From the moment you realize you think you are having a heart attack, you are in a race to beat the clock. You are now part of the team to save your life. This team is trained, ready, and everyone knows their role, but you are the most important by starting the call to 911.
According to Buena Vista Regional Medical Center Director of ER Joan Prach, “The patients that call 911 start the process to help themselves and activates our staff to do their role. Those patients that choose to drive themselves in can be losing precious minutes of saving themselves.”
Seconds become minutes and minutes become hours. According to the American Heart Association, the ideal time to save a heart attack patient is 3 hours or less. BVRMC is leading the area by working with the American Heart Association Mission: Lifeline to maximize every minute to save a heart attack patient.
The heart is a muscle that once damaged cannot repair itself. It is not like your skin that can heal a wound over time. A heart attack patient needs a specialized doctor, a cardiologist, who work with specialized staff and equipment called a carth lab. A cath lab, or a cardiac catheterization laboratory, is a specialized exam room with diagnostic imaging equipment used to find any disease in the heart muscle, valves or coronary arteries. The closest to Storm Lake are in Sioux City and Fort Dodge.
After you call 911, the faster the ambulance, emergency room, and heart specialists work together the better your chance for surviving a heart attack.
About two years ago, the BVRMC staff started looking at how they worked with heart attack patients. The procedure, like most rural hospitals, was to have the ambulance pick up the patient and bring them to the emergency room. Then the emergency room staff would take an electrocardiogram (EKG) test, send the results to a cardiologist and wait for instructions on how that cardiologist wanted the patient treated. Every cardiologist may have different instructions on how they want the patient treated. If the EKG, which measures the electrical activity of your heart, shows problems then the patient would be transported to the cath lab by ambulance or medical helicopter.
What the BVRMC staff recognized was that it took precious time to transport the patient to the emergency room, perform and read the EKG, to then often transport the patient to a cath lab about an hour away. They started to talk about how they could save time off this process. It would require everyone in the group who was responding to a 911 call to work together and agree on a standard set of rules to follow, no personal preferences based on individuals so that everyone wouldn’t waste time trying to figure out what those preferences would be.
What came out of the BVRMC staff wanting to provide better care for patients was a system that trained the Emergency Services Staff (EMS) who were the first to respond to a 911 call to have portable EKG monitors that could measure and read heart activity and send a report directly to a cardiologist. As the EMS staff continue to help the patient and start the transport, if the cardiologist feels the patient needs a cath lab then the ambulance could bypass BVRMC and go directly to a cath lab or meet the medical helicopter. Minutes, precious minutes are now saved. BVRMC is the first rural hospital in the area to offer this service.
Because of this work, BVRMC was asked to join the American Heart Association Mission: Lifeline initiative for the state of Iowa, which has the goal of standardizing how rural hospitals respond to heart attack calls in the state. Director of Emergency Services Joan Prach serves on the Referring Hospitals Committee and Paramedic Matt Imming serves on the EMS Providers Committee.
BVRMC Specialty Clinic doctor, Dr. Deborah Majerus serves on the Receiving Hospitals Committee.
“The work of Mission Lifeline is a system of care where everyone knows their role without asking, which saves patients precious minutes to save the heart muscle. From an EMS perspective we can perform and react faster to better help a patient because I know what each team member before and after me will be doing,” explains Matt Imming.
Joan Prach goes on to say, “What people don’t always realize is it isn’t just one person that saves a life – it’s a team of people you see and don’t see. If that team is trained to respond knowing their role to save even a minute during a heart attack we can save more lives.”
A unified protocol results in better outcomes. BVRMC patients can expect consistent and faster response to their needs. BVRMC staff has a unified protocol which takes the variable out of different orders from different doctors. Cardiologists that work with BVRMC know they will see patients quickly so they can perform life-saving procedures in their cath labs. The team wins.