Healthcare Delivery

How you can save the life of a patient in cardiac arrest

By 2030 India alone will account for 60 percent of the world’s cardiac patients, nearly four times its share of the world’s population. The major reason for these alarming statistics is lack of awareness towards ‘healthy’ lifestyle and the lack of knowledge of few simple steps that can be taken during emergency or before reaching the hospital.

Out of the people who die from heart attack, about 50 percent die within an hour of their initial symptoms before they reach the hospital. The chances of survival of the victim can increase significantly if S/h is provided Cardiopulmonary resuscitation (CPR) immediately. Hence, people present at the scene can help avert the risk of death by proving CPR promptly to the victim.

As we observe World Heart Day, doctors from Columbia Asia Referral Hospital, Yeshwanthpur (CARHY) are educating people to take charge and be aware of Basic Life Support (BLS) and Cardiopulmonary resuscitation (CPR) techniques that can successfully improve the quality of life of the victim.

“Providing BLS and CPR during the golden hour can help in preventing pre-hospital deaths from injuries as well as heart attack if there is a delay in receiving hospital treatment or medical care. Mostly, the steps we take in haste while attending to an emergency, makes a deep-rooted impact in saving the life of the patient. Thus, it is vital for all to learn the BLS and CPR techniques, so that we can take the right measures when required,” said Dr. Firozahmad H. Torgal, Consultant Emergency Medicine, Columbia Asia Referral Hospital, Yeshwanthpur.

“These are simple steps like early recognition and initiating chest compression in cardiac arrest or protecting cervical spine with c-collar in road traffic accident victims and for this you don’t need to be an expert in medicine to take these lifesaving steps. Therefore, CPR and BLS should be made mandatory in secondary level of education and to all public service job holders as the chances of survival of the victim increase double fold if appropriate emergency medical care is provided immediately,” added Dr. Firozahmad H. Torgal.

Time is the essence while treating a heart attack and cardiac arrest victims. “When the heart stops beating, blood flow to the body organs ceases. Of all the organs, brain is affected first. People become unconscious within 15 -20 seconds after the heart stops and chances of brain recovery decreases with time so much so that irreversible brain damage is common if circulation is not restored within 5 minutes of cardiac arrest,” explained Dr. Prabhakar Shetty Heggunje, Chief of Cardiology, Columbia Asia Referral Hospital, Yeshwanthpur.

“The need of the hour is to train common people to do CPR and BLS before the victim reaches the hospital. This training will help them to learn special skills required to deal with heart related emergencies. Skills to perform CPR through chest compressions, maintaining victims breathing by providing appropriate rescue breaths, can greatly improve the chances of survival of these unfortunate people,” he added.

You too can save a life. And for this you don’t need a medical degree. Below mentioned are two cases that amplify the message from the emergency team of doctors from Columbia Asia Referral Hospital, Yeshwanthpur. 

Case: 1 

At around 10:00 am emergency team of Columbia Asia Hospital got a call for ambulance, from a nearby place stating that a 44-year-old man has collapsed and requires urgent medical attention. Doctors from Columbia Asia confirmed if the wife of the victim knew Basic Life support. The hospital sent an advanced cardiac Life support team along with the ambulance as the wife was unaware of the basic techniques. The team of professionals trained by American Heart Association tried reviving the victim on their way to the hospital. After effective CPR for 45 minutes in the emergency department the patient was declared dead.

Had the victim’s wife or someone from the neighbours knew CPR, the patient could have survived.

Case: 2 

A 65-year-old male with the history of severe chest pain, uneasiness and sweating, collapsed at home. Daughter of the victim called emergency team at Columbia Asia Hospital and wanted ambulance immediately. Doctor from the hospital advised victim’s daughter to start CPR till the ambulance arrives. Fortunately, the girl knew CPR techniques and continued performing chest compressions. On arrival of the patient to the hospital, the cardiology team along with the emergency doctors successfully resuscitated the patient and shifted him to Cath lab. Patient underwent angioplasty and had survived a major heart attack.  Some days later patient was discharged and went home walking.

As we can see in both cases simpke knowledge of CPR and BLS was key to the survival of the patient. It is best to educate ourselves or visit hospitals that provide these training. Below is a video from that give us these basic steps that we can perform ourselves.




Healthcare Delivery Public Health

How to survive an heart attack ?

Recently I visited the Philips Innovation Center in Bangalore. While talking to Dr Mabel who had come there to give a demonstration of the lastest Philips Automated External Defibrillator (AED) I came to know of some interesting facts.

Did you know that 7,00,000 people have heart attacks in India each year. and out of them only 10 % survive? This is because a patient needs to get to the hospital within an hour of the initial cheat pain.

Artificial defibrillation just at the moment the heart stops beating can revive almost 80-85 % of the patients. For more on the visit and the demo, please watch my vidoe from the center above.

As always comments and suggestions are welcome.

Healthcare Delivery Public Health

Shot through the heart: What is the Government doing to screen for heart diseases

Cardiovascular diseases continue to be the scourge of India. As discussed in my earlier post, India has probably the largest pool of heart patients in the world, today. The number of heart patients today stands at around 45 million India. So in the run up to the world heart day, on the 29th of September I am doing a three part series on the heart issues in India. The post you are reading is the second part. If you want to read the first part please click here.

So the natural question is what is the Government doing about it ?

To get the answers of this question and many others like this, I spoke to Mr Amol Naikawadi Joint managing director at Indus Health Plus and a member of the CII sub-committee on healthcare.

Amol has been running preventive health initiatives in Pune and the state of Maharashtra and he gave me a very interesting insight to the problem. Some of them are shared below

Insight 1- Gender and location may play a part but the gap is coming down rapidly

According to him heart problems affect all sections of society. But interestingly though earlier men were more affected than women, today the gap has narrowed down considerably. Also there is no clear demarcation between urban and rural Indians when it comes to cardiac ailments.

Insight 2- Heart problems are industry and job agnostic

Though people think heart problems affect IT and other industries where the role is more sedentary, but increasingly it has started affecting people working in all sectors. It is your life style that determines your risk exposure to cardiac problems.

Insight 3- Younger people are more aware of the situation

Many young people in their 30’s are increasingly coming for preventive health check-ups to organizations like Indus Health Plus. This is due to increased prevalence as well as increased awareness of the problems facing the country.

To counter this issue and to get more people to get into the preventive mode, the Government of India has launched scheme under the National Health Mission (NHM) to cover all those who don’t have access to quality healthcare. The scheme would cover both the rural and urban poor, a good indication that the disease today affects both.

The objective is two fold

  • Awareness & Detection
  • Education on lifestyle and stress factors

The plan was to cover Hypertension and Diabetes both indicators and predecessors to cardiac issues and eventually to cover conditions like cancer. The program is funded by the central government, which has allocated thousands of crores of rupees for the scheme. When launched the paln was to cover 40 crore people but after 2 years only 4.5 crore people have been screened. So obviously the program is running into delay and there are not too many people. In addition to this the NHM already has schemes running to reduce infant mortality rate among the urban poor.

“Though the processes and procedures are clearly laid down in the policy documents, but their implementation as always has led to a lot being desired” reflected Amol.

There are also schemes for those with finances to be given tax incentives under 80 D in order to encourage them to undergo preventive screenings.

Finally families earning less than 1 lakh can also look to Government support for preventive care.

One of the most interesting Government schemes comes from the state of Kerala. They launched a scheme called the ‘Karunya Benevolent Fund’ which raises money from the Kerala State Lottery.

‘Karunya Benevolent Fund is providing financial assistance to under-privileged people suffering from acute ailments like Cancer, Haemophilia, Kidney and Heart diseases and for Palliative Care. The amount for the health scheme is raised through lottery. This welfare measure will be helpful to those who suffer from ailments, the cost of treatment of which are proved to be unbearable to lower and even middle strata of society.’

The income generated through the sale of Karunya Lottery is exclusively devoted for extending financial assistance to the purpose. Karunya Lottery comes out with an attractive structure offering Rs. 1 crore as 1st prize.

Source : Kerala Government Website

For more on this article please click here

So one might wonder if the government is doing so much, what about private sector? What are they doing? For that please wait for the concluding part 3 of the series….




Healthcare Delivery Public Health

Shot through the heart: How heart troubles are complicating the India story

My grandmother always used to tell me that working hard 9-5 and having a good night’s sleep were the secrets of a healthy heart. And she also told me that heart problems were a 60’s thing (people in their 60’s)

Her statement could not have been truer as she remained healthy her working life and dies at the age of 65 as you could have guessed of an heart attack. But times have changed.

Today 30 is the new 60’s.

According to statistics from the WHO, India has the largest cardio vascular burden in the world. 1 in 5 Indians die because of cardiovascular diseases. By 2020 the figure will jump to 1 in 3. Currently there are about 45 million heart patients in India. Obviously this figure is much greater as many in the rural areas don’t have the infrastructure to detect heart ailments.

There are two key reasons why such data has come out in the open.

  1. There is a key shift in mortality due to non-communicable life style diseases. So about 50 years ago while malaria and typhoid would have killed many people, today it is Diabetes, Hypertension and Cardiovascular diseases. So clearly mechanization and urbanization has its own perils.
  2. There is increased awareness and screening.  Many more people have been empowered by the media and other social sites. These people read articles like the one you are reading now and become aware of the situation and proactively reach out to care providers to undergo screening.

A combination of these two factors see’s India as the diabetes capital of the world. Indians have the tendency to develop diabetes a good 10-15 years ahead of their western counterpart. The average Indian develops the condition at the age of 45 years.

As the world celebrates ‘World Heart Day’ on the 29th of September I have decided to do a three part series beginning with this post. The second post in the  series would look at what is the government doing to face the challenges posed by cardiovascular diseases and the third post would look at how the private healthcare sector is working on innovative strategies to counter the issue.

I will be back soon and till then comments and suggestions are always welcome…