KK's death underscores the need for emergency care at public events

New Delhi, June 5:  The recent death of veteran singer Krishnakumar Kunnath (KK) after a concert in Kolkata has highlighted the need to learn the basic nuances of handling the health emergencies for all.

The post mortem report of singer indicated that KK had significant blockages in his heart vessels, which led to a heart attack. Even, he can be seen distressed and sweating during his live performance. The singer was taken to his hotel and then to a hospital where doctors declared him dead following a cardiac arrest.

The major point which is being widely discussed is -- Had he survived if he had been promptly transported to a hospital?

"Timely CPR even by a lay person and immediate shifting to cardiac Centre might have different result", says Dr (Prof) Tarun kumar, ABVIMS and RML hospital. He told IANS that if he had any symptoms, he should have been immediately taken to nearest medical Centre, instead of going to hotel. Time is both precious and precarious in such medical emergency, he said.

Emergency medical and critical care services can play a significant role in designing and implementing an effective approach towards public health. The top three reasons people visit an emergency are heart attack, a stroke, or an accident. In the case of a heart attack or accident, the patient must get to a hospital within 60 minutes. The time-to-treatment is most crucial in the case of heart attack. The medical guidelines say this should be 90 minutes or less to perform angioplasty in such cases.

The essential elements of an emergency medical system for cardiac patients are: ambulance operations, a call centre, and healthcare facilities.

"A heart attack is a medical emergency. It usually occurs when a blood clot blocks blood flow to the heart. It leads to myocardial injury and needs proper treatment to salvage the myocardium. In cardiac arrest, the heart abruptly stops beating. Without prompt intervention, it can result in the person's death. Heart function stops abruptly and needs urgent intervention", said Dr Kumar.

Availability of Cardiac defibrillator at public places is sometimes life saving, said Dr Kumar, highlighting the need of self awareness and proper training in such emergency cases. To handle the medical emergency, he emphasised on self awareness and regular cardiac check.

To prevent such incidents, Cardio-Pulmonary Resuscitation (CPR) may be helpful in certain situations if he or she has proper training. "Installation of Cardiac defibrillator at public places like bus stand, railway station, airport, stadium and General public awareness and training at mass level in CPR and usage of cardiac defibrillators can help us deal with any such health emergency", Dr Kumar told IANS.

Deployment of ambulances at least equipped with necessary medicines and trained paramedics should be made mandatory at large gatherings or public events, he added further.

However, a 2020 AIIMS Delhi report on emergency and injury care at district hospitals in India says that even 88 per cent of hospitals had in-house ambulances, trained paramedics needed to assist ambulance services were present only in 3 per cent.

"Provision of specialized care during ambulance transport was largely poor: only 12 per cent hospitals had mobile Stroke/ STEMI (for heart attack) program. Most of the hospitals lacked Pre-hospital arrival notification system", the study pointed out.

"Emergency care system in our country has seen uneven progress. Some states have done well, while others are still in the budding stages. Overall, it suffers from fragmentation of services from pre-hospital care to facility-based care in government as well as in the private sector. The system also suffers from lack of trained human resource, finances, legislation and regulations governing the system. Absence of standalone academic department since its inception is another factor which is ailing the system", the study said about emergency services in the country.

Dr Abhishek Shankar, Associate Professor, Department of Radiation Oncology, AIIMS Patna, says that awareness about health for any minor issues in India is so poor that people land in trouble.

Dr Rohan Krishnan, President of Federation of All India Medical Association, emphasised on providing health education at plus two level irrespective of students' stream. He said that students must be taught basic life saving skills at college level to deal with such emergency situation. Along with creating a mass level awareness on basic life saving skills, the general public also needs to imbibe 'accepting attitude' and abstain from 'ignoring attitude', as public visit hospital only when the condition becomes grave, said Dr Krishnan.