56 years old gentleman has had 6 hours history of non specific chest pain , it was thought to be releated to stomach ache initially. As the pain was getting worse he was taken by his son to a clinic in town for test and evaluations around 12 noon the next day , the attending laboratory technician did the basic bloods tests and the ECG but needed a reporting physician to come and report it later in the evening. which happened around 7 pm
He was then advised for an emergency admission to either in a governement medical college hospital or a private fascilities for urgent treatment as he had a heart attack , advised by the doctor who reported the ECG.
The attending son who is a 2nd year university student started paniking and decided to take his father to a local clinic to get quicker assessments
He was admitted to this local clinic around 9 pm, he was commenced on basic pain kilers and iv fluids, his chest pain was getting worse and worse.
The busy physician who was on his to clinic only arrived around 2 am in the next morning to complete his busy day schedule.
By this time the patients condition has deteriorate and he was informed that his chances of survival is very slim , he had a massive heart attack, with low blood pressures and wowful ECG traces on monitor.
A decision has been made by the family to take him to a tertiary hospital , it took another 3 hours to made the arrangement and ambulance payment in advance and so on
He was on his way to Dhaka United Hospital where the attending cardiologist were informed by a relative who is doctors living 6 thousaad miles awayw
Unfortunately the patient died an hour before he reached the tertiary hospital
This is the sad story we do hear all the time, not ony in Bangladesh but globally where state founded strong protocol based treatment is not readily available.
He left behind a big family and 3 children all studying , depended on fathers icome only
He was the only bread winner
the lack of coordinations and communications and actions in a timely fashion is so desperately needed
timely actions possibly could have avoided the early death or at least the consolation to the family that all have been done to help him during this trying times
We have all the fascilities and trainned people around to help but lack of communications and poorly desigend infrastructuires are mainly to blame, we all know
We need to educate our people more and more , create infrasturctures in such a way where people can rely on with trust and confidence
This is the social responsibilities we can not ignore
Following this event, Janaan health conducted seminar in rural comunity to raise the awareness and “WHAT TO DO IN CHEST PAIN , IN THE PRE HOSPITAL SETTING”
SUDDEN ONSET CHEST PAIN ,-TWO COMMON THINGS TO BE EXCLDED
1. HEART ATTACK AND
2. CLOTS IN THE LUNGS
TO GET MEDICAL ADVISE IN A DESIGNATED STATE RUN SETTING
Dr Amin Islam
London 17th December 2017