The results are in: Mission: Lifeline has saved lives for Wyoming heart attack patients

By The Pulse Aug 28, 2015

Channel 13's Jackie Wetzler films inside a WMC ambulance while reporting on progress for the Mission: Lifeline program on Friday, Aug. 28.

Channel 13's Jackie Wetzler films inside a WMC ambulance while reporting on progress for the Mission: Lifeline program on Friday, Aug. 28.

As the three-year Mission:Lifeline Wyoming grant nears its conclusion, the American Heart Association says the initiative helped shave 17 minutes from the time a patient reports heart attack symptoms to the time blood flow is restored to the heart.

“For patients who have severe heart attacks, getting the fastest treatment is essential: time saves heart muscle, heart function and reduces death,” said cardiologist Adrian Fluture, M.D., F.A.C.C., F.S.C.A.I., Director of Regional Myocardial Infarction Care at Wyoming Medical Center.

The $7.1 million program, which began in 2012, focused on improving the system of care for Wyoming heart attack and cardiac arrest patients through a coordinated effort between hospitals and emergency first responders (EMS).

Never before has an initiative of this scope been orchestrated in the state of Wyoming. Nearly $3 million of the funding was invested directly into technology improvements, including equipment upgrades for Wyoming EMS and hospitals. The ST Segment Elevation Myocardial Infarction (STEMI) heart attack mortality rate at hospitals participating in the project was reduced from 7.1 to 4.4 percent, compared to the national average of 6.4 percent.

“We have made significant improvements in our overall completeness of care for myocardial infarction over the last few years," Fluture said. "Wyoming Medical Center's time to detect and then to treat heart attacks has been consistently among the very best in the nation. Major changes have been made in emergency medical services approach. All these have led to significant improvements in our heart attack survival rate.”


WATCH: Dr. Adrian Fluture why calling 911 at first sign of heart attack could save your life.

The American College of Cardiology recommends less than 90 minutes in door-to-balloon time – the time from when a patient arrives at the Emergency Room to the time a balloon is inflated in the blocked vessel. WMC averaged 77 minutes two years ago. With the help of Mission Lifeline, and after streamlining processes both in the hospital and before patients arrive via ambulance, we’ve cut our door-to-balloon time to an average of 45 minutes, within the top 10 percent of hospitals in the country. In fact, when a patient calls 911 instead of driving themselves to the hospital, we can cut another 10 minutes off door-to-balloon time.

In May, Wyoming Medical Center’s EMS earned Mission: Lifeline’s Silver Level award for treatment of heart attack patients in the field. In June, WMC won a Gold Level Plus Award for its treatment of patients inside the hospital.

Mission: Lifeline Wyoming provided the first statewide data tool for STEMI care quality measurement and improvement, offered ongoing medical provider training and STEMI heart attack education; coordinated protocols for rural EMS and hospital personnel and regional plans for rapid transport of patients. The program included funding for a statewide public awareness campaign designed to help Wyomingites recognize the signs and symptoms of a heart attack and to underscore the importance of dialing 911 at the first sign of a heart attack.

“The impressive level of commitment to the initiative demonstrated by Wyoming EMS agencies and hospitals is represented by the successes revealed in the most current data,” said Ben Leonard, AHA Mission: Lifeline director. Data collected since 2012 reveal the following key outcomes:

  • Increased EMS utilization (public calling 911) reduces time to lifesaving treatment by 47 minutes compared to personally operated vehicle transport;
  • 17-minute reduction in symptom-onset to arterial reperfusion (SOAR) time, which signifies the trend is declining between the time someone experiences heart attack symptoms to the time they receive treatments, saving heart muscle and lives;
    Cardiac team members pose in the Wyoming Medical Center Cath Lab control room. They are, from left, Drew Parsell, Samuel Cann, Wendy Johnson, Kim Mischke and Colin Gransbery.

    Cardiac team members pose in the Wyoming Medical Center Cath Lab control room. They are, from left, Drew Parsell, Samuel Cann, Wendy Johnson, Kim Mischke and Colin Gransbery. WMC won a Mission: Lifeline Gold Plus level award from the American Heart Association for our fast, expert care of heart attack patients.

  • Patients taken directly to a hospital equipped to treat heart attacks with lifesaving percutaneous coronary intervention (PCI) are receiving definitive treatment at an average time of 50 minutes, six minutes faster than the national average;
  • Acute care and critical access hospital’s (non-PCI hospitals) improved administration of lifesaving medication (thrombolytics) for STEMI patients transferring to PCI hospitals;
  • There was widespread hospital participation and engagement in the Mission: Lifeline Wyoming initiative with four WY PCI hospitals, five border-state PCI hospitals, 22 acute care and critical access hospitals;
  • 81 percent of Wyoming EMS participated and engaged in the efforts;
  • 555 hospital and EMS personnel received STEMI identification training;
  • Approximately 200 new Automated External Defibrillators (AEDs) were placed statewide.

Mission: Lifeline Wyoming was implemented after research indicated approximately 51 Wyoming residents are diagnosed with heart disease each day, putting them at greater risk for heart attack or sudden cardiac arrest. During a cardiac episode, every second counts in the race to restore blood flow to the heart. Shedding time from onset of symptoms to hospital care was found to be a challenge in a rural state like Wyoming.

About Mission: Lifeline

The $7.1 million program was funded through a $5.9 million grant from The Leona M. and Harry B. Helmsley Charitable Trust with additional funding from First Interstate Bank and the Wyoming Community Foundation’s Working for Wyoming Fund. Since 2010, the American Heart Association and the Helmsley Charitable Trust have launched similar Mission: Lifeline projects in Iowa, Minnesota, Montana, Nebraska, North Dakota and South Dakota. To learn more, visit www.heart.org/mlwyoming.

Call 911

At the first signs of heart attack, call 911. Never drive yourself to the hospital or have someone else drive you.  Here’s why:

Paramedic Eric Evenson shows a printout from an ambulance's portable EKG. The same readout is sent remotely to the Wyoming Medical Center Emergency Room in cases of a heart attack. Treatment begins immediately for patients who call 911 at the first signs of heart attack.

Paramedic Eric Evenson shows a printout from an ambulance's portable EKG. The same readout is sent remotely to the Wyoming Medical Center Emergency Room in cases of a heart attack. Treatment begins immediately for patients who call 911 at the first signs of heart attack.

  • You may crash your car: If you suffer a heart rhythm disturbance on the drive, you will likely crash. Worse, you may crash into another car or run over pedestrians. “These are unpredictable things. The thing I tell my patients is they may kill a mom with kids coming from school. Just be responsible,” Fluture said.
  • Cardiac resuscitation requires a team effort: Even if a loved one is trained in cardiac resuscitation, one person is not enough. He needs help to arrive as quickly as possible, and calling 911 is the fastest way to get it. If a loved one decides to drive you to the hospital and you go into cardiac arrest, he can’t do anything for you while he’s behind the wheel.
  • We can treat you faster if you arrive by ambulance: For people who call 911, treatment begins in the field. Paramedics will hook you to a 12-lead EKG and send the results straight to the ER who can send them straight to the cardiologists cell phone. If you are having a heart attack, a Code Heart can be called while you are still on your way to the hospital, meaning you will go straight to the Cardiac Cath Lab and shaving minutes off your treatment time.

Adrian Fluture M.D., F.A.C.C., F.S.C.A.I.

Dr. Adrian Fluture specializes in cardiology, interventional cardiology and vascular/endovascular medicine at Wyoming Cardiopulmonary Services, 1230 E. First St. in Casper. He is board certified in internal medicine, cardiovascular disease, interventional cardiology, nuclear cardiology, echocardiography and vascular medicine; and CT Angiography. He is also Director of Regional Myocardial Infarction Care at Wyoming Medical Center. For more information or referrals, call (307) 266-3174. 

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