Bilal Ahmad Chopan, a 27-year-old from Banihal of Jammu and Kashmir, was admitted to a local hospital with severe chest pain a few weeks ago. The doctors of the sub-district hospital conducted an ECG on him which pointed out that the patient had suffered a heart attack.
Understanding the gravity of the situation, Dr Auqib Najam from the sub-district hospital in Ramban district uploaded the ECG report of the patient on their real-time network, where doctors and senior cardiologists advised him to go for thrombolysis (using medication to dissolve clots in the blood vessels). “I acted immediately and we saved the life of the patient. In such emergencies, the crucial first hour is the golden hour,” the doctor told The Indian Express.
Bilal was then shifted to Sher-I-Kashmir Institute of Medical Sciences (SKIMS) of Srinagar, after providing basic medical treatment in the sub-district hospital, where a stent was used to keep his arteries open.
According to officials of Directorate of Health Services, Kashmir, the department uses a “hub and spoke model” to provide life-saving treatment to those suffering from cardiac emergencies, particularly Myocardial Infarction or heart attack. “The hubs are the tertiary care centres in Srinagar, like SKIMS and Shri Maharaja Hari Singh (SMHS) Hospital, and the peripheral district and sub-district hospitals function as spokes,” Dr Saleem-ur-Rehman, Director-General, Health Services, Kashmir told IE.
Doctors and cardiologists from the ‘hub’ hospitals are connected with doctors posted at government health facilities in remote areas through WhatsApp groups. And this keeps the communication line open for the advice on the line of treatment round the clock.
Chopan is among hundreds of patients who have been saved by doctors posted in remote areas of the Valley under ‘Save Hearts Initiative’ launched by the Directorate of Health Services of Kashmir, last December. According to official data, more than 1,500 cardiac emergencies have been treated under this initiative, including 120 heart attack cases.
As soon as suspected cardiac emergency patients are brought to district or sub-district hospitals, they are taken to the emergency room for the ECG. The doctor immediately shares the ECG on a dedicated network, which operates 24×7. The cardiologist from SKIMS and other specialists give their advice, Dr Nasir Shams, who is from the Health Department and is actively involved in the programme, told Indian Express. “If required, patients are immediately referred for further treatment, and the cardiology department of SKIMS or SMHS is alerted,” he added.
An official informed that a doctor from Australia is currently associated with this programme and prescribes medical intervention on the WhatsApp group when doctors from Kashmir are not available. They are now adding Kashmiri doctors working abroad, in US and other places, to the WhatsApp group to take advantage of different time zones, so that patients do not go unattended in the middle of the night. Najam is among the around 200 other medical officers who have been trained by the department for this programme, especially in reading ECGs.
From Banihal itself, 5-6 patients have been referred to SKIMS in Srinagar. All of whom have survived and are now coming up for follow up treatment in the district hospitals. At Khaltsi Primary Health Centre (PHC) in Leh, thrombolysis was conducted on a heart attack patient for the first time at a peripheral level institute. Dr Tsering Angmo, an anaesthetist associated with the PHC, told The Indian Express that the procedure was conducted on a 48-year-old Army porter who was brought unconscious to the health centre that afternoon.
Says Dr Irfan Ahmad Bhat, cardiologist consultant at SMHS Hospital informs that more than 100 lives have been save under the programme, after they were referred from peripheral centres.