Cardiac Alert program speeds heart attack care - East Valley Tribune: News

Cardiac Alert program speeds heart attack care

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Posted: Friday, October 31, 2008 6:02 pm | Updated: 9:39 pm, Fri Oct 7, 2011.

Six weeks ago, while working in his Apache Junction home office, Richard Rollins felt an unfamiliar pain gripping his chest. His initial response was to drive himself to the nearest hospital. Then, reason took over.

"Something in my head said 'No, let the (paramedics) do it,' " Rollins said. "They were here in minutes. The A.J. Fire Department saved my life. They knew what to do. They knew where to take me when I suggested another hospital. They got information to the hospital and got me to the right hospital quickly."

That hospital was Banner Baywood Heart Hospital, 6750 E. Baywood Ave. in east Mesa, which 10 months ago started a program that has delivered what emergency officials said are among the quickest response times for heart attack victims in the East Valley. The Cardiac Alert program is a partnership that has worked between Baywood hospitals and the Apache Junction Fire Department. Last week, the Mesa and Gilbert fire departments came on board.

In the Cardiac Alert program, a patient experiencing possible heart attack symptomscan have specially trained paramedics fax an electrocardiogram to a cardiologist for rapid diagnosis, rather than waiting until going to an emergency department and undergoing several procedures before doctors begin treatment.

Municipalities that haven't signed on to the program will continue to provide care but, in most cases, not as quickly as those that are part of Cardiac Alert. Under those procedures, the diagnosis of a heart attack is not made until the patient arrives at the hospital, which costs critical minutes during the initial response and transport by paramedics.

With the new program, first responders begin the diagnostic process, so that by the time the patient arrives at the hospital, doctors have already begun preparing a treatment plan that might include surgery.

"The new devices and cutting down the time involved saves lives," said Bill Hayes, chief of the Mesa Fire Department Emergency Medical Services unit.

In the program, a cardiologist reads the EKG and makes a diagnosis to paramedics by phone. Paramedics use 12-lead EKGs, rather than the normal ones with five leads. This literally gives cardiologists at the other end a more thorough picture to look at before making a diagnosis. If the cardiologist determines the patient is having a heart attack, he is brought to the hospital's emergency department and hustled to surgery. There, the blocked artery or arteries are opened.

The American College of Cardiology has a standard of 90 minutes from the time heart attack patients get to an emergency room to when their arteries are opened with a balloon - commonly known as an angioplasty. Longer than that, heart muscles and tissue can sustain serious damage, or a patient could die, doctors say.

From January to September, Banner treated 25 patients using Cardiac Alert. Patients' arteries were opened on an average of 48 minutes and as short as 29 minutes, which was Rollins' "door-to-balloon" time.The 60-year-old custom builder returned to one of Banner's five labs where a device was placed in a blood vessel and then guided to the heart to open the artery. Last week was his first time back to the room where the surgery was performed. The surgery was to implant a tiny wire-mesh stent in a clogged artery to prop it open.

Dave Montgomery, an Apache Junction battalion chief and fire marshal, said the program gives paramedics an opportunity to do things in the field that they hadn't been able to do before. "It goes to the most basic that if somebody's heart muscle is robbed of oxygen, there could be irreversible damage," Montgomery said. "The sooner we can get someone from the moment they feel something happening to having a doctor make a diagnosis is best for everyone."

According to Dr. Gary Smith, medical director for the Mesa Fire Department, fast response time for people who think they are having heart attacks is critical.

"Anyone who's experiencing heart attack symptoms needs to call 911, get a paramedic to evaluate them and get to the hospital fast," said Smith, a family and emergency medical physician. "That person needs to be taken to a 24/7 catheterization lab, which is much better for them."

Hayes agrees the program is ahead of standard care. "Before this, we could not tell if somebody was really having a heart attack before we got them to a hospital," he said. "The hospital tells us it sees about five patients like this a month. You save one, and it's a big deal."

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