Emergency heart-care system launched
A new system of care aimed at rushing patients with the most deadly form of heart attacks to balloon therapy in 90 minutes or less was formally launched Thursday.
However, another big piece of the life-saving puzzle is persuading those patients to call 911 in the first place, experts said.
After a year of hammering out the details, a dozen local hospitals and hospital systems and 13 regional emergency medical systems signed agreements to form the Heart Alert Response System, similar to the regional trauma system developed here a decade ago.
Under the system, paramedics diagnose heart attacks using portable EKG machines they've been trained to interpret. The paramedics then sound a “heart alert” to scramble the hospital's cath lab teams regardless of the hour.
“While they're traveling to the hospital, the cardiologist and cath lab team are also traveling to the hospital, hoping to arrive in roughly the same amount of time,” said Dudley Wait, director of Schertz EMS and chairman of the committee that organized the heart alert system. “And then we take the patient right into the cath lab.”
Ideally, all heart attacks should go as well as Bruce Runyan's heart attack did Dec. 12.
The 54-year-old Rackspace Hosting Inc. executive woke up one morning perspiring heavily with mild chest discomfort, nausea and shortness of breath.
His wife quickly drove him (although experts urge people to call EMS rather than drive) the two blocks from their home to the Alamo Heights Fire Station, where paramedics hooked him to an EKG and notified Northeast Baptist Hospital he was suffering a STEMI — or ST-segment Elevation Myocardial Infarction, the kind of life-threatening heart attack the system was designed for.
Less than an hour from being put in an ambulance, he was having three blocked arteries opened with a balloon catheter and stents.
Runyan's voice broke as he stood at a podium and thanked the paramedics and medical staff who saved his life.
“What you guys do is really important,” he said. “We're talking about real people and real lives, so thank you from me and my family — and for the hundreds and thousands of people in the next year or two you're going to save.”
While some EMS systems have the ability to wirelessly transmit those EKG results to the emergency room before arrival, not all of them can — San Antonio's EMS being the biggest that currently can't.
However, Assistant Fire Chief Mario Guerra, division commander of EMS, said the city has set aside funds to upgrade the 12-lead EKG devices in every EMS unit.
Seventeen of 20 local hospitals have interventional cath labs capable of opening clogged coronary blood vessels — a procedure known as percutaneous coronary intervention, or PCI. Dr. Craig Manifold, medical director of San Antonio EMS, said a national survey of EMS systems released this week found only half had 12-lead EKG machines in most of their ambulances, and only a third of STEMI patients currently are taken first to a hospital capable of treating them.
“We're ahead of most areas when it comes to providing care to heart attack patients, which we as a community should be very proud of,” Manifold said.
But the whole elaborate system of care is for naught when patients don't seek help, said Dr. Marc Feldman, an interventional cardiologist at University Hospital.
“No one wants to be sick, so even if you're having chest pain you always say, ‘It must be indigestion,'” Feldman said. “At University, we get so many people who walk in one or two days after a heart attack, when they've had symptoms and their wives pushed them in. They changed their whole future. Once your muscle's damaged, you can be short of breath and tired the rest of your life.”
When new techniques and technology are used in health care, the hospital and medical staff are taking on a huge risk and responsibility to ensure that they are trained properly and the equipment is working correctly. Many mistakes will happen over the next few years and the Law Firm of Fears & Nachawati are standing by to fight for your family. If you need help or have lost a loved due to a mistake or negligence by a hospital or the staff contact us immediately at 214 890 0711.
