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Hello shnmukesh

I couldn't agree with you more that we need some kind of a system to ensure proper patient care.

What I was alluding to earlier was regarding the 'semantics'. A guideline is defined as a statement or other indication of policy or procedure by which to determine a course of action. In contrast, a protocol is a precise and detailed plan for the study of a biomedical problem or for a regimen or therapy.

The effectiveness of a protocol hence would depend on the quality of evidence that it is based on. It also is dependant on the compliance by clinician or health provider. Guideline on the other hand, as understandable guides you as to what you should do in a given situation. It is not rigorous and does not certainly require you to abide by it. In other words, you could still use your clinical judgement based on the guidance.

Even in the 'west', I am sure, they do not have protocols for most conditions. But depending on the local set-up each organisation/institute may choose to develope their 'own' protocol.

Coming back to your example of STEMI, you could certainly use a protocol from any other hospital/ centre provided their service provision facilities and yours match well. Say, if they use PCIs as part of their protocol and your nearest PCI facility is 30 mins away, it may not work quite that well (Just an example... you may well have state of the art Angio suite!!!).

All said, one should certainly strive to put in the energy to create more protocols and improve health care provision. I am sure it would be well worth the effort.