If you’re having a heart attack, every minute counts.
Ellis Hospital in Schenectady donated enhanced EKG units to three area emergency medical service agencies recently to allow EMS crews to immediately transmit EKG information from the field to the emergency department and the cardiologist-on-call’s cell phone.
It is part of an initiative, which is also occurring in other area hospitals, to shave down the door-to-balloon time, which is the time it takes to get a heart attack patient into treatment. Ellis Hospital’s average time to get patients with the most common type of heart attack ` known as STEMI, or ST-segment elevation myocardial infarction — into treatment is 56 minutes, versus the industry’s standard expectation of 90 minutes.
`We’ve done several meetings with paramedics to give them a cardiologist’s view of EKG interpretation, which helps them to interpret readings more effectively,` said Dr. Steve Weitz, a cardiologist at Ellis Hospital.
`We can be in the ambulance in a virtual way where we can see the EKG on our mobile device when the patient is in the field, and we can confirm the diagnosis, and, at our discretion, call the ambulance and ask if they need any help or direction in taking care of the patient before they arrive,` said Weitz.
If a patient is having a STEMI heart attack, an EMS calls and activates a STEMI alert. A single call by the hospital operator pages the entire Cath Lab team, where the patient is taken for treatment. By the time the patient arrives at the hospital, everyone is ready and waiting.
Ron Mazure, a Rotterdam resident, had a heart attack last year. It started some time on a Sunday night, but it wasn’t until early in the morning that he decided to seek treatment. At first, he said that he felt like he had indigestion or heart burn, but despite his efforts to make himself feel better, his discomfort kept getting worse.
`I was loading up on the antacids, and it wasn’t going away and I was up at about 4 o’clock in the morning. I started feeling the funny feeling in my arm, so I said to my wife, ‘You’d better call 911, I think I’m having a heart attack,’` said Mazure.
Paramedics arrived shortly thereafter, and did an EKG minutes later, affirming that Mazure was having a heart attack.
`[The paramedic] had already called the hospital and this set off the alert. I had no idea what was going on, but when we got there the whole team was waiting for me. It reminded me of the Indianapolis 500,` said Mazure.
`You’ve got the pit crew there and you’ve got the pit crew chief and everybody’s got a job to do and they’re doing it. It was a well-oiled machine,` said Mazure.
Azure’s door-to-balloon time was 59 minutes.
Larry Kirshenbaum of Clifton Park had a similar experience last November.
`A little less than a year ago, I woke up in the morning with what I thought was some indigestion. I took some Tums, and went back to bed. A couple hours later I realized that one, it wasn’t going away, and that two, it seemed to be getting a little worse. I went to an Urgent Call here and they did some tests,` said Kirshenbaum.
`They did an EKG and said those words I really didn’t want to hear: ‘You’re having a heart attack,’` said Kirshenbaum.
The physician at Urgent Care called an ambulance, and it took Kirshenbaum to Ellis Hospital.
`I swear, it was the fastest ride from Clifton Park to Schenectady that I’ve ever made,` said Kirshenbaum.
In the ambulance, paramedics performed another EKG and were on the phone communicating with the hospital about Kirshenbaum, putting into place a plan of action for when he arrived.
`I got to the hospital, they opened up the ambulance and took me out on the gurney. I’ve never seen so much blue ` everyone was in blue. It was amazingly fast. They did an echocardiogram, Dr. Weitz talked to me there, and they told me [about the procedure they had performed]. The main artery was completely blocked, but that I was OK,` said Kirshenbaum.
Ellis Hospital’s donation of EKG machines is part of a larger program to make sure that heart attack care in the Capital District is going as well as possible, and that it continues improving.
`[The program] was started by the Medical Advisory Committee ` Ellis, St. Peter’s and Albany Medical Center were partners in that,` said Dr. Michael Dailey, medical director for Region Emergency Medical Organization.
`I’m really excited by the project. Frankly, collaboration between the cardiologists, the emergency physicians and EMS, as well as the collaboration between the various agencies and hospitals, is relatively unheard of,` said Dailey.
The initiative in the Capital District has made it the first in New York State to be a part of the Mission Lifeline program.
`Mission Lifeline’s main goal is to improve STEMI system care. The way that we do that is to concentrate on every step of care, [starting with] the patient onset of systems,` said Laurie Young, director of state health alliances for the American Heart Association.
They work on improving each piece of the chain, from teaching people how to recognize that they’re having a heart attack, to making sure EMS has all the materials that they need, to making sure EMS and emergency departments are working together.
`The final piece of Mission Lifeline is after [the patient has] been treated and has good outcomes. We want to put that person back in their community for follow-up care and rehab, send them back to their doctor who they usually see,` said Young.
Weitz said he is happy to see the progress in emergency cardiac care in the area.
`I always think it’s a nice thing to live in an area where there’s a nice safety net if you have something bad happen, and we can certainly say we’ve led the effort.
`We’re even luckier that wherever you go in the Capital District, you have a nice safety blanket for heart attack care at all three of the major heart centers to get heart attacks treated very rapidly and very well,` said Weitz. `We have the ability at any of these centers to do very rapid treatment with door-to-balloon time, and we all share our protocols and our knowledge base so that we all learn from each other to better every program in the Capital District.`
For information, visit the American Heart Association’s Web site at www.americanheart.org. “