SC issues interim directions for robust uniform trauma care framework

New Delhi: Observing that the right to trauma care of citizens is an integral part of the right to life enshrined under Article 21 of the Constitution of India, the Supreme Court recently issued interim directions to operationalise and implement a uniform and robust trauma response system across the country.

These directions include the operationalisation of one common helpline number '112', setting up the Good Samaritan Grievance Redressal Systems, issuance of a medical rescue protocol, Automotive Industry Standard compliance, implementation of NCAHP-notified EMT curriculum, issuance of guidelines prescribing the requisite data format for a Trauma Registry, grading and designation of all medical facilities, implementation of the PM RAHAT scheme, etc.

A Supreme Court bench comprising Justices JK Maheshwari and Atul S. Chandurkar passed the judgment in a plea filed under Article 32 by SaveLife Foundation, seeking to improve road safety and provide emergency medical care to the victims of road accidents, which is also known as 'trauma care'.

In its plea, the organisation relied on various reports and empirical data to effectively urge that in the case of traumatic events suffered in road accidents and otherwise, a major cause of fatalities is the lack of access to quick emergency/trauma care. With a staggering increase in the number of accidents in recent years, and as a corollary, the number of injuries suffered and number of unfortunate deaths, this requirement for a robust system for urgent trauma care is only becoming more pertinent by the day, the organisation submitted.

Observations by the Supreme Court: 

While considering the plea, the top court bench noted that 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.

"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," it noted.

"It is indeed true that there are different stages of care after such an incident: the initial response and first aid being perhaps the most crucial, the transportation of the victim to the nearest available healthcare facility and the post-hospitalization immediate care by the health workers. A robust mechanism for trauma care, therefore, must take a bottom-up approach, which accounts for various stakeholders. 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. Usually, however, no matter how strong the urge to be a Good Samaritan is, the bystander hesitates: suffers a reactive paralysis, sometimes due to fear of legal proceedings, of getting summoned to the police station as a witness; and sometimes due to the psychological weight of the situation itself, the sight of blood or a person crying out in pain. To address these barriers, what is required is a systemic intervention, creation of a uniform framework for trauma care, building public awareness, standardization of first aid skills and proper Good Samaritan laws; since right to trauma care of citizens is an integral part of right to life enshrined under Article 21 of the Constitution of India," observed the bench.

The court observed that the Supreme Court in the case of Savelife Foundation v. Union of India, had recognized the need for Good Samaritan laws in India and had given credence to the guidelines of the Ministry of Road Transport and Highways to protect Good Samaritans. These guidelines were subsequently ratified through the legislative channel, being incorporated as Section 134A of the Motor Vehicles Act, 1988 after its 2019 Amendment.

In this regard, the court further noted that a "quick response in the form of transportation, equipped with trained paramedics, as well as a healthcare facility which is well equipped to deal with urgent care, are subsequent steps which are necessary to realize proper trauma care."

On 01.08.2025, the Court had requested the learned Attorney General of India to scrutinise the stands of different State Governments and Union Territories and submit a report as to what steps can be taken in the facts and looking to the prayer as made in the Writ Petition. Meanwhile, the petitioners also made certain suggestions which were considered by the Union and other stakeholders.

The learned Attorney General submitted before the Court that the role of the Union is to act as the enabler and lay down a framework at the national level which it has done by bringing about several policies / schemes / rules, including but not limited to PM RAHAT cashless treatment scheme, Rah-Veer Scheme, the Good Samaritan Rules, National Ambulance Code, NELS Curriculum, ERSS-112 and the MoHFW trauma guidelines, but ultimately, implementation of the overarching framework is at the hands of the different States / UTs. He further stated that implementation of these policies as well as various advisories, however, is scanty and fragmented across different States / UTs. He therefore suggested that this Court should issue directions to the States / UTs to bring about effective implementation of the different schemes and policies floated by the Union of India and seek time-bound compliance reporting from them.

During the proceedings, the Court perused the affidavit dated 12.05.2026 filed by the Union of India, in which, the response of 34 State Governments and UTs were compiled. 

Taking note of the same, the bench observed,"From the responses of the States and UTs, there appears to be willingness to progressively implement the schemes and policies of the Union and bring about uniformity in respect of trauma care, yet implementation is fragmented and its status differs from one place to another. A uniform and robust system of trauma care, steps towards its progressive realization and increasing public awareness are well-intentioned and may turn out to be absolutely critical in reducing preventable deaths. 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." 

Court's Directions: 

Accordingly, after considering the suggestions of the petitioner organisation, the Union and the affidavits filed by 34 State Governments and UTs, the top court bench issued the following interim directions:

a) All States / UTs shall complete full technical and operational integration of all emergency / ambulance helplines (100, 101, 108, 102, 1033, 1091, etc.) into helpline 112 within a period of three months and undertake concurrent mass-media publicity of helpline 112, and report compliance;

b) All States / UTs shall establish functional (physical and digital) Good Samaritan Grievance Redressal Systems, with designated nodal authorities at State and District level, within three months, and furnish periodic compliance reports by organizing monthly meetings and uploading the minutes on the concerned portals;

c) The Union of India (Ministry of Health and Family Welfare/Ministry of Road Transport and Highways) is permitted to issue a medical rescue protocol for trauma cases in a period of three months and all States / UTs are directed to operationalize the same at State / UT level upon its issue within three months thereof;

d) All States / UTs shall ensure full Automative Industry Standard - 125 (AIS-125) compliance across all registered ambulances (public and private); mandate Global Positioning System (GPS) / Vehicle Location Tracking Device (VLTD) fitment and real-time integration with helpline 112; and conduct periodic structured audits (response times, quality of care, equipment, outcomes) with compliance reporting to a designated Union-level authority, within a period of three months;

e) In respect of Prayer E, as the curriculum already stands notified by the National Commission for Allied and Healthcare Professionals (NCAHP), all States / UTs shall adopt and implement the NCAHP-notified EMT curriculum, and to align their training institutions and personnel certified, within a period of three months;

f) The Union of India (Ministry of Health and Family Welfare) shall issue guidelines prescribing the requisite data format for a Trauma Registry within eight weeks and all States / UTs are directed to establish State Trauma Registries in conformity, covering all medical facilities and linking the same to a Coordinated Trauma Registry within a period of four months;

g) All States / UTs shall undertake grading and designation of all medical facilities (public and private) in accordance with the said Ministry of Health and Family Welfare guidelines, with geographic scope extended beyond National Highways to State Highways, Major District Roads and Urban / Peri-Urban areas, within a period of three months and report compliance;

h) In respect of Prayer I, as the Union of India has already framed a uniform national scheme answering this prayer, i.e., the PM RAHAT scheme, all States / UTs (Respondent Nos. 2 to 37) shall take steps to fully operationalize PM RAHAT scheme within eight weeks – designation of hospitals, on-boarding of State Health Agency (SHA) on Transaction Management System (TMS), district-police deployment on electronic Detailed Accident Report (eDAR), opening of DC sub-agency accounts within a period of three months. It is clarified that non-implementation of the above would amount to a violation of the MV Act;

i) The Union and States / UTs shall undertake sustained, structured, multi-lingual mass-media campaigns covering helpline 112, the Good Samaritan protections under Section 134A of Motor Vehicles Act, 1988 and the grievance redressal system, and the cashless treatment scheme (PM RAHAT) with defined obligations and compliance reporting within a period of one month.

"In addition to the above, all States and UTs that have not yet adopted the Cashless Treatment of Road Accident Victims Scheme, 2025 – PM RAHAT, shall take necessary steps to fully operationalize the said schemes within a period of three months in terms of direction (h) above," the Court ordered.

To ensure the compliance of the aforesaid directions, the bench ordered to send a copy of the order to the Chief Secretaries of all the States/UTs to issue general directions in their respective States/UTs.

"The Action taken report and the ground realities indicating inaction or good practices if any, adopted by them shall also be reported within the time as specified to the Registry of this Court which shall be placed for consideration," it mentioned.

The bench has listed the matter after four months for issuance of further directions based on such reports. Further, it directed the Attorney General that after receiving the reports, to inform the Court of the structured recourse suggesting the way out for the efficient and effective implementation of trauma care so that "the public cause as espoused may be ventilated in right earnest."

To view the order, click on the link below:

https://medicaldialogues.in/pdf_upload/2026/05/29/supreme-court-trauma-care-350694.pdf

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