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Tuesday, September 11, 2018

Critical brain care

Realising the danger of permanent disability or death arising out of brain disorders, Wockhardt Hospital Mumbai Central has started Emergency Neurological Life Support Certified (ENLS-USA) certified Brain Resuscitation services in the critical hours of neurological emergencies. It is the only hospital across India with all five emergency doctors and 16 emergency nurses being ENLS, USA, certified, the hospital says.

ENLS is a common practice across the world, but is still in its infancy in India. Giving neurological emergencies the importance they deserve, Dr Shirish Hastak, Director, Neurology and stroke services at Wockhardt came up initially with the Code White Emergency measure. Code White is a metaphoric alert button pushed by the emergency team in the hospital for acute stroke, which is a part of the ENLS plan. On activation of Code White, a brain resuscitation team reaches the emergency department within five minutes and within 15 minutes imaging is done for proper diagnosis. ENLS creates a collaborative, multi-disciplinary approach and provides a consistent set of protocols, practical checklists, decision points and suggested communication for patient management. The emergencies in ENLS include not only stroke but also seizure, encephalopathy, traumatic brain/spine injury, brain infections and systematic approach to coma.

Dr Hastak says: “All major hospitals in India have emergency cardiac life support as a basic training requirement for emergency doctors and nurses; hence heart emergencies are treated rapidly. Similarly the brain is also a vital organ and in neurological emergencies needs urgent care and support. This has been neglected in the past. We have often seen that the vital time is lost in mobilizing neurological services in the hospital. In these past six months, the hospital, using ENLS, has successfully helped around 50 patients and seven in the past month alone.

He adds: “A five-minute seizure is quite different from a 30-minute seizure. It can create a huge difference in the morbidity of a patient. Even a stroke treated at two hours is different from the one treated at four hours and this can change the outcome.”

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