A vital project to recognise and facilitate early treatment of heart attacks in semi-urban and rural areas has been stuck at the level of identifying a nodal agency to run the project.
Officials said although the Centre has released ₹2.2 crore under National Health Mission (NHM) for the project, there has been a delay in the tender process for identifying the nodal agency.
To avoid delay in providing diagnosis and treatment to heart attack patients in rural areas, the State-run Sri Jayadeva Institute of Cardiovascular Sciences had conceptualised a heart attack (ST-Elevation Myocardial Infarction-STEMI) management project at the taluk level.
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To be taken up under NHM-coordinated Non-Communicable Diseases (NCD) programme, STEMI India project was designed to be initiated in 40 identified taluks of three Jayadeva divisions - Bengaluru, Mysuru, and Kalaburgi, which will be the hub hospitals.
Institute director C.N. Manjunath told The Hindu on Tuesday that under the project, doctors in taluk hospitals and primary health centres, who are the first point of contact for patients in rural areas, will be trained to diagnose heart attack cases at the earliest and start initial treatment within the golden hour. “The project will run on a hub and spoke model,” he said.
Nearly 25% of deaths in India are due to cardiovascular diseases, the most common of which are heart attacks. The project is all the more important now due to the marginal increase in the incidence of heart attacks post COVID, he said.
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Time-dependent
“As heart attack treatment is time-dependent, the main objective is to diagnose at the earliest and initiate treatment. For every 30 minutes delay in initiating treatment for heart attack, the death rate is likely to increase by 7%. This project will significantly reduce mortality rate,” Dr. Manjunath said.
Under the project, the nodal agency should provide each taluk (spoke) hospital with a heart attack management kit that includes an ECG machine, defibrillator, pulse oximeter, and a mobile phone.
“The ECG should be immediately transferred to the divisional Jayadeva hospital for a confirmed diagnosis through the cloud system. This will also alert the hospital about the patient’s visit. If the designated taluk hospital is within 30-40 km of the divisional hub (Jayadeva) hospital, the patient will be transferred directly to the hospital in a 108 ambulance,” he said.
“In distant taluks, where travel time takes over an hour, the patient will be provided thrombolytic therapy for dissolving clots. This will help the patient buy 24-hours’ time. Meanwhile, after a few hours, the patient will be transferred to the hub hospital for angioplasty. Otherwise, during a heart attack, angioplasty should be performed within the first six hours,” the doctor explained.
The nodal agency will have to monitor all these activities, analyse the data of patients transferred, and study the impact of this programme.
Tenders called twice
Arundathi Chandrashekar, State NHM Mission director, said although tenders for the project had been called twice, the response was not good. “We did not get eligible bidders,” she said.
Pointing out that a similar project has been taken up in Tamil Nadu and Chhattisgarh, the official said: “We are now studying the implementation of the project in those States. In the next one week, we will take a call on whether to re-tender or entrust the project to the agency that is running a similar project in those States with 4(g) exemption under the Karnataka Transparency in Public Procurements Act.”