11/11/07 — Paramedic units work to increase heart attack survival rates

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Paramedic units work to increase heart attack survival rates

By Matthew Whittle
Published in News on November 11, 2007 2:12 AM

With impressive results being reported by emergency medical officials, doctors and the 65 hospitals participating in a statewide program headed up by Duke University Medical Center to improve cardiac care in North Carolina, both Wayne and Duplin counties' emergency medical departments also are working to provide better and faster treatment to patients suffering from heart attacks.

But they are doing so in different ways.

Heart attacks occur when arteries become blocked. The best treatment is angioplasty, also known as heart catherization. It involves using a small balloon to re-open the artery. The other option utilizes clot-busting drugs. To be most effective though, those drugs must be administered within 30 minutes, while angioplasty must be done within 90.

To help them meet those timeframes, Duplin's paramedics are preparing to use new technologies to improve their diagnostic abilities and to decrease the amount of time it takes to initiate treatments, while Wayne paramedics are continuing to focus on reducing response and transport times.

The goal of both approaches is to get patients into treatment faster because speedier care means more lives saved.

In Duplin, the plan is to begin outfitting each of the county's nine paramedic ambulances with a 12-lead EKG monitor by Dec. 1.

Currently, said county Emergency Management Director Brian Pearce, officials are finishing the training process.

Once the machines are in place, they will allow paramedics to take a much more detailed picture of a patient's heart than is currently possible.

Right now, Pearce explained, they are able to take pictures of the heart from only three angles. With the new equipment, they will be able to look at it from 12, allowing the paramedics to interpret what those pictures mean and then diagnosis the patient's condition.

Then, he explained, the last piece of the puzzle will eventually be for the ambulances to transmit those pictures directly to the patient's doctor while en-route so a treatment plan can be prepared. That option will likely be available in early 2008.

"Everything is time frame with this," Pearce said. "Everything about this is about saving time and there is quite a time savings by going ahead and recognizing a heart attack pre-hospital."

In Wayne, though, explained Emergency Medical Services Director Blair Tyndall, those machines aren't being used.

"We don't have the 12-lead EKGs," Tyndall said. "We have the three-lead monitors. We try to base all our stuff on response times and getting to the patients quickly."

He explained that the decision to forego the equipment was based largely on the advice of county medical director Dr. Terry Grant.

Tyndall explained that Grant's concerns included the amount of training such systems require, their expense and the human cost if a diagnosis turned out to be wrong on the ambulance.

"It's certainly something that should be done in a controlled setting, and something that cannot be trusted in the back of an ambulance," he said.

Besides, with an average response time of six minutes, it's often easier to just go ahead and bring the patient into the hospital for diagnosis and treatment, Tyndall said.

"About 90 percent of the time we can be on the scene within six minutes (from one of our nine paramedic stations)," he said. "We try respond to the patients as soon as possible and get them to a medical facility as soon as possible."

But if necessary, Wayne's paramedics also are qualified to provide care -- including administering certain types of cardiac drugs -- on the scene, Tyndall added.

"We've got all the tools and medication that they would have in the emergency room," he said. "But our main goal is to stabilize the patients and get them to a medical facility as soon as possible."