ICMR-AIIMS emergency mobile service initiative sees expansion

New Delhi: People living within a 5-km radius of the AIIMS can now avail an emergency mobile medical service in case of anyone suffering heart attack or chest pain with the authorities expanding the initiative''s reach, officials said.

The facility, a joint initiative of the All India Institute of Medical Sciences (AIIMS) and the Indian Council of Medical Research (ICMR), was launched in April and was earlier available within an radius of 3 km.

Under ''Mission DELHI'' (Delhi Emergency Life Heart-Attack Initiative), a pair of motorcycle-borne trained paramedic nurses are the first responders for treating heart attack patients.

The initiative has so far received 44 cases.

"The project has now been extended to 78 sq km around AIIMS, New Delhi and will now cater to a population of 20-25 lakhs in the national capital," Dr Chandni Suvarna, a scientist at AIIMS, said.

On receiving a call at Mission Delhi''s toll-free emergency helpline numbers (1800111044 and 14430), the mobile medical nurse team is dispatched immediately for examining the patient, providing necessary medication/CPR, transmitting ECG to consultant at AIIMS.

While the emergency treatment is being provided, a CATS ambulance will arrive and take the patient for further treatment.

Even as the patient is on way to the hospital, doctors at AIIMS control centre will evaluate the data received from the nurses to establish further course of treatment.

The ICMR has signed a memorandum with CATS (Centralized Ambulance Trauma Services) for this project.

"With bike-ambulances and trained nurses, Mission Delhi focuses on the importance of reaching with the medical help much faster, timely response and doorstep care saving the heart in time, given the high-density traffic conditions in the city where the movement of four-wheeler ambulances becomes difficult," Suvarna said.

An ST-segment elevation myocardial infarction (STEMI) heart attack is an acute, high risk, time-sensitive life-threatening disease. The management of STEMI heart attack patient requires treatment to be started within the golden hour (90 minutes) of the onset of symptoms and providing clot buster therapy to patient within 30 minutes of reaching the hospital.

Delays in reaching hospital and initiation of clot-buster therapy are the major causes of deaths in STEMI heart attack patients.

According to AIIMS Director Randeep Guleria, the idea has been tried in remote areas of the country but not specifically for reaching those with heart trouble. Guleria earlier said the attempt is to reach patients within 10 minutes.

The 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 (coronary arteries). If any of these pipes are clogged by clot, the tissues in that part of the heart die.

It is important to remove the clot that is stopping the blood flow. If the heart walls are damaged, they cannot be repaired. Clot busters are almost equal to angioplasty.

The average age of the occurrence of cardiac arrest in the Indian population is 53 to 55 years, about 10 years less than in the United States and Europe where it is 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 prevalence in the world is in India, Bangladesh and Pakistan. Young heart patients that doctors see mostly have problems associated with tobacco use.