New Delhi, February 05: Like ordering for food or groceries
over phone, you may soon be able call for a motorbike-borne emergency
medical assistance unit in the eventuality of a heart attack.  The Indian Council of Medical Research
(ICMR) is all set to launch a pilot project named Mission DELHI or Delhi
Emergency Life Heart Attack Initiative.

By Dr T V Venkateswaran and Jyoti Singh

(India Science Wire)

Under this project, a pair of motorcycle-borne paramedics
would be the first responders for treating heart attack patients.
On getting a call, the pair would rush to the spot, conduct a quick medical
examination, take the ECG of the patient, gather basic information on his or
her medical history and establish a virtual connect to a cardiologist at the
All India Institute of Medical Sciences (AIIMS).

CATS ambulance : idea is to reach with medical help much faster

While the emergency treatment is provided, a CATS ambulance
will arrive and take the patient for further treatment. Even as the patient is
on the way to the hospital, qualified doctors posted round the clock at the
control center will evaluate the data received from the paramedics to find out
what type of treatment will be required so that it can be started soon after
the patient reaches the hospital. ICMR has already signed a memorandum of
understanding with CATS for this project.

The idea is to reach with medical help much faster, given the
high density traffic condition in the city where movement of ambulance becomes
difficult. Motorcycle ambulances can reach people in narrow lanes in congested
areas as well. The idea has been tried in some remote areas in the country but
not specifically for reaching those with heart trouble.   

“It is a pilot study that we will cover a distance of around
three kilometers from AIIMS and be linked with the Centralized Ambulance Trauma
Service (CATS). The idea is to reach the site under ten minutes so that the
patient gets immediate help,” Dr Balram Bhargava, ICMR Director General,
elaborated in an interview with India Science Wire and Eureka
telecast on Rajya Sabha Television.

The range of emergency therapies that will be available
under the project would include clot buster medication. “Clot busters are
almost equal to angioplasty. Clot buster medication is low-cost treatment
whereas angioplasty is expensive. Clot busters can be given within a short time
after a heart attack,” said Dr Bhargava.

Explaining further, he said, “heart is like a room that pumps blood to the entire body. Before the blood is pumped to the body, it is pumped to the walls of the heart through three pipes. If any of these pipes are clogged the tissues in that part of the heart dies. It is important to remove the clot that is stopping the blood flow. If the heart walls are damaged they cannot be repaired”.

The programme, he said, assumes importance particularly since
the average age of the occurrence of cardiac arrest in Indian population is 53 to
55 years which is about ten years earlier than in US and Europe where it is about
63 or 64. Genetic predisposition is an important cause for this. But, the high
rates of smoking and chewing tobacco in India also contribute in a large way.
Ninety per cent of chewing tobacco incidence in the world is in India,
Bangladesh and Pakistan. “The young heart patients we see mostly have problems associated
with tobacco use,” he said.

Dr Bhargava is also passionate about developing affordable,
low-cost and need-driven medical facilities and devices. As a step in this
direction, he has established a School of International Biodesign in
collaboration with AIIMS, IIT-Delhi and Stanford University (USA) at Delhi. The
programme is called GANDHI (Global Affordable Need Driven Healthcare
Innovation).

Under the program, some very basic, low-cost and need driven medical devices have been developed. Consure is one such device. It is used for managing stools in incontinence patients. “For urine there is catheter but for stools there is nothing available in the world except diapers. Consure is a self-expandable device made out of Nithinol and can be put in the back passage of the patient by either the family member or the caregiver. It expands inside and collects the stool in a bag”. The device was conceived, developed and tested in AIIMS. It is now approved by US Food and Drug Authority and manufactured under Start-up Consure International. It is marketed in 60 hospitals in the USA and 60 hospitals in India.

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