11/14/06 — Hospital, EMS personnel try to stem heart attack deaths

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Hospital, EMS personnel try to stem heart attack deaths

By Matthew Whittle
Published in News on November 14, 2006 1:45 PM

A regional hospital and local emergency medical personnel are implementing a new program for heart attack victims that could allow lifesaving treatment to begin before they get to the hospital.

Every year approximately 1.5 million people experience a heart attack. Of those, nearly 600,000 die. Many of those deaths, however, are preventable if blood flow can quickly be restored to the heart -- the goal of a new program being implemented by the Cardiovascular Center at Pitt County Memorial Hospital in Greenville.

Working with emergency medical personnel in eastern North Carolina counties like Duplin and Wayne, the hospital is participating in a new statewide initiative named RACE (reperfusion of acute myocardial infarction) -- a program that focuses on restoring blood flow to the heart as quickly as possible, whether through clot-busting drugs or artery-expanding balloons, beginning on the way to the hospital.

Ideally, said Dr. Joseph Babb, an interventional cardiologist at Pitt, such treatments should be used within 30 and 90 minutes, respectively, after patients arrive at the emergency room. Once time begins elapsing, heart muscle cells begin to die, and they do not regenerate.

"The object of heart attack therapy is to open obstructed arteries as soon as possible and save muscle," Babb said.

That saves lives.

The problem, Babb continued, is that too often doctors are not able to open the arteries quickly enough. The delays come from waiting for the results of an EKG that is performed once the patient arrives in the emergency room. The goal of the RACE program is to outfit emergency response vehicles with portable 12-lead EKG machines, which provide an electrical picture of the entire heart.

Then, Babb explained, paramedics will be able to perform the EKG while en route to the hospital, determine whether or not a heart attack is occurring and send the information directly to the emergency room via cell phone. Doctors can then determine a method of treatment and begin it as soon as the patient arrives.

"Making that diagnosis early compresses treatment time and minutes are heart muscle. Every minute you save relates to a .1 percent reduction in mortality. Minutes are very important here," Babb said.

In Duplin County, there are eight trucks that officials are hoping to outfit with the portable EKGs. All of the county's paramedics are qualified to use the machines.

"It's taught in the paramedic program right now," Duplin emergency medical services director Brian Pearce said. "If we can achieve the grants, it shouldn't be hard to implement at all -- just purchasing the equipment and doing some in-service training on it."

The project will cost about $102,000 to set up, but county and hospital officials are hopeful much of that can be paid for through grants.

"We recognize that it is a significant expense," Babb said. "We at Pitt and East Carolina University are committed to writing grants that will help fund the project."

The program was presented to the Duplin County Commissioners earlier this month in order to gain their approval.

Duplin is one of seven counties in the first phase of this project. The estimated cost for all 29 eastern North Carolina counties is approximately $3.5 million. Wayne County will be included in either Phase 2 or Phase 3.

"There's a need for this in all the counties," RACE outreach coordinator Mary Printz said. "We have (the program) in three phases, but that doesn't mean any one phase is more important than the others.

"We've just got to start somewhere. Eventually we hope to work with all 29 counties and we're hoping it'll go very quickly. It's just a matter of getting the support from everybody. It's a collaborative effort."