC 1 KARAPATTU PHC 1 KADALADI PHC 1 MEKKALUR PHC 1 MALAMANJANUR PHC 5 MANGALAM PHC 1 MEYYUR PHC 1 TIRUVANNAMALAI MCH PERUNGULATHUR PHC 1 NORTHAMPOONDI PHC 2 PUDUPALAYAM PHC 1 SATHANUR DAM PHC 2 9 T.V.MALAI THIRUVANNAMALAI GH NEONATAL POLUR GH 1 THANDRAMPATTU PHC 1 SOMASIPADI PHC 1 THANIPADI GH 1 THURINJAPURAM PHC 3 VALATHI PHC 1 VETTAVALAM PHC 1 VANAPURAM PHC 2 POLUR GH 2 KALAMBUR PHC 1 VELLORE ADUKAMPARAI MCH THATCHUR PHC 1 TIRUVANNAMALAI MCH 7 THIRUKOILUR GH 1 MUNDIAMBAKKAM MCH ARIYUR PHC 1 EDUTHAVAINATHAM PHC 1 KALLAKURICHI GH SERAPATTU PHC 1 THIRUVANNAMALAI MCH 6 ICH Total Number of cases 64

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Neonatal Cases Admission- April'15 S.No District Location Referral Hospital No. Cases Destination Hospitals ALAMELUMANGAPURAM PHC 1 ARANI GH 4 ANAICUT PHC 2 BANAVARAM PHC 6 ARCOT GH 1 CHEYYAR GH 2 KATHALAMBATTU PHC 1 KAMAKUR PHC 1 LADAVARAM PHC 1 VELLORE ADUKAMPARAI MCH LALAPET PHC 1 MALAYAMPATTU PHC 1 LATHERI PHC 1 MELVISHARAM PHC 2 MUSIRI PHC 1 MAMBAKKAM PHC 1 VELLORE GH (PENTLAND) 1 POYGAI PHC 2 WALLAJAPET GH 8 LADAVARAM PHC 1 10 VELLORE WALLAJAH GH NEONATAL ARUNKUNDRAM PHC 1 MUSIRI PHC 3 ARAKONAM GH VILAMPAKKAM PHC 1 MELVISHARAM PHC 1 MADURAMANGALAM PHC 1 THIRUPPUKUZHI PHC 1 KANCHIPURAM GH PANAPAKKAM PHC 1 THIRUPATHUR GH 3 VELLORE MCH (ADUKKAMPARAI) 2 ICH ARAKONAM GH 5 KANCHIPURAM GH 1 PERAMPATTU PHC 1 GUDIYATTAM GH KOVALAI PHC 1 CHENGALPET MCH PANAIYUR PHC 1 ARANI GH GURUVARAJAPETTAI PHC 1 ARAKONAM GH VELLORE MCH (ADUKKAMPARAI) 1 THIRUPUKUZHI PHC 1 Not an Emergency WALLAJAPET GH 1 Total Number of cases 65 AYYEMPETTAI GH 1 KALPANA PVT HOSPITAL 1 HARIDHUVARAMANGALAM PHC 1 KUMBAKONAM GH 11 MANNARKUDI GH 4 NADUCAUVERI PHC 1 MELATTUR PHC 3 MAYILADUTHURAI GH 1 PATTUKKOTTAI GH 7 PANDARAVADAI PHC 1 RAJA MIRASDAR GH SALIAMANGALAM PHC 1 POONDI PHC 2 PULAVANATHAM(Pt residence) 1 THIRUMANOR PHC 1 11 THANJAVUR RMH NEONATAL SENTHALAI PHC 1 THIRUKATTUPALLI GH 2 THIRUVALAMPOZHIL PHC 1 THIRUVAIYARU GH 1 VEERAMANGUDI PHC 1 AYYAMPETTAI (Pt residence) 1 KABISTHALAM PHC 1 AMMAPETTAI PHC 1 THANJAVUR MEDICAL COLLEGE HOSPITAL PANDARAVADAI PHC 1 KUMBAKONAM GH 4 SUNDARAPERUMALKOIL PHC 1 KUMBAKONAM GH GANDVARVAKOOTAI GH 1 Not an Emergency KUMBAKONAM GH 2 Total Number of cases 54 PARTHIBANUR PHC 1 NAINARKOIL PHC 1 PARAMAKUDI GH SAYALKUDI PHC 1 UTCHIPULI PHC 1 SAYALKUDI PHC 1 RAMANATHAPURAM GH R.S.MANGALAM PHC 1 VALINOCKAM PHC 1 KOMBUKARANENDAL PHC 1 SIVAGANGA MCH 12 RAMNAD PARAMAGUDI GH - NEONATAL ARUPUKOTTAI GH 1 PARAMAKUDI GH 11 MADURAI GRH RAMANATHAPURAM GH 4 SIVAGANGA MCH 1 VEERACHOLAM PHC 2 ARUPUKOTTAI GH UCHIPILI PHC 1 KARIPATTI PHC 1 Not an Emergency THAYALKUDI PHC 1 Total Number of cases 30 Page 27 of 35

Neonatal Cases Admission- April'15 S.No District Location Referral Hospital No. Cases Destination Hospitals ATHANUR PHC 1 ARIYAPALAYAM PHC 1 ACHANGUTTAPATTI PHC 1 EDAPADI GH 1 E.KATTUR PHC 2 ATTHUR GH 4 ELAMPILLAI PHC 1 GOODAMALAI PHC 1 HARUR GH 1 KOMPURANKADU PHC 1 KALLAKURICHI GH 1 KADAYAMPATTI PHC 1 MASINAICKENPATTI PHC 1 MECHERI PHC 1 KONGANAPURAM PHC 1 SALEM MEDICAL COLLEGE HOSPITAL NAMAKKAL GH, NAMAKKAL 1 NANGAVALLI PHC 3 NAINAMPATTI PHC 1 ONDIVEERANUR PHC 1 OMALUR GH 3 13 SALEM SALEM GH NEONATAL POOLAVARI PHC 1 SEDAPATTY PHC 1 RASIPURAM GH 2 THAMMAMPATTI PHC 1 THARAMANGALAM PHC 2 THATHAGAPATTI PHC 1 THUMBAL PHC 1 TIRUCHENGODE GH 1 VAZHAPADI PHC 1 MULLIKURUCHI PHC 1 NAMAKKAL GH MOOKAREDDIPATTI PHC 1 HARUR GH CHINNANKUPPAM PHC 2 DHARMAPURI MEDICAL COLLEGE HOSPITAL HARUR GH 2 ARIYAPALAYAM PHC 1 ATTHUR GH PEDDANAICKENPALAYAM PHC 1 KATTUKOTTAI PHC 1 POOLAVARI PHC 1 ATHANUR PHC 1 Not an Emergency GANGAVALLI GH 1 KAYATHOPUR PHC 1 Total Number of cases 52 ALOOR(Pt residence) 1 GANAPATHIPURAM PHC 1 AGASTHEESWARAM PHC 1 KULITHURAI GH 3 KUMARASAMY PVT HOSPITAL 1 KOTTARAM PHC 1 KANYAKUMARI MEDICAL COLLEGE HOSPITAL MARUNGUR PHC 1 RAJAKKAMANGALAM PHC 1 PANAGUDI PHC 1 SANKARANKOIL GH 1 SHENBAGARAMANPUDHUR PHC 4 14 KANYAKUMARI THUCKLAY GH NEONATAL THUCKLAY GH 4 KOLLENCODE PHC 2 KILKULAM PHC 1 KULITHURAI GH THOOTHOOR PHC 2 EDAICODE PHC 1 SRI CHITHRA INSTITUDE OF MEDCAL SCIENCE AND KULITHURAI GH 1 TECHNOLOGY NADUVAKKARAI PHC 1 KANYAKUMARI MEDICAL MISSION & CSI HOSP SANKANAPURAM PHC 1 KUMARSWAMY HOSPITAL 1 Not an Emergency THUCKLAY GH 1 Total Number of cases 31 IDAIKALI NADU PHC 1 NANDHIVARAM PHC 6 KOOVATHUR PHC 1 PADALAM PHC 1 SADRAS PHC 1 CHENGALPET MCH SALAVAKKAM PHC 1 UTHIRAMERUR GH 1 THIRUKALUKUNDRAM GH 1 TINDIVANAM GH 1 VALLIPURAM PHC 1 CHENNAI MMC 1 CHENGALPET MCH 7 KANCHIPURAM GH 9 MUNDIAMBAKKAM MCH, VILLUPURAM 2 MARAIMALAINAGAR PHC 1 PADALAM PHC 1 THIRUVALLUR GH 1 ICH 15 KANCHIPURAM CHENGALPET - NEONATAL SOMANGALAM PHC 1 SIRUKUNDRAM PHC 1 TIRUPATTUR GH 1 TIRUVANNAMALAI MCH 6 VRIDHACHALAM GH 1 VELLORE MCH (ADUKKAMPARAI) 1 VEERARAGAVAPURAM HSC 1 THIRUPPUKUZHI PHC 1 AVALOOR PHC 1 KANCHIPURAM GH MOLACHUR PHC 1 BANAVARAM PHC 1 VELLORE MCH (ADUKKAMPARAI) ANAIPOGI PHC 1 TIRUVANNAMALAI MCH ARAKONAM GH 1 THIRUVALLUR GH TINDIVANAM GH 1 MUNDIAMBAKKAM MCH MUNDIAMBAKKAM MCH, VILLUPURAM 1 KANCHEEPURAM GH 1 Not an Emergency DHADHAPURAM PHC 1 Total Number of cases 59 Page 28 of 35

Neonatal Cases Admission- April'15 S.No District Location Referral Hospital No. Cases Destination Hospitals ANBIL PHC 2 INAMKOLATHUR PHC 1 ANDANALLUR PHC 1 KARUR GH, KARUR 1 KATTUR PHC 2 KARIAMANICKAM PHC 1 KULITHALAI GH 7 LALGUDI GH 1 MELARASUR PHC 1 MANAPPARAI GH 5 MADAIYUR PHC 2 NAGAMANGALAM PHC 1 TRICHY GH NEIDALUR(Pt residence) 1 PERAMBALUR GH 1 SOMARASANPETTAI PHC 1 SRIRANGAM GH 1 RANGA NURSING HOME 1 THIRUNEDUMKULAM PHC 1 SUBRAMANIYAPURAM CORP HOSP 3 16 TRICHY TRICHY MEDICAL COLLEGE- NEONATAL THANDALAIPUDUR PHC 1 THOGAIMALAI PHC 1 THURAIYUR GH 1 THUVAKUDI GH 1 VELIYANUR PHC 1 KODUMBALUR PHC 1 SUKKAMPATTI T PHC 1 CHETTIAPATTY PHC 1 MANAPARAI GH VALANADU PHC 4 THUVARANKURICHI GH 1 THOGAIMALAI PHC 4 TRICHY GH 1 RAJA MIRASDAR GH ERAGUDI PHC 1 THURAIYUR GH TRICHY GH, TRICHY 1 MADURAI GRH KARUR GH 1 KUTHANATHAM PHC 1 SUBRAMANIYAPURAM PHC 1 Not an Emergency THANDALAIPUTHUR PHC 1 TRICHY GH 1 Total Number of cases 59 KOTTARAKUDI PHC 2 KODAVASAL GH 1 ENANKUDI PHC 1 MUTHUPETTAI PHC 1 KULIKARAI PHC 2 THIRUVARUR MEDICAL COLLEGE HOSPITAL NAGAPATTINAM GH, NAGAPATTINAM 1 POONTHOTTAM PHC 1 THIRUTHURAIPOONDI URBAN PHC 1 THIRUTURAIPOONDI GH 6 VIJAYAPURAM GH 1 MANNARKUDI GH 2 THANJAVUR MEDICAL COLLEGE HOSPITAL 17 THIRUVARUR THIRUVARUR MCH-NEONATAL KUMBAKONAM GH 4 MANNARKUDI GH 3 MAYILADUTHURAI GH 4 RAJA MIRASDAR GH NAGAPATTINAM GH 1 SIRKALI GH 1 THIRUVARUR MEDICAL COLLEGE HOSPITAL 3 KEEZHAIYUR PHC 1 NAGAPATTINAM GH VADUGACHERI PHC 1 THIRUNAGESWARAM PHC 1 KUMBAKONAM GH SIRKALI GH 3 CHIDAMBARAM MCH Total Number of cases 41 ATHIYUR PHC 1 ARUMBAVUR PHC 1 AVATTI PHC 2 PADALUR PHC 1 KRISHNAPURAM GH 1 PERAMBALUR GH NELKUPPAI PHC 1 TITTAKUDI GH 4 18 PERAMBALUR PERAMBALUR GH PASUMPALUR PHC 1 VALIKONDAPURAM PHC 1 VELUR PHC 2 VRIDHACHALAM GH 1 CUDDALORE GH AVATTI PHC 1 ANGANUR PHC 1 Not an Emergency Total Number of cases 18 AMMAYANAICKANUR PHC 1 PILATHU PHC 1 SIDDAYANKOTTAI PHC 1 KOSUKURICHI PHC 1 DINDIGUL GH SAKKAINAIKKANUR PHC 1 DINDIGUL GH 1 KOSAVAPATTI PHC 1 DINDIGUL GH 8 19 DINDIGUL DINDIGUL GH- NEONATAL SEKKIPATTI PHC 1 KARUR GH, KARUR 1 MADURAI GRH USILAMPATTI GH 1 THENI MEDICAL COLLEGE HOSPITAL, THENI 3 PERIYAKULAM GH 2 THENI MEDICAL COLLEGE HOSPITAL BODI GH 1 MANAPPARAI GH 1 TRICHY GH THUMMBALPATI PHC 1 Not an Emergency Total Number of cases 26 Page 29 of 35

Neonatal Cases Admission- April'15 S.No District Location Referral Hospital No. Cases Destination Hospitals ALANGANATHAM PHC 1 ERNAPURAM PHC 5 MALAYALAPAATY PHC 1 MULLUKURICHI PHC 1 MOHANUR PHC 3 MANICKAMPALAYAM PHC 1 NAMAKKAL GH PARAMATHIVELUR GH 1 PAVITHIRAM PHC 3 PUDUCHATHIRAM PHC _ NMKL 1 20 NAMAKKAL NAMAKKAL GH,NEONATAL VINAITHEERTHAPURAM PHC 1 VALAVANTHINADU PHC 3 SENDHAMANGALAM GH 2 NAMAKKAL GH, NAMAKKAL 3 ATHANUR PHC 2 SALEM MEDICAL COLLEGE HOSPITAL THIRUCHENCODE GH 3 MANICKAMPALAYAM PHC 1 TIRUCHENGODE GH KARUR GH 1 MADURAI GRH Total Number of cases 33 ARAVAKURICHI GH 1 UPPIDAMANGALAM PHC 1 MYLAMPATTI PHC 1 VEPPANGUDI PHC 1 KARUR GH GOVINDANPALAYAM PHC 2 VELLODU.R PHC 1 21 KARUR KARUR GH NEONATAL SENGAL PHC 1 GUJILIAMPARAI PHC 1 PALANI GH 1 MADURAI GRH PARAMATHIVELUR GH 1 NAMAKKAL GH KARUR GH, KARUR 1 TRICHY GH KULITHALAI GH 1 Total Number of cases 13 KAZHUDUR PHC 1 VIRUDHACHALAM GH PENNADAM PHC 1 PERAMBALUR GH IRUVELPATTU PHC 1 KANDATCHIPURAM PHC 1 TINDIVANAM GH 1 MUNDIAMBAKKAM MCH VEPPUR PHC 1 ULUNDURPET GH 3 ARASAKULI PHC 1 KARAIKADU PHC 1 CUDDALORE GH KURINJIPADI GH 1 22 CUDDALORE VIRUDHACHALAM GH MUNDIAMBAKKAM MCH, VILLUPURAM 1 CHENGALPET MCH VRIDHACHALAM GH 2 CHIDAMBARAM MCH VIRUDHACHALAM GH 1 ICH MUNDIAMBAKKAM MCH, VILLUPURAM 1 SIRUPAKKAM PHC 1 KALLAKURICHI GH VRIDHACHALAM GH 1 JIPMER, PONDY VIRUDHACHALAM GH 1 ARASAKULI GH 1 Not an Emergency MUNDIAMBAKKAM MCH, VILLUPURAM 1 Total Number of cases 22 ISWARYA WOMEN HOSPITALS FACILITY CENTER 1 DHARAPURAM GH 3 KALVEERAMPALAYAM PHC 1 KARADIMADAI PHC 1 METTUPALAYAM GH 4 KINATHUKADAVU PHC 2 NANJUNDAPURAM CORP HOSP 2 POLLACHI GH 5 METTUPALAYAM(Pt residence) 1 COIMBATORE MEDICAL COLLEGE HOSPITAL PULUVAPATTI PHC 2 23 COIMBATORE COIMBATORE MCH SINGANALLUR PHC 1 PULLAMPATTI PHC 1 TIRUPUR NEW GH (PERICHIPALAYAM GH) 3 SULUR GH 1 URABAN HEALTH POAT (CORPORATON HOSP) 1 VEERAPANDI 24 PHC 1 VELLAKINARU(Pt residence) 1 VALPARAI GH 2 POLLACHI GH ANAMALAI PHC 1 Not an Emergency Total Number of cases 34 KOOTHAKUDY PHC 1 KARIYALUR PHC 1 EDUTHAVAINATHAM PHC 1 KANANGUR(Pt residence) 1 KEELAKADU PHC 1 KALLAKURICHI GH VANAPURAM PHC 2 SEERAPATTU PHC 1 PUDHUPATTU PHC 1 MOTTAMPATTI PHC 1 24 VILLUPURAM KALLAKURICHI GH NEONATAL THIRUNAVALUR PHC 1 KALLAKURICHI GH 1 KANDATCHIPURAM PHC 1 MUNDIAMBAKKAM MCH, VILLUPURAM ULUNDURPET GH 1 THIRUKOILUR GH 1 VILLUPURAM OLD GH 1 MUNDIAMBAKKAM MCH, VILLUPURAM 2 ICH ULUNDURPET GH 1 Not an Emergency Total Number of cases 19 Page 30 of 35

Neonatal Cases Admission- April'15 S.No District Location Referral Hospital No. Cases Destination Hospitals COONOOR GH 1 ARUVANKADU PHC 1 COIMBATORE MEDICAL COLLEGE HOSPITAL KODANADU PHC 1 UDHAGAMANDALAM GH 12 KOTHAGIRI GH 1 25 NILGIRIS OOTY GH GUDALUR GH 1 UDHAGAMANDALAM GH KODANADU PHC 1 KETTI PHC 1 OOTY SAIT HOSPITAL ITHNARI PHC 1 Not an Emergency Total Number of cases 20 MANAMADURAI GH 2 MARAVAMANGALAM PHC 2 MUTHANANTHAL PHC 2 SIVAGANGA MCH SATHARASANKOTTAI PHC 1 SEMBANUR PHC 1 ARASANUR PHC 1 SIVAGANGA MCH, SIVAGANGAI 2 PARAMAKUDI GH 1 26 SIVAGANGAI SIVAGANGAI MCH THIRUPUVANAM GH 1 MADURAI GRH PIRANMALAI PHC 1 SEKKIMANGALAM PHC 1 KARAIKUDI NEW GH 1 POOVANTHI PHC 1 DEVAKOTTAI GH 1 KARAIKUDI NEW GH SIVAGANGAI MCH 1 Not an Emergency Total Number of cases 19 AVINASHI(Pt residence) 1 BOOMALUR PHC 1 15 VELAMPALAYAM PHC 1 MANGALAM PHC _ TIRUPUR 3 TIRUPUR NEW GH (PERICHIPALAYAM GH) KUNNATHUR PHC 1 UTHUKULI PHC 2 SEVUR PHC 2 DHARAPURAM GH 4 METTUPALAYAM GH 1 27 TIRUPUR TIRUPUR GH NEONATAL POLLACHI GH 3 COIMBATORE MEDICAL COLLEGE HOSPITAL TIRUPUR NEW GH (PERICHIPALAYAM GH) 9 TIRUPUR OLD GH 1 UDUMALAIPET GH 1 PALANI GH 1 MADURAI GRH KUNNATHUR PHC 1 GOBICHETTIPALAYAM GH TIRUPUR GH 2 Not an Emergency KANKAYAM GH 1 Total Number of cases 35 ARACHALUR PHC 1 ANTHIYUR GH 3 AVALPOONTHURAI PHC 1 GOBICHETTIPALAYAM GH 1 ELANTHAKUTTAI PHC 1 JAMBI PHC 1 KUMARAPALAYAM GH 1 KOKKARAYANPETTAI PHC 2 KALLAKATTUVALASU PHC 2 ERODE GH OLAGADAM PHC 1 PALLIPALAYAM PHC 1 NASIYANOOR PHC 1 PERUNDURAI MCH SANITORIYAM 1 28 ERODE ERODE GH NEONATAL PERIYAPULIYUR PHC 1 SIVAGIRI PHC 1 THINDAL PHC 3 KUTHIALATHUR PHC 1 TIRUCHENGODE GH 1 SALEM MEDICAL COLLEGE HOSPITAL ERAYAMANGALAM PHC 1 TIRUCHENGODE GH KOKKARAYANPETTAI PHC 1 ERODE GH 2 GOBICHETTIPALAYAM GH 1 DHARAPURAM GH 1 COIMBATORE MEDICAL COLLEGE HOSPITAL JAMBAI PHC 2 BHAVANI GH PERIYAPULIYUR PHC 1 Not an Emergency KOOKKARAYAPETTAI PHC 1 Total Number of cases 34 ANDIMADAM PHC 1 JAYAMKONDAM GH 7 KULUMOR PHC 1 ARIYALUR GH KUMILIUM PHC 1 VILANKUDI PHC 2 MANAKUDAYAN PHC 1 VARIYANKAVAL PHC 1 T.PALUR PHC 1 JAYAMKONDAM GH UDKOTTAI PHC 1 ANAIKUDICHAN PHC 1 29 ARIYALUR ARIYALUR GH ARIYALUR GH 6 KUMBAKONAM GH 3 JAYAMKONDAM GH 3 RAJA MIRASDAR GH VENGANOR PHC 2 THIRUMANOR PHC 1 ARIYALUR GH 2 THANJAVUR MEDICAL COLLEGE HOSPITAL CUDDALORE GH 1 MUNDIAMBAKKAM MCH KEELAKATTUR PHC 1 KUMBAKONAM GH VIRUDHACHALAM GH 1 JIPMER, PONDY IRUMBILIKURICHI PHC 1 Not an Emergency Total Number of cases 38 Page 31 of 35

Neonatal Cases Admission- April'15 S.No District Location Referral Hospital No. Cases Destination Hospitals THIRUVENGADU PHC 2 MAYILADUTHURAI GH MAYILADUTHURAI GH 3 RAJA MIRASDAR GH 30 NAGAPPATINAM NAGAPATTINAM GH MAYILADUTHURAI GH 1 THANJAVUR MEDICAL COLLEGE HOSPITAL NAGAPATTINAM GH 1 THIRUVARUR MEDICAL COLLEGE HOSPITAL Total Number of cases 7 ALANGULAM PHC 2 ABISHKAPATTI(Pt residence) 1 ALWARTHIRUNAGAR(Pt residence) 1 ANANDHAPURAM PHC 1 AMBASAMUDRAM GH 2 GANGAIKONDAN PHC 2 MANUR PHC 1 MELAPALAYAM GH 1 MUTHAMIZH PRIVATE HOSPITAL 1 RAJAPALAYAM GH 1 TIRUNELVELI MEDICAL COLLEGE HOSPITAL SANKARANKOIL GH 2 31 TIRUNELVELI TIRUNELVELI MCH NETTUR PHC 1 TENKASI GH 1 SRIVAIKUNDAM GH 1 SINGIKULAM PHC 1 THISAYANVILLAI PHC 1 THIRUKURANGUDI PHC 1 UKKIRANKOTTAI PHC 1 TIRUCHENDUR GH 1 KULATHUR PHC 1 THOOTHUKUDI MEDICAL COLLEGE HOSPITAL VELLALANKOTTAI PHC 1 KOVILPATTI GH Total Number of cases 25 ESI HOSPITAL , SIVAKASI 1 MUKKULAM.A PHC 1 ARUPUKOTTAI GH 6 RAJAPALAYAM GH 4 RAJAPALAYAM MATERNITY GH 4 SATTUR GH 2 MADURAI GRH SRIVILLIPUTUR GH 2 THENI MEDICAL COLLEGE HOSPITAL, THENI 1 THIRUMANGALAM GH 1 USILAMPATTI GH 1 32 VIRUDHUNAGAR VIRUDHUNAGAR GH NEONATAL VIRUDHUNAGAR GH, VIRUDHUNAGAR 4 SIVAKASI GH 1 VILUR PHC 2 KOTTAIYUR PHC 1 VIRUDHUNAGAR GH KANNISERIPUDUR PHC 1 ATHIYUR(Pt residence) 1 KALKURICHI PHC 1 SANKARANKOIL GH 1 TIRUNELVELI MEDICAL COLLEGE HOSPITAL UPPATHUR PHC 1 KOVILPATTI GH SIVAGASI GH 1 Not an Emergency Total Number of cases 37 ARAKONAM GH 2 ADYAR CHC 4 CHENNAI MMC 1 CHENGALPET MCH 2 CUDDALORE GH 1 EGUVARPALAYAM PHC 1 ESI HOSP. AYANAVARAM 1 GUMMIDIPOONDI GH 1 KANCHIPURAM GH 1 IOG EGMORE 1 KAVARAPETTAI PHC 1 KELAMBAKKAM PHC 1 KAVERI PVT HOSP 1 KODAMBAKKAM CHC 2 MADAMBAKKAM PHC 1 KILPAUK MCH 1 ICH MADAMBAKKAM PHC 3 MEENAKSHI HOSPITAL 1 MUNDIAMBAKKAM MCH 1 MIRSAHIB PET CHC 1 N.R PVT HOSP,PERIYAR NAGAR 1 PONNERI GH 3 PERAMBUR RAILWAY HOSPITAL 1 33 CHENNAI TRIPLICANE RSRM 1 PULIYANTHOPE CHC 2 SAIDAPET GH 4 SHENOY NAGAR CHC 2 SANJEEVARAYANPET CHC(SOLAIYAPPAN STREET) 1 TAMBARAM GH 1 THIRUVANNAMALAI MCH 2 VELLORE MCH (ADUKKAMPARAI) 1 PADAPPAI PHC 1 SANJEEVARAYANPET CHC(SOLAIYAPPAN STREET) 1 STANLEY MCH PURASAVAKKAM CORP HOSP 1 ADYAR CHC 1 SAIDAPET GH MANGADU PHC 1 KILPAUK MCH MIRSAHIB PET CHC 5 GOSHA MEDAVAKKAM PHC 1 NANDHIVARAM PHC 1 CHENGALPET MCH MANALI PHC 1 ADAYAR CORPORATION HOSPITAL 1 MESAGIPATTY PHC 1 MUNDIAMBAKKAM MCH 1 Not an Emergency MEDAVAKKAM PHC 1 GOSHA 2 THIRUVALLUR GH 1 Total Number of cases 67 Page 32 of 35

Neonatal Cases Admission- April'15 S.No District Location Referral Hospital No. Cases Destination Hospitals ERAL PHC 2 EPPODUMVENDRAN PHC 1 AGARAM(Pt residence) 1 JACOB PVT HOSP 1 KOVILPATTI GH 8 KK PVT HOSPITAL 1 LURTHAMMALPURAM PHC 2 MUDIVAITHANANDAL PHC 1 THOOTHUKUDI MEDICAL COLLEGE HOSPITAL MAPPILLIAIURANI PHC 1 NAGALAPURAM PHC 1 PUDUKOTTAI PHC 2 34 TUTICORIN THOOTHUKUDI GH NEONATAL OTTAPIDARAM GH 1 SIVAKALAI PHC 1 VEPPALODAI PHC 1 TIRUCHENDUR GH 4 KOVILPATTI GH 4 TIRUNELVELI MEDICAL COLLEGE HOSPITAL PARAMANKURICHI PHC 1 TIRUCHENDUR GH NAGALAPURAM PHC 1 MADURAI GRH KOVILPATTI GH 1 PULAPATTU PHC 1 Not an Emergency KARUNGULAM PHC 1 Total Number of cases 37 KANDAMANADI PHC 1 KARUVATCHI PHC 1 THIRUKOILUR GH 1 MUNDIAMBAKKAM MCH MUGAIYUR PHC 1 KANDATCHIPURAM PHC 1 THIRUKOILUR GH 1 TIRUVANNAMALAI MCH CUDDALORE GH 1 RAJIV GANDHI GH FOR W&C EDUTHAVAINATHAM PHC 1 KALLAKURICHI GH 35 VILLUPURAM VILLUPURAM MEDICAL COLLEGE SIRUMADURAI PHC 1 VANUR GH 1 MURUKKERI PHC 1 JIPMER, PONDY THIRUKOILUR GH 1 MUNDIYAMBAKKAM MCH 1 ICH VEERAPERUMANALLUR PHC 1 CUDDALORE GH TINDIVANAM GH 2 CHENGALPET MCH MUNDIAMBAKKAM MCH, VILLUPURAM 1 Not an Emergency Total Number of cases 17 TOTAL NUMBER OF CASES 1323 36 THENI FC-DOWNTIME 37 THIRUVALLUR FC-DOWNTIME

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Neonatal Ambulance Performance (Apr’14 – Apr’15)

Launch Till S NO LOCATION Apr'14 May'14 Jun'14 Jul'14 Aug'14 Sep'14 Oct'14 Nov'14 Dec'14 Jan'15 Feb'15 Mar'15 Apr'15 date 1 ICH 83 108 99 70 127 147 86 39 74 72 87 76 107 3086 2 TRIPLICANE NEONATAL 82 74 59 81 9 5 108 79 48 35 54 67 1975 3 KANCHEEPURAM NEONATAL 10 23 42 42 55 75 80 50 40 37 19 21 1 2057 4 CUDDALORE NEONATAL 33 31 27 28 13 23 33 22 27 23 26 33 23 761 5 DHARMAPURI NEONATAL 75 68 80 70 76 78 70 102 56 66 59 53 56 1926 6 MADURAI NEONATAL 52 58 42 51 63 51 45 20 38 49 37 69 61 1465 7 CHENGALPET NEONATAL 58 35 32 38 11 9 7 29 40 19 41 39 59 1218 8 TIRUPATTUR NEONATAL 65 80 56 60 78 69 71 59 81 55 55 30 64 1478 9 KRISHNAGIRI GH -NEONATAL 42 36 40 36 56 43 46 54 49 39 34 63 30 731 10 RANI'S GH NEONATAL 25 29 16 22 10 21 7 18 34 26 17 34 28 405 11 VIRUDHUNAGAR GH NEONATAL 32 32 31 41 18 44 43 42 36 30 35 22 509 12 TUTICORIN NEONATAL 37 43 33 39 51 36 37 32 19 40 37 475 13 THIRUVANNAMALAI GH NEONATAL 33 45 30 33 36 64 60 63 42 12 24 57 64 625 14 WALLAJAH GH NEONATAL 45 56 48 67 59 73 89 75 68 46 44 65 65 899 15 TIRUNELVELI MEDICAL COLLEGE HOSPITAL NEONATAL 48 38 10 18 43 42 41 36 29 26 30 25 461 16 RMH (TANJORE) NEONATAL 48 51 49 47 51 52 61 51 45 40 41 59 54 732 17 PARAMAGUDI GH NEONATAL 31 36 39 41 35 36 31 30 20 24 17 12 30 424 18 SALEM GH NEONATAL 53 41 25 56 52 52 52 52 50 40 43 51 52 675 19 THUCKLAY GH NEONATAL 23 21 23 8 22 29 29 14 21 10 17 23 31 313 20 TRICHY MCH NEONATAL 18 19 35 37 46 25 30 26 15 38 30 41 56 428 21 VILLUPURAM MCH NEONATAL 16 9 42 47 63 45 63 43 34 10 5 17 421 22 THIRUVARUR MCH-NEONATAL 14 17 25 30 29 38 32 38 34 40 41 338 23 PERAMBALUR GH NEONATAL 3 9 21 31 50 21 36 22 20 19 18 250 24 DINDIGUL GH- NEONATAL 11 19 41 37 35 46 37 52 26 28 26 358 25 THENI MCH NEONATAL 22 29 42 50 39 46 41 27 38 52 386 26 THIRUVALLUR GH NEONATAL 31 48 61 59 70 48 63 31 25 29 465 27 NAMAKKAL GH NEONATAL 2 11 15 15 16 21 20 28 25 33 186 28 KARUR GH NEONATAL 11 19 14 19 32 33 21 9 10 13 181 29 VIRUDHACHALAM GH NEONATAL 3 14 12 14 16 23 26 21 20 37 186 30 COIMBATORE MCH NEONATAL 17 44 40 46 44 41 26 33 45 34 370 31 KALLAKURICHI GH NEONATAL 8 12 17 13 19 21 13 13 24 19 159 32 OOTY GH NEONATAL 16 24 9 18 16 9 16 22 25 20 175 33 SIVAGANGAI MCH NEONATAL 12 19 26 32 30 27 21 17 21 19 224 34 TIRUPUR GH NEONATAL 10 46 56 42 48 44 38 35 38 35 392 35 ERODE GH NEONATAL 3 16 22 33 39 24 21 30 30 34 252 36 ARIYALUR GH NEONATAL 15 18 19 16 15 14 21 21 38 177 37 NAGAPATTINAM GH NEONATAL 9 11 4 6 18 15 18 23 7 111 TOTAL 626 629 632 827 1350 1113 1429 1420 1413 1152 1096 1335 1323 17583 Page 34 of 35

Annexure N: Issues to be sorted out

• Suggested police out-post at Govt. Hospitals for admitting unaccompanied patients.

• Speedy admission for all cases at Govt. hospitals

• Co-ordination meeting with DDHS/JDHS/DPMU co-ordinators at the district level to improve Home to PHC/GH utilisation

Legend:

NA – Not Applicable

*- Ineffective Calls – Calls falling under the category of No Response call , Wrong call , Nuisance, Disconnected call , Missed call , General Enquiry call, and Silent Call are classified as Ineffective calls. These calls land in the call center and when attended by the Communication Officer it would either be a nuisance call or disconnected call or any one of the category as mentioned above.

** - Ambulance Busy – Whenever all the ambulances closer to the area have been assigned for an emergency case, and a new emergency case comes in the same area, the Dispatch Officer will enquire with the caller, if he/she can assign a ambulance from the nearby location. The Dispatch Officer will also tell them about the distance the ambulance has to travel and the approximate time it will take to reach the incident location. If the caller is not willing to wait till the specified time, then the Dispatch officer will close this case as “Ambulance Busy” after confirming with the caller.

*** - Life Saved count is an update that is received on a daily basis after verification of PCR and confirmation after 48 hour follow-up, there will be a change in the numbers reported as they keep on adding to the earlier reported life save count, based on the date the case was handled by the team.

Place: Chennai – Tamil Nadu P. Vijayakumar State Head - Operations

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