Acute heart attacks are challenging clinical conditions, but if treated promptly the results are gratifying, say cardiologists.
Four tertiary care hospitals in the State have joined hands to develop a care model for patients who suffer from acute heart attacks. The model relies on modern technology to provide care in ambulances, while a patient is being shifted to the hospital.
Acute heart attacks are challenging clinical conditions, but if treated promptly the results are gratifying, say cardiologists. Studies have shown that even in urban areas in India, on an average a person reaches a hospital six hours after suffering a heart attack. However, standardised care by trained paramedical staff while transporting the patient in an ambulance could prevent serious damage to heart muscles, doctors say.
At present, even in the best ambulance services, paramedics are trained only to monitor vital systems. There is no participation from a specialist. STEMI (ST Elevation Myocardial Infarction), a non-profit organisation, has evolved a model which uses a hand-held ECG monitoring device with the facility to transmit data to a cardiologist, who will manage the patient.
In an experiment in Erode with a multispecialty hospital as the hub and smaller hospitals as the spokes, around 100 heart attack patients from neighbouring towns and villages were transported to the hub and cardiologists monitored the patients. The study proved that patients could reach a hospital in less than three hours with 75 per cent of them using an ambulance.
The study is in the process of being expanded with four large hospitals as hubs. STEMI has tied up with CMC, Vellore; Kovai Medical Centre, Coimbatore and Chennai-based Madras Medical Mission and Madras Medical College to which the Rajiv Gandhi Government General Hospital is attached, to conduct a pilot study.
“We are in the process of finalising all parts of this project. It is linked to the Chief Minister’s comprehensive health insurance scheme and so is affordable for everybody. The second component is making it inclusive. MMC, a government institution, is one of the clusters,” Thomas Alexander, consultant cardiologist with Kovai Medical Centre told me.
“The third component is the technology. STEMI’s hand-held device doubles up as an ECG machine, monitors data entry and is a transmission tool. The fourth component is the transportation, We are working to make GVK EMRI 108 a part of the system,” he added. The project, costing Rs. 50 lakh, is being funded by the Indian Council of Medical Research.
Keywords: heart attacks, heart treatment, STEMI
I worked in the cardiology department of ulster hospital, Belfast, Northern Ireland in 2001-02.Northern Ireland had a very high incidence of coronary disease.We had a hotline in the coronary care unit and the 999 calls with a suggestion of cardiac arrest or severe chest pains were directed to that number and if the doctor after talking to the patient/family member thought it sounded strongly cardiac then we(the doctor and a experienced ccu nurse)were rushed to the patient by a cardiac ambulance and the patient was given the thrombolysis(when indicated)at home itself thereby saving the heart muscle from damage swiftly.The patient was brought to the coronary care unit after that.
That sort of management can be trialled here with good coordination and support between doctors in the ccu of different hospitals(nearest ones) and paramedics.The current initiative deserves warm appreciation. Dr mohan venkataraman
Consultant,Internal medicine&pulmonology, Billroth Hospital
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