Updated on: Monday, December 23, 2019, 07:40 AM IST

Golden hour need; ‘108’ ambulances will soon handle stroke patients

Thus, the brain cells begin to die within minutes and it is a medical emergency and requires prompt action and treatment.
Representative image |

Representative image |


Mumbai: Stroke is known as one of the leading causes of death and disability in India. The incidence of stroke is rising at an alarming rate in India.

It occurs when the blood supply to a part of the brain gets interrupted or reduced, preventing the brain tissue from getting oxygen and nutrients.

Thus, the brain cells begin to die within minutes and it is a medical emergency and requires prompt action and treatment. The Golden hour (the period within five hours) is vital for treating patients with stroke.

Every 20 seconds, an Indian suffers a brain stroke and the numbers are increasing alarmingly due to changing lifestyles. At this rate, around 1.54 million Indians are affected by stroke every year and the worse part is that about 90 per cent of stroke patients failed to reach the hospital on time.

The risk of stroke after the age of 55 is 1 in 5 for women and 1 in 6 for men.

As per Indian Council of Medical Research (ICMR) report 2016, stroke is the fourth leading cause of death and the fifth leading cause of disability. But, a lot of these deaths and disability are preventable by raising awareness, and better preventive and curative stroke services.

Mumbai Stroke Society had joined hands with Global Hospitals in Parel and the Rotary Club of Bombay in Worli to provide training to doctors and 108 emergency services staff to handle stroke patients in time.

Every major public and private hospital needs to have a dedicated 24x7 stroke unit, where stroke patients are attended by a multi-professional team that includes medical, nursing and therapy staff having specialist knowledge, training, and skills in stroke care. Even ambulance services play an important role in saving patients, where time is critical.

“Ambulance services like 108 are geared up for cardiac emergencies, but there is not sufficient focus given to stroke-related emergencies,” said Dr Shirish Hastak, Regional Director, Neurology, Stroke and Neurocritical Care, Global Hospitals.

The state government of Maharashtra has come up with 108 emergency ambulance services that have been started to help patients deal with a stroke, fire injuries, road accidents, and cardiac arrest. To allow doctors to tackle stroke at the right time, this training session is much-needed.

Dr Rahul Chakor, Professor at the Department of Neurology, BYL Nair Charitable Hospital said, if left untreated, stroke loses 1.9 million neurons each minute.

Compared with the normal rate of neuron loss in brain ageing, the ischemic brain ages at the rate of 3.6 years each hour without definitive treatment.

“If a person is brought to the hospital within the golden hours, upon his arrival at the hospital, he will immediately undergo a brain scan to determine the type of stroke.

If it is an ischemic stroke or stroke due to clot, we will immediately start thrombolysis (a procedure wherein a clot buster or a medication to dissolve the clot and restore blood flow will be given). While this is done, the patient’s blood pressure is controlled through medications,” he said.

Dr Hastak said there are few steps to resuscitate the brain after a stroke and those steps are called ABCD3 which means A stands for Airway, B for breathing, C for circulation, D for the deficit, duration, and drugs. ABC is well-established but D3 is not. It is time to take stroke seriously and nip it in the bud.

“Currently, there are 937 emergency ambulances in Maharashtra, and around 2600 B.A.M.S. or B.U.M.S doctors. In Mumbai, there are about 112 ambulances and the doctors are trained for advanced life support, basic life support and disaster management.

The average time taken to reach the patient site (after notification) is 18.75 minutes, and an average time taken to reach Hospital from the patient site is 26.25 minutes. This training session will help Mumbai become stroke smart, and save hands, legs, and speech of the patients.”

Dr Vivek Talaulikar, CEO, Global Hospital, Mumbai said they have joined hands with the Mumbai Stroke Society to make the citizen’s Stroke Smart. “This session will enhance the knowledge of the doctors of the 108 Ambulance regarding the management of Stroke patients during the Golden Hour.”

In addition, through this initiative, we aim to empower more doctors through collective knowledge which will benefit the society at large,” he said.

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Published on: Monday, December 23, 2019, 07:40 AM IST