A survey on the line of management of myocardial infarction patients by the primary health care physicians in Puducherry.
Journal Title: Journal of the Indian Medical Association - Year 2018, Vol 116, Issue 9
Abstract
Myocardial Infarction (MI) is the common cause of the mortality globally. If prompt treatment/referral is initiated within 90 minutes of development of infarction, the mortality rate can be minimized almost to 3%. Whenever patients develop any acute illness including chest pain, they usually attend the clinic of family physician first that are easily accessible to them. Therefore the role of family physician in management of MI is very significant. Hence a survey based on a validated questionnaire was conducted among general practitioners of Puducherry. It was observed from the survey that 93% of family physicians are aware of the importance of early administration of aspirin as a prehospital medication. However about 41% of physicians informed that they use enteric coated aspirin and not soluble aspirin. With regard to referring the patient for catheterization laboratory, 58% of physicians only felt that 3 hours as a maximum period. Only 21% of physicians preferred to use morphine as analgesic while the rest suggested drugs such as tramadol, diclofenac, aspirin, pentazocine, paracetamol and pethedine as alternatives to morphine. Most of physicians felt that non availability of morphine is due to stringent regulations and it is the main reason for not using the same. Streptokinase was preferred thrombolytic for 29% of physicians and tenecteplase was preferred by 35%. From our present survey we feel that continuing medical education programs on MI pertaining to use of analgesics, referral time limit to Primary Percutaneous coronary intervention (PPCI) and use of most effective thrombolytic may be organized for primary care physicians so that timely management by them can reduce the mortality in MI significantly
Authors and Affiliations
M Thulasimani, S Amarnath, Arun Sharma
Keywords
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