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Self Regional, area EMS aim for quicker diagnosis of heart attacks

First Byline: 
STAFF REPORT

GREENWOOD - Approximately one million Americans will suffer a heart attack this year, and one will die every minute, according to the American Heart Association.

Patients with heart attacks in the Lakelands region are expected to fare better, however, thanks to new technology on board area ambulances and in Self Regional Healthcare’s Emergency Care Center.

For the past few months, staff members at Self Regional have been participating in an effort to get heart attack patients to the Cardiac Catheterization Laboratory in the hospital’s Heart Center as quickly as possible so life-saving procedures can be performed, reestablishing blood flow to the heart.

The goal of this project, known as Door-to-Balloon, or D2B, is to get blockages in the arteries that supply blood to the heart opened within 90 minutes from the time emergency services personnel see the patient in the field. Part of this effort involves improving the ability to diagnose heart attacks with a 12-lead electrocardiogram (ECG). The ECG can then be transmitted to the Self Regional Emergency Care Center, giving emergency physicians, nurses and cardiologists advance time to prepare for the patient’s arrival.

“Our new protocol for this new technology has evolved from guidelines established by the American Heart Association,” noted Dr. Priya Kumar, an interventional cardiologist with Piedmont Cardiology Associates. “The new system is known as the South Carolina Mission Lifeline. One of the primary steps is to equip Emergency Medical Services (EMS) staff with 12-lead ECG capability. The other ingredient is an advanced workstation in our ECC that serves as a portal between EMS in the field and physicians and nurses in the ECC.”

            EMS personnel from throughout the seven-county Lakelands region converged on the Self Regional campus in February for specialized training related to the D2B project. This included learning to recognize an abnormality in the ECG known as ST-segment elevation, which helps caregivers more accurately diagnose a heart attack, or acute myocardial infarction (AMI).

            Dr. Kumar said this early link between paramedics, who relay ECG readings, and physicians at the hospital enable the physician to determine whether a patient is suffering a ST-segment elevation heart attack and whether the patient will benefit from treatment in the Cardiac Catheterization Lab.

            “The golden opportunity is this one- to two-hour period after the onset of the heart attack,” she said. “The less time that passes, the more heart muscle can be saved, thereby improving the outcome of these patients.”

            In a ST-segment elevation heart attack, a blood clot blocks the flow of blood to a portion of heart muscle, causing heart muscle damage and chest pain. Cardiologists can perform a procedure called angioplasty in which a catheter can cross though the blockage and a balloon on the catheter inflated to clear the occlusion.

Dr. Bruce Cook, an emergency medicine physician in Self Regional’s ECC, said one of the practices derived from the project is the formation of an AMI team that is notified when a heart attack victim is en route to the hospital. A special call is made and the team assembles to await the patient’s arrival.

“This is especially crucial at night or on weekends when our heart catheterization laboratory staff may not be physically in the hospital,” Dr. Cook said. “It allows us to alert members of our team to get to the hospital as soon as possible to prepare for the patient’s arrival.”

According to an article published in The New England Journal of Medicine, approximately 30 percent of heart attacks in the United States fall under the ST-segment elevation category.

 

Cutline:  Chief Tommy Crawford (center) and Phillip Brooks (right) of the Honea Path Rescue Unit attended a workshop at Self Regional Healthcare in Greenwood which introduced area EMS units to the Door-to-Balloon project. Part of this effort involves improving the ability to diagnose heart attacks with a 12-lead electrocardiogram (ECG) on board area ambulances.


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