Implementing a STEMI system of care in urban Bangalore

Rationale and Study Design for heart rescue India

Aruna Ramesh, Kenneth A. LaBresh, Rhea Begeman, Bentley J Bobrow, Teri Campbell, Nayanjeet Chaudhury, Marcia Edison, Timothy B. Erickson, John D. Manning, Bellur S. Prabhakar, Pavitra Kotini-Shah, Naresh Shetty, Pamela A. Williams, Terry Vanden Hoek

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: A system of care designed to measure and improve process measures such as symptom recognition, emergency response, and hospital care has the potential to reduce mortality and improve quality of life for patients with ST-elevation myocardial infarction (STEMI). Objective: To document the methodology and rationale for the implementation and impact measurement of the Heart Rescue India project on STEMI morbidity and mortality in Bangalore, India. Study Design: A hub and spoke STEMI system of care comprised of two interventional, hub hospitals and five spoke hospitals will build and deploy a dedicated emergency response and transport system covering a 10 Km. radius area of Bangalore, India. High risk patients will receive a dedicated emergency response number to call for symptoms of heart attack. A dedicated operations center will use geo-tracking strategies to optimize response times including first responder motor scooter transport, equipped with ECG machines to transmit ECG's for immediate interpretation and optimal triage. At the same time, a dedicated ambulance will be deployed for transport of appropriate STEMI patients to a hub hospital while non-STEMI patients will be transported to spoke hospitals. To enhance patient recognition and initiation of therapy, school children will be trained in basic CPR and signs and symptom of chest pain. Hub hospitals will refine their emergency department and cardiac catheterization laboratory protocols using continuous quality improvement techniques to minimize treatment delays. Prior to hospital discharge, secondary prevention measures will be initiated to enhance long-term patient outcomes.

Original languageEnglish (US)
Pages (from-to)105-110
Number of pages6
JournalContemporary Clinical Trials Communications
Volume10
DOIs
StatePublished - Jun 1 2018

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India
Emergencies
Electrocardiography
Process Assessment (Health Care)
Ambulances
Mortality
Triage
Cardiopulmonary Resuscitation
Cardiac Catheterization
Quality Improvement
Secondary Prevention
ST Elevation Myocardial Infarction
Chest Pain
Reaction Time
Signs and Symptoms
Hospital Emergency Service
Myocardial Infarction
Quality of Life
Morbidity
Therapeutics

Keywords

  • Angioplasty
  • Quality improvement
  • STEMI
  • Thrombolysis

ASJC Scopus subject areas

  • Pharmacology

Cite this

Implementing a STEMI system of care in urban Bangalore : Rationale and Study Design for heart rescue India. / Ramesh, Aruna; LaBresh, Kenneth A.; Begeman, Rhea; Bobrow, Bentley J; Campbell, Teri; Chaudhury, Nayanjeet; Edison, Marcia; Erickson, Timothy B.; Manning, John D.; Prabhakar, Bellur S.; Kotini-Shah, Pavitra; Shetty, Naresh; Williams, Pamela A.; Vanden Hoek, Terry.

In: Contemporary Clinical Trials Communications, Vol. 10, 01.06.2018, p. 105-110.

Research output: Contribution to journalArticle

Ramesh, A, LaBresh, KA, Begeman, R, Bobrow, BJ, Campbell, T, Chaudhury, N, Edison, M, Erickson, TB, Manning, JD, Prabhakar, BS, Kotini-Shah, P, Shetty, N, Williams, PA & Vanden Hoek, T 2018, 'Implementing a STEMI system of care in urban Bangalore: Rationale and Study Design for heart rescue India', Contemporary Clinical Trials Communications, vol. 10, pp. 105-110. https://doi.org/10.1016/j.conctc.2018.04.002
Ramesh, Aruna ; LaBresh, Kenneth A. ; Begeman, Rhea ; Bobrow, Bentley J ; Campbell, Teri ; Chaudhury, Nayanjeet ; Edison, Marcia ; Erickson, Timothy B. ; Manning, John D. ; Prabhakar, Bellur S. ; Kotini-Shah, Pavitra ; Shetty, Naresh ; Williams, Pamela A. ; Vanden Hoek, Terry. / Implementing a STEMI system of care in urban Bangalore : Rationale and Study Design for heart rescue India. In: Contemporary Clinical Trials Communications. 2018 ; Vol. 10. pp. 105-110.
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