The 5 Road Safety Rules The Supreme Court Wanted—And Why Most States Ignored Them

Every year, nearly 1.77 lakh people lose their lives on India's roads. While preventing accidents remains the long-term goal, ensuring victims receive timely medical care after a crash can significantly improve their chances of survival.

Recognising this, the Supreme Court directed states to build a uniform trauma-care system, identifying five key measures that could strengthen emergency response during the critical "Golden Hour" after an accident. However, data submitted by states and Union Territories shows that not a single state has fully implemented the framework. Here's a look at what the court wanted, why these measures matter, and how states have performed.

What Are The Supreme Court's Five Road Safety Measures?

The Supreme Court, in its May 26 order, directed states to implement nine road safety measures, with five forming the core of a nationwide trauma-care framework. These are: a unified emergency phone number, GPS-equipped ambulances, a Good Samaritan law, a trauma registry, and a standard rescue protocol.

The directions came in response to a petition by SaveLIFE Foundation, which argued for a uniform trauma-care system across India. Together, these five measures are designed to improve emergency response during the "Golden Hour" — the crucial first hour after a road crash when timely medical intervention can mean the difference between life and death.

However, data submitted by states and Union Territories over the past nine months shows that not a single state has fully implemented all five measures. According to the submissions, seven of the eight states accounting for nearly two-thirds of India's road accident deaths have still not integrated all emergency services under the national 112 system. Only eight states have a grievance redressal system for Good Samaritans, 17 have a rescue protocol, 22 lack a trauma registry, and 13 states either do not have GPS-enabled ambulances or have GPS only in some government ambulances.

Why The First 60 Minutes After A Crash Matter

The first 60 minutes after a road crash, known as the "Golden Hour", are considered the most critical period for saving lives. During this period, rapid assessment and immediate life-saving treatments prevent excessive blood loss, stabilise vital organs, and reduce the risk of irreversible long-term damage. 

The Supreme Court's five key road safety measures were intended to ensure that accident victims receive quick medical attention during this window.

The urgency is reflected in a 2021 NITI Aayog-AIIMS Emergency and Injury Care Report, which found that at least 30% of all trauma-related deaths in India are attributable to delays in emergency care.

Despite this, states continue to lag in building the emergency-response infrastructure needed to reduce these preventable deaths.

Why Most States Still Don't Have A Unified Emergency System

One of the Supreme Court's key directions was the integration of all emergency helplines under the nationwide 112 Emergency Response Support System (ERSS), launched by the Union Home Ministry in 2019. The idea was to eliminate confusion by replacing multiple emergency numbers for police, fire, ambulance, highways and women with a single number.

However, court submissions reveal that seven of the eight states with the highest road fatalities have yet to complete this integration. Karnataka did not provide information.

The problem extends beyond phone numbers. Although these states claimed their ambulances are GPS-enabled, their submissions did not cover private ambulances. Six states acknowledged that while they have ambulance-tracking dashboards, these are not publicly accessible, making it difficult for families to verify whether the nearest ambulance was dispatched.

Further, seven of the eight high-fatality states do not integrate real-time ambulance tracking with the 112 system, making it difficult to monitor response times accurately.

Among the better performers, Uttar Pradesh said it has integrated most emergency numbers, with only the 102 medical helpline remaining. Andhra Pradesh said it continues to operate its long-standing 108 emergency service launched in 2005, before the rollout of 112.

What Is A Trauma Registry And Why Does It Save Lives?

A trauma registry is a clinical database that tracks an accident victim's journey from the crash site through ambulance transport, hospital treatment and discharge. It helps hospitals audit patient care, monitor treatment outcomes and improve policymaking.

Yet, five of the eight states with the highest road fatalities still do not have a trauma registry and continue relying on manual records or fragmented hospital databases.

Tamil Nadu, Maharashtra and Madhya Pradesh reported having trauma registries. Tamil Nadu's system is among the most comprehensive, recording pre-hospital ambulance details, hospital admission, resuscitation and patient outcomes in real time.

Uttar Pradesh said trauma data is currently maintained only at the hospital level through information systems and manual records, while a statewide registry is still under consideration. Karnataka said it will establish a trauma registry after the Centre finalises its policy. Rajasthan said its standard operating procedure for a trauma registry is under preparation, while Bihar said trauma cases are recorded within accident and emergency records but not through a dedicated registry.

How Good Samaritan Laws Protect People Who Help Accident Victims

Fear of police questioning and hospital harassment remains one of the biggest reasons why bystanders hesitate to help victims of road accidents.

To address this, the Supreme Court recognised the rights of Good Samaritans in 2016. The Ministry of Road Transport and Highways later notified the Good Samaritan Rules in 2020 under Section 134A of the Motor Vehicles (Amendment) Act, 2019. The rules protect people who assist accident victims and provide a reward of Rs 25,000 to those who help ensure victims receive medical care within the Golden Hour.

However, implementation remains weak. Of the eight states responsible for nearly two-thirds of India's road deaths, only Maharashtra and Karnataka have a dedicated grievance redressal system for Good Samaritans. Four states do not have one, while two did not provide information to the Supreme Court.

Across all states and Union Territories, only eight have established such grievance mechanisms.

Which States Have Performed Better?

No state has fully complied with the Supreme Court's roadmap, but some have made greater progress than others.

Tamil Nadu has one of the most detailed rescue protocols, including scene safety procedures, triage based on the Canadian Triage and Acuity Scale (CTAS), and advanced hospital notifications through a mobile application. It also operates a real-time trauma registry.

Maharashtra has a Good Samaritan grievance mechanism, although GPS tracking currently covers only its 108 emergency ambulances.

Uttar Pradesh has integrated most emergency numbers into 112 and has a standard operating procedure for rescuing crash victims, but it has yet to establish a statewide trauma registry and lacks a dedicated Good Samaritan grievance system.

Madhya Pradesh has developed a comprehensive trauma care policy covering the roles of police, health authorities and road agencies, though its Good Samaritan grievance system remains under process.

Karnataka has a Good Samaritan grievance mechanism, but does not yet have a trauma registry or a rescue protocol. Rajasthan is developing a trauma registry SOP, Bihar records trauma cases without a dedicated registry, while Andhra Pradesh continues to rely primarily on its legacy 108 emergency response system.