Christian Hospital takes heart attack care to the scene

Through Christian Hospital’s new HeartWatch program and its Heart Attack Rapid Response Team, heart attack victims in North County are now getting care at the scene that links emergency department physicians and staff, cardiologists, cardiac catheterization and intervention lab staff, and other ancillary departments to anticipate the patient’s hospital arrival.

Earlier this summer, Christian Hospital equipped its eight, advanced life-support ambulances with12-lead EKG machines, the same used in the emergency department, to begin diagnostic work immediately in the field.

The EKG is then transmitted to the emergency department via fax or phone technology soon after completion — before the patient gets to the hospital. Lab draws also are done in the field.

If appropriate, thrombolytic drugs can be administered at the scene. Otherwise the patient will be taken to the cardiac catheterization laboratory for emergency catheterization, angiography and intervention using coronary angioplasty and stent within the shortest possible time to expedite needed opening of the occluded coronary artery to minimize damage to the heart muscle.

“What we’ve started is a program that expedites the treatment of acute heart attacks,” says Antonio Penilla, MD, CH cardiologist. “Everybody knows the sooner the treatment is given the better the outcome for the patient. With that in mind, we put together a package we call HeartWatch to give residents the most rapid and appropriate treatment of acute heart attacks, by facilitating the diagnosis and recognition of the heart attack quickly.

“We have been working closely beginning with paramedics in the field through the emergency department to the cath lab and up to the ICU and telemetry units where the patients end up – from first contact to being placed in a bed,” says Dr. Penilla. He said that by the time a heart attack patient arrives here via a CH ambulance, everyone is ready and waiting.

“The goal is to reduce the time the patient has to spend in emergency when they’re having an acute heart attack,” says Jacqueline Randolph, Christian Hospital EMS manager. “We’re trying to minimize the field-to-cath lab time in order to reduce the amount of time the patient has to be in the emergency department. We have a checklist the cath lab needs completed.”

Christian Hospital currently exceeds all state and national best practice averages related to emergency care for heart attack and congestive heart failure, according to the U.S. Department of Health and Human Services.

“We’re a mobile emergency room when it comes to treating a heart patient, and that is our goal,” says Kevin Altman, EMS ambulance paramedic. “We cover a 110 square miles right here in North County and we run almost 30,000 calls a year and see a lot of cardiac and respiratory patients.”

Randolph points out that future plans call for Christian to train other EMS providers in the area on offering 12-lead EKGs and transmitting to the emergency department from the field. “We’re raising the bar for heart care in North County,” says Randolph, “and we will share the technology with our counterparts as we continually improve health care in this community.”
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