New tech aids heart attack victims

EMS will be able to transmit EKG results straight from ambulance

There's a saying about those who suffer a heart attack: time is muscle. In other words, the more time you waste, the more heart muscle you lose.

St. Francis Hospital is taking steps to make sure no time is wasted.

The Columbus hospital plans to become the first local medical facility to implement a regional program that allows Emergency Medical Services workers to transmit electrocardiograms, heart tests called EKGs for short, from ambulance trucks straight to the hospital.

St. Francis officials say this initiative, called its ST elevation myocardial infarction management program -- or STEMI -- could reduce door-to-balloon times by as much as 45 minutes, almost half of the current St. Francis average of 83 minutes. Door-to-balloon time is the interval between the heart attack patient's emergency room arrival and the opening of blocked arteries leading to the heart.

"That's all saved heart muscle," said Kristie Johnson, director of St. Francis' Patrick Heart Institute.

The program aims to put the special equipment in all 56 ambulance trucks in Georgia EMS Region 7, which encompasses 13 counties, and Russell and Lee counties in Alabama.

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Quicker response

STEMI patients experience a severe kind of heart attack that requires an angioplasty, stent or open heart surgery.

A number of local paramedics help identify STEMI patients through EKG monitors inside their trucks. Usually, they interpret these tests -- which show which parts of the heart are being affected -- and call physicians to report their findings.

Paramedics are the highest level of EMS workers and are trained to read EKGs.

The new equipment would allow physicians to look at EKGs before a patient even gets to the hospital. With a confirmed test in hand, a physician could "activate" the catheterization laboratory -- cath lab for short -- and call on cardiologists and staff ahead of time.

That saved time could be crucial for patients coming from rural counties like Clay, Randolph and Quitman -- which are at least a 45-minute drive away.

And for EMS workers, "it takes a little pressure off the paramedic," said Marie Harrell, EMS coordinator for Columbus Fire and Emergency Medical Services.

Otis Peters, a Columbus firemedic, has had 10 years of EMS experience -- half of those as a paramedic and firemedic. While he is confident in his abilities to read an EKG, he said "it gives us backup as to what we're looking at" and can help new paramedics.

"When you're in pressure situations... it (should) help the paramedic feel better about it," Peters said. "School is totally different from being there with the patient."

Costs

The idea for the program came while St. Francis was working toward accreditation as Columbus' first chest pain center from the Society of Chest Pain Centers. It was accredited this month.

Johnson at St. Francis estimated the project will cost about $300,000. St. Francis has already bought the $30,000 piece of equipment -- called a LIFENET receiving station -- that will sit at the hospital and receive transmitted EKGs. Columbus Fire and EMS and Stewart and Webster counties have equipment inside their trucks that's compatible with the receiving station.

The remaining $270,000 will pay for upgrading or replacing ambulance truck equipment in other counties -- Harris, Talbot, Taylor, Macon, Schley, Marion, Chattahoochee, Quitman Randolph and Clay counties in Georgia and Russell and Lee counties in Alabama. Equipped EMS trucks would also have to maintain a cellular connection to transmit EKGs, which would cost about $30 per truck per month.

St. Francis has submitted a request to Rep. Sanford Bishop, D-Albany, for the remaining $270,000. The request falls under the Labor Health and Human Services bill, which has yet to go before a full appropriations committee. Caroline Burns, Bishop's spokeswoman, said it was possible they would find out more about the request at the beginning of December.

Johnson said if the request does not go through, they still plan to come up with funds through the St. Francis Hospital Foundation.

Elsewhere

If implemented, local EMS could become one of less than 10 percent of EMS services across the country with EKG transmitting capabilities. In Georgia, the Columbus region could be one of two.Mike Willingham, senior director of EMS for the American Heart Association, said Atlanta is the only city in Georgia with a STEMI management plan -- at least that he's aware of. Willingham is over AHA's Mission: Lifeline program, which registers all medical systems that implement a STEMI plan.

Willingham said one reason more hospitals may not have such programs is EMS services may simply not be equipped. Certain counties in Georgia have a limited number of ambulance trucks -- or no coverage at all.

Connie Meyer, a board member-at-large for the National Association of Emergency Medical Technicians, said a STEMI management program has worked where she is based. Meyer is a full-time paramedic and nurse in Kansas City area. "We've had patients where we didn't even stop in the ER," she said. "We went straight to the cath lab... You just can't waste time with that."

Meyer said cooperation between EMS, hospitals and physicians is necessary for these systems to work.

"It becomes a system approach to the problem, not the EMS working and the hospital working independently," Meyer said.

source:ledger-enquirer