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Two days ago a patient was brought into the hospital with a heart attack. Though he had raised the alarm that he had severe chest pain, and though his immediate family had recognized that this could be a heart attack, he took full two-and-a-half hours to reach our hospital emergency room, the nearest one, in the middle of the night when there was practically no traffic!


This is how:


First there was the transport issue: the family didn’t own a car. So they had to wake their neighbor and explain to him about the crisis and then it took some minutes for the neighbor to dress and take the car out of his house premises.


Then, the patient was driven to the house of a doctor within the same locality. The good doc was awoken, listened to the patient’s story, mercifully conducted a cursory examination in the car itself, without wasting much time. He also felt that this looked like a heart attack, and since he did not have the facility to perform an ECG test in his house, he suggested that the patient be taken to a nearby nursing home.


The nursing home was a short drive, the patient had to be put on a stretcher, carried into the casualty area, and an ECG was obtained. There was a junior doctor on duty who confirmed the family’s suspicion that this was indeed a heart attack. But since there was no ICU facility in the nursing home, the family was advised to shift the patient to a bigger hospital. This meant that the whole drama of lifting the stretcher, putting the patient into the car and driving around had to restart.


Mercifully someone had the forethought of calling up a friend and then after consensus they drove to the nearby tertiary care hospital, where we could attend to him. Though valuable time was lost patient survived with some damage to the heart muscle.


Things could have been worse: he could have had a cardiac arrest while being driven around or even inside the nursing home and might never have reached the tertiary care hospital at all! How could this have been bettered?


You know, if you walk into a hotel lobby or a high rise corporate office, you have detailed building evacuation plan in case of fire or some such disaster. Why can’t we have such disaster management plans for our homes? I’m suggesting one for cardiac emergencies. Make this plan today when all is well at home.


First, identify a hospital which has the facility of ECG and has an ICU to treat heart attack patients, which is the fastest to reach. Remember, fastest need not be the physically closest one. In many metros in India, during peak hour traffic some places are hard to reach in a hurry. In fact, you can identify different hospitals for day and night time when the traffic conditions are likely to be different.


Get the emergency contact numbers for hospital you are going to reach and write it down someplace handy: it can be a wall calendar in the kitchen (common middle class family practice in south India), or on a sticker on the undersurface of your telephone.


Next, pre-determine the mode of transport in case of emergencies. If a car and a designated driver are at home, then that is your transport mode. Call the hospital emergency that you are coming and the designated driver will drive.


If a car is unavailable, or if the designated driver is not at home or himself/herself is the casualty, then the best bet is to get an ambulance. The ambulance can be from the same hospital or from another nearby source. Get the emergency contact numbers of one or more ambulance services and write it down along with the hospital emergency numbers.


Keep aspirin tablets handy: 325 milligram tablets should be fine. In case someone has chest pain & you suspect it is heart related one tablet of aspirin should be chewed, not swallowed. Many of us are advised by friends or family that sorbitrate tablets should be given to patients for heart pain. Unless, advised by a doctor, this can actually cause blood pressure to drop and be dangerous.


The most important thing to do in a suspected heart attack to get good secondary care treatment as early as possible. Plan ahead and do not waste time in getting to the right place. The instructions to family members as to what to do in a crisis situation should be explicit and should be followed as a reflex even in the middle of the night.


Even organisations can have similar medical disaster management plans drawn up for their shop floors and facilities so when men (or women) at work are affected, things move fast.


That should save some lives!






  1. nice thing .to forward

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  4. hmm mezmeryzd by dis info…
    cn u plz wryt abt CPR.hw effctiv iz mouth2mouth breathin whyl doin CPR?..

  5. nnn hw effctiv iz CPR widout defibrilatrz??

  6. Good article Dr Venkatesh. We published a link to this article on our blog as well. Here is a link –

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