In June 30 IssueBy John ThompsonTimes Journal Reporter
The Russell County Ambulance Service underwent a time trial this past week to evaluate their response time to a staged heart attack.
The new response procedure, termed "STEMI," (or Code STEMI) has a reasonable expectation of lowering the time from when the Ambulance Service reacts to the point where the heart patient is in the hospital receiving treatment to one-half the time or potentially more.
The time savings centers on connecting the ambulance with a hospital and cath lab (catheterization laboratory) via computer modem, so that the on-call doctor can assess the patient by directly monitoring their status in part, but the big time savings will come in having the proper facilities prepared to perform potentially lifesaving medical techniques and delivering those patients directly to the facility.
Current procedure is for the ambulance service to deliver someone having a potential heart attack to the closest hospital facility. The delay from having someone taken to the nearest facility instead of to the facility that has the proper equipment, in this case a cath lab, can result in even hours of delay before procedures needed to minimize damage can be completed.
The closest hospital facility in our area with a cat lab is at the Lake Cumberland Regional Hospital in Somerset.
"The idea came about in early fall of last year when Lake Cumberland Regional Hospital and our Evac were kind of heading it up," said Terry Hancock, Russell County EMS Director, "We wanted to get more people involved with it." Area hospitals that become involved in the new Stemi program are Adair, Russell, Clinton and Wayne.
Air Evac Lifeteam, the air medical evacuation service developed the protocol for the patient delivery program that allows for better evaluation while the patient is in route while bypassing unneeded stops on the way to proper treatment.
"The object is, if you identify someone who has a stemi, is to get the patient, from the time of the call to delivering them to the cath lab, to be less than 90 minutes," said Terry, "that's our goal."
On Friday the Russell County EMS responded to a staged potential heart attack call involving Deputy Judge Executive Chris Ramsey who volunteered to be the patient. From the time of the call to getting the patient to the awaiting helicopter was just over 30 minutes, and with the estimated flight time to getting the patient directly to Lake Cumberland Regional Hospital in Somerset the total was at 44 minutes.
Ultimately the new patient delivery procedure cuts out a potentially costly, in terms of health, stop at the Russell County Hospital which can add an extra hour or two before getting the patient to a facility that has the needed equipment.
The word stemi comes from "ST segment elevation on the pre-hospital 12-lead ECG," a definition that is no clearer having said it, but what it means is that the elevation in the reading is an indicator that the heart has a blockage preventing blood to circulate in one of the heart's main arteries. Without opening the blockage as quickly as possible, the heart can't receive the appropriate oxygen supply from the blood, causing damage to the heart muscle.
The procedure is in widespread use throughout the country and will likely save lives and help insure a better quality of life for those who have had a major heart attack. The method of prioritizing patients and having a clearer indication of treatment needed will allow for a patient to be cared for as quickly and as safely as possible so that they can be moved quickly into the cardiac cat lab for immediate care.
The American Heart Association recommends that STEMI patients receive "door to balloon" care in less than 90 minutes. STEMI patients should be in the cardiac catheterization lab, and have their blocked artery open within 90 minutes after arrival.
Once the procedure is well established it will be expanded to include stroke victims, another medical emergency in which the quickness of treatment is paramount in saving lives and quality of life.
According to the American Heart Association, the warning signs of a potential heart attack include:
CHEST DISCOMFORT - Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.
DISCOMFORT IN OTHER AREAS OF THE UPPER BODY - Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach.
SHORTNESS OF BREATH - With or without chest discomfort.
OTHER SIGNS - may include breaking out in a cold sweat, nausea or lightheadedness.
If you see someone, or you yourself experience these symptoms, call 911 immediately for assistance.