Precious time is saved through new way to handle heart attack
Aug 05, 2008 - 11:51:33 CDT
When St. Peters’ resident Barbara Mitchell was visiting recently in the Farmington area, she became dizzy and felt as though she would pass out. Thinking her blood sugar might be low, she ate some candy but this didn’t help. Soon she broke out in a cold sweat and felt pressure in her chest and between her shoulder blades.
When she arrived at Parkland Health Center’s Emergency Department in Farmington, her arms felt strange. She also felt nauseated and remembers thinking, “If only I could burp.” But she couldn’t. Emergency nurse Rachel Wren suspected that Mitchell was experiencing a heart attack and immediately performed an EKG. Wren was right.
After consultation with the emergency department physician, long-time emergency department nurse Kathy Ferguson began a new way of taking care of patients with a specific kind of heart attack. Ferguson is specially trained in a new protocol for “STEMI” patients (a type of heart attack called S.T. Elevation Myocardial Infarction).
The protocol, called Heart LifeLine Alliance, is in partnership with Missouri Baptist Medical Center in St. Louis and Air Evac.
Within minutes, Mitchell had received the pertinent medications which had been assembled in advance in a special kit, and she was airlifted to Missouri Baptist. Meanwhile, with one phone call and one fax, the special protocol was in high gear; the cardiac catheterization team was already assembling and preparing for her arrival in St. Louis.
Within 16 minutes of landing at Missouri Baptist, Mitchell was in the cath lab with a balloon inserted in her clogged artery. “This is incredible time,” said Nancy Nahlik, manager of Regional Development at Missouri Baptist.
The beauty of the Heart LifeLine Alliance protocol is that it saves precious minutes that can mean the difference between life and death for a STEMI patient. The local emergency physician has the power to set the protocol in action without consulting with a cardiologist — this saves 20 to 60 minutes. Special medicines are assembled in advance in a kit — this saves 15 to 20 minutes. The patient is loaded into the helicopter with engines running and rotors spinning instead of shutting the engine down — this saves four to 14 minutes.
Patsy Coleman, manager of the E.R. department at Parkland said while the previous way to handle patients was a good one, the new one is better. The system is designed to shave minutes off the total time from when the patient enters the Emergency Department to when the patient receives the cardiac catheter. When weather prohibits transfer by air, the patient is taken by ground in an ambulance. If the patient’s heart attack does not qualify for this protocol, special “clot buster” medicines called thrombolytic therapy are given.
Dr. John Hunt, Medical Director of Parkland’s emergency department, said, “Like your brain, your heart needs oxygen; every minute without it may result in irreversible damage and/or death.”
He said the new way of transferring patients is a “high speed conduit leading from Parkland to some of the best heart facilities in the world.” He said that dramatically shortens the time it takes to get the heart breathing again.
Mitchell was the first Parkland Health Center patient to utilize this special new protocol. She was released from the hospital two days after her heart attack, and she says she feels great. A smoker for 42 years, she has quit. Her only prior hospitalization was to give birth to her two daughters. She had no prior symptoms, although her cholesterol was slightly high. Her advice to women is to educate themselves on the symptoms of a heart attack. “You may have all or none, but if in doubt, do something — do not ignore it,” says Mitchell.
Heart attack symptoms can differ between male and female victims. Coleman points out that Mitchell did not have typical heart attack symptoms such as gripping pain.
“It is more common for women to have atypical symptoms,” said Coleman. Typical symptoms include uncomfortable chest pain, pressure or squeezing sensation in the chest that lasts for more than a few minutes; pain that radiates to the shoulders, neck, jaw or arms; and chest pain accompanied by dizziness, sweating, nausea or shortness of breath.
“Women, however, can have less typical symptoms such as those of Barbara Mitchell,” says Coleman. In addition to the dizziness and the feeling of needing to burp but being unable to do so, atypical symptoms can also include pain or discomfort in the arms, back, neck, jaw or stomach; shortness of breath; breaking out in a cold sweat; nausea or light-headedness. Sometimes women experience no pain during a heart attack. If someone suspects someone is having a heart attack, call 911 immediately.
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When she arrived at Parkland Health Center’s Emergency Department in Farmington, her arms felt strange. She also felt nauseated and remembers thinking, “If only I could burp.” But she couldn’t. Emergency nurse Rachel Wren suspected that Mitchell was experiencing a heart attack and immediately performed an EKG. Wren was right.
After consultation with the emergency department physician, long-time emergency department nurse Kathy Ferguson began a new way of taking care of patients with a specific kind of heart attack. Ferguson is specially trained in a new protocol for “STEMI” patients (a type of heart attack called S.T. Elevation Myocardial Infarction).
The protocol, called Heart LifeLine Alliance, is in partnership with Missouri Baptist Medical Center in St. Louis and Air Evac.
Within minutes, Mitchell had received the pertinent medications which had been assembled in advance in a special kit, and she was airlifted to Missouri Baptist. Meanwhile, with one phone call and one fax, the special protocol was in high gear; the cardiac catheterization team was already assembling and preparing for her arrival in St. Louis.
Within 16 minutes of landing at Missouri Baptist, Mitchell was in the cath lab with a balloon inserted in her clogged artery. “This is incredible time,” said Nancy Nahlik, manager of Regional Development at Missouri Baptist.
The beauty of the Heart LifeLine Alliance protocol is that it saves precious minutes that can mean the difference between life and death for a STEMI patient. The local emergency physician has the power to set the protocol in action without consulting with a cardiologist — this saves 20 to 60 minutes. Special medicines are assembled in advance in a kit — this saves 15 to 20 minutes. The patient is loaded into the helicopter with engines running and rotors spinning instead of shutting the engine down — this saves four to 14 minutes.
Patsy Coleman, manager of the E.R. department at Parkland said while the previous way to handle patients was a good one, the new one is better. The system is designed to shave minutes off the total time from when the patient enters the Emergency Department to when the patient receives the cardiac catheter. When weather prohibits transfer by air, the patient is taken by ground in an ambulance. If the patient’s heart attack does not qualify for this protocol, special “clot buster” medicines called thrombolytic therapy are given.
Dr. John Hunt, Medical Director of Parkland’s emergency department, said, “Like your brain, your heart needs oxygen; every minute without it may result in irreversible damage and/or death.”
He said the new way of transferring patients is a “high speed conduit leading from Parkland to some of the best heart facilities in the world.” He said that dramatically shortens the time it takes to get the heart breathing again.
Mitchell was the first Parkland Health Center patient to utilize this special new protocol. She was released from the hospital two days after her heart attack, and she says she feels great. A smoker for 42 years, she has quit. Her only prior hospitalization was to give birth to her two daughters. She had no prior symptoms, although her cholesterol was slightly high. Her advice to women is to educate themselves on the symptoms of a heart attack. “You may have all or none, but if in doubt, do something — do not ignore it,” says Mitchell.
Heart attack symptoms can differ between male and female victims. Coleman points out that Mitchell did not have typical heart attack symptoms such as gripping pain.
“It is more common for women to have atypical symptoms,” said Coleman. Typical symptoms include uncomfortable chest pain, pressure or squeezing sensation in the chest that lasts for more than a few minutes; pain that radiates to the shoulders, neck, jaw or arms; and chest pain accompanied by dizziness, sweating, nausea or shortness of breath.
“Women, however, can have less typical symptoms such as those of Barbara Mitchell,” says Coleman. In addition to the dizziness and the feeling of needing to burp but being unable to do so, atypical symptoms can also include pain or discomfort in the arms, back, neck, jaw or stomach; shortness of breath; breaking out in a cold sweat; nausea or light-headedness. Sometimes women experience no pain during a heart attack. If someone suspects someone is having a heart attack, call 911 immediately.