City ambulances lack equipment

BANGALORE, DEC. 6. The death of popular footballer Cristiano Delima Junior has raised questions about the efficiency of emergency medical facilities in Bangalore.

Cristiano collapsed while playing in the Federation Cup final in the city on Sunday.

The city has several ambulance services, but many of them are not adequately equipped to deal with emergencies such as cardiac arrest or lack of oxygen flow to the lungs.

Cristiano's team and a section of the medical fraternity believe that he could have been saved if immediate medical attention had been provided.

According to cardiologists, 50 per cent of deaths caused by such emergency conditions can be prevented before the patient reaches the hospital.

Many institutions

There are 45 institutions, including hospitals, private organisations and non-governmental organisations (NGOs), which provide ambulance services. However, many of them are not geared to deal with emergencies and can only take patients to hospitals.

"An ambulance should ideally be equipped with a monitor to see the heart beat, a defibrillator (a machine that is used to give small electric shocks to revive the functioning of the heart), an echocardiogram, oxygen supply to deal with cardiac arrest and intra-venous fluids and blood substitutes (in case of loss of blood)," Kiron Varghese, interventional cardiologist at St. John's Medical College Hospital, said.

"Unfortunately in India, unlike in the West, not all ambulance services have these equipment as they are expensive. If the person has received a blow on the chest, as might have happened in Cristiano's case, causing the heart to stop functioning, medical attention has to be given within five minutes. If not, there will be lack of oxygen supply to the brain, which may cause death. A defibrillator can save a person's life in such times," Dr. Varghese said.

He added that paramedical staff should be present so that the patient could be given a "cardiac massage."


According to N.K. Venkataramana, director of Manipal Institute of Neurological Disorders and project director of Comprehensive Trauma Consortium (CTC), all major events should have medical support for emergencies. "There is a need for preparedness, and it is essential that during such events, ambulances are close by. They should have a defibrillator and spinal board. The patient should always be taken to the nearest hospital," Dr. Venkataramana said.

The CTC, which launched Operation Sanjeevani to deal with medical emergencies a few years ago, has saved the lives of 780 persons, most of them accident victims.

It has a network of 25 hospitals, which have well-equipped ambulances.

`Transport vehicles'

S.S. Ramesh, chief cardiologist and managing director of Bhagawan Mahaveer Jain Heart Centre, said most ambulances were perceived as vehicles to take patients to hospitals and they did not have life-saving equipment. "Some sportspersons develop thickening of heart muscles, which can lead to irregularity of heart beat if there is a blow. Even laypersons, especially those connected with sportspersons, should be trained to give mouth-to-mouth resuscitation and cardiac compression," he said.

Moreover, most of the time, ambulances are not able to reach their destinations on time owing to heavy traffic.

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