STEMI-India planning quick reaction network of hospitals, ambulance service

A recently formed national body of interventional cardiologists will look at forming a quick reaction network of hospitals and ambulance service providers in Tamil Nadu to save persons who have suffered a heart attack. The effort is to enable quick shifting of patients to hospitals for life-saving treatment.

ST (a segment) elevation in myocardial infarction (STEMI) or heart attack is one of the leading causes of death in the world, says Chief Cardiologist at Kovai Medical Center and Hospital (KMCH) Thomas Alexander, one of the heart specialists pushing hard for the project.

STEMI-India, the new national-level body, may contemplate national-level models after the one in the State becomes fully functional.

Dr. Alexander says the announcement of the Statewide initiative may be made after Kovai Lumen, a two-day workshop here on March 12 and 13. Lumen is the world's premier STEMI meeting held annually at Miami in the U.S.

KMCH and Lumen had teamed up to hold the first workshop here last year. Dr. Alexander is the Course Director of the event this year also. The programme will carry out a comprehensive review and training of medical teams in the management of heart attack patients. Everyone — right from the paramedics in the ambulance to the specialist doctor and also the catheterisation laboratory technicians — will be trained.

“We carried out a pilot project in Erode and identified problems such as the lack of catheterisation laboratories in rural areas. Now the focus is on developing linkage, as it is a difficult task,” says Dr. Alexander.

The plan now is to have a hub and spokes model wherein the State will be divided into many regions and each region will have a major heart care centre linked to smaller hospitals or sub-centres.

If the patients are not close to the main centre, they will be taken to the nearest sub-centre for basic measures such as providing drugs to dilute the clot in the blood vessel in the heart. They can then be shifted to the main centre where advanced investigations and procedures such as angioplasty will be done.

“For this, we need ambulances to shift patients first to the sub-centres and from there to the main centre,” explains Dr. Alexander. Moves are afoot to involve Emergency Management and Research Institute (EMRI) ambulances. “EMRI does not make hospital to hospital transfer of patients at present. We are trying to work that out because that will be crucial in our programme.”

Dr. Alexander says the programme is being planned in co-ordination with Star Health Insurance and Reliance.

“First, we want to link all hospitals that are covered under the insurance programme of Star. Reliance is willing to supply at subsidised rates the latest drugs to dissolve the clot in the blood vessel in the heart. We are trying to rope in other pharmaceutical companies also.”

The Tamil Nadu model will lay down clear guidelines to save time and cost for the patients. Star will specify the protocols for myocardial infarction management. Dr. Alexander says the contribution of the pharmaceutical firms will be significant because there is no insurance coverage for the initial, vital dose of drugs to dissolve the clot.

The Indian Council of Medical Research, which has a national registry of cases, has evinced interest in partnering in the Tamil Nadu programme, says Dr. Alexander.