Wyoming Medical Center earns American Heart Association's Mission: Lifeline EMS Silver Level award
By Kristy Bleizeffer May 13, 2015
Wyoming Medical Center has received the American Heart Association’s Mission: Lifeline® EMS Silver Award for implementing quality improvement measures for the treatment of patients who experience severe heart attacks.
Every year, more than 250,000 people experience a STEMI, or ST Elevation Myocardial Infarction, a type of heart attack caused by a complete blockage of blood flow to the heart that requires timely treatment. To prevent death, it’s critical to restore blood flow as quickly as possible, either by surgically opening the blocked vessel or by giving clot-busting medication.
Unfortunately, a significant number don't receive this prompt treatment. Mission: Lifeline seeks to save lives by closing the gaps that separate STEMI patients from timely access to appropriate treatments. The EMS recognition program recognizes emergency responders for their efforts in improving STEMI systems of care and improving the quality of life for these patients.
All WMC ambulances are equipped with 12M-lead EKG machines that can remotely send test results to ER doctors. Those doctors can determine if a patient has indeed suffered a heart attack and, if so, can send the test results to a cardiologist’s cell phone. Cardiologists, then, can head to the hospital while the heart team here can prepare the Cath Lab.
"Every minute counts when treating heart attacks," said Adrian Fluture, MD, FACC, FSCAI, Director of Regional Myocardial Infarction Care at WMC. "Two years ago, we introduced our new prehospital EKG protocol to accelerate our treatment. This allows physicians to start treatment protocols before the ambulance and patients have reached the hospital."
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. After streamlining processes both in the hospital and before patients arrive via ambulance, we've cut our door-to-balloon time to 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.
Agencies that receive the Mission: Lifeline Silver award have demonstrated at least 75 percent compliance for each of the following criteria:
- Patients over 35 years old with non-traumatic chest pain over 35 receives a pre-hospital 12-lead EKG if transported by EMS.
- STEMI patients transported to a STEMI Receiving Center, with pre-hospital first medical contact to treatment in less than 90 minutes.
- STEMI patients transported to a STEMI Referring Center with arrival to fibrinolytic therapy (using drugs to break up blood clots) in less than 30 minutes.
"Wyoming Medical Center ambulance staff has done a great job in making this accomplishment possible. When we first started this process, we scored 70 percent for accuracy," said Eric Evenson, ambulance manager at WMC. "Our team addressed the issues and designed new checks and balances. Our scores for 2014 accuracy was an amazing 99.63 percent. This is a clear representation of how great our EMS team is. I'm very proud to be a part of this team."
Ambulances are mobile emergency medical clinics. When paramedics reach you, they can treat low blood pressure, administer IVs and aspirin, remove clothing and prep you for immediate admission to the hospital. If you go into cardiac arrest, paramedics are trained with defibrillators and can resuscitate you – at home or en route to the hospital. Casper Fire/EMS crews, which may arrive on emergency scenes before anyone else, also carry and are trained on defibrillators.
“EMTs and paramedics play a vital part in the system of care for those who have heart attacks,” said Nancy Brown, Chief Executive Officer of the American Heart Association/American Stroke Association. “Since they often are the first medical point of contact, they can shave precious minutes of life-saving treatment time by activating the emergency response system that alerts hospitals. We applaud Wyoming Medical Center EMS for achieving this award that shows it meets evidence-based guidelines in the treatment of people who have severe heart attacks.”
The American Heart Association’s Mission: Lifeline® program helps hospitals and emergency medical services develop systems of care that follow proven standards and procedures for STEMI patients. The program works by mobilizing teams across the continuum of care to implement American Heart Association/American College of Cardiology clinical treatment guidelines. For more information, visit heart.org/missionlifeline and heart.org/quality.
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Dr. Adrian Fluture specializes in cardiology, interventional cardiology, and vascular/endovascular medicine. He is Director of Regional Myocardial Infarction Care at Wyoming Medical Center. Dr. Fluture is board certified in internal medicine, cardiovascular disease, interventional cardiology, nuclear cardiology, echocardiography and vascular medicine, and CT angiography. He came to Casper in 2008 and practices at Wyoming Cardiopulmonary Services.