Development of an emergency nurse-paramedic motorcycle response system for acute STEMI and sudden cardiac arrest care in India

Abstract

India has more cardiovascular disease (CVD) than any other country claiming nearly 5 million
lives annually. It is projected that by 2020, nearly 60% of patients with CVD world-wide will be of
Indian descent as Indians have a higher genetic predisposition for and earlier risk of CVDs than
other ethnicities. Specifically, ST segment elevation myocardial infarction (STEMI) and sudden
cardiac arrest (SCA) are major contributors to disability and death in India with over half of patients
dying in pre-hospital settings prior to reaching hospitals. The high rates of acute STEMI and SCA
through-out India is an expanding public health problem that is currently being addressed by the
Heart Rescue India (HRI) program. An innovative pre - hospital system using nurse-paramedic
first responders on motorcycles with complementary ambulance unit back-up and transport, when
combined with community risk screening and education, provides rapid STEMI/SCA identification
and treatment. Our goals are to increase the capacity of the paramedic response system, develop
standard protocols for acute CVD management and ultimately improve overall patient survival.
This pre-hospital response system may foster a scalable model that can be integrated into the current
healthcare system and large urban centers throughout India.