Wyoming Medical Center EMS earns American Heart Association’s Gold level award for quick care of heart attack patients
By Kristy Bleizeffer May 17, 2016
Wyoming Medical Center has received the American Heart Association’s Mission: Lifeline® EMS Gold 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.
"Every minute counts when treating heart attacks," said Adrian Fluture, MD, FACC, FSCAI, Director of Regional Myocardial Infarction Care at WMC. "Four years ago, we introduced our new prehospital EKG protocol to accelerate our treatment. This allows physicians to start treatment before the ambulance and patients have reached the hospital."
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 prepares the Cath Lab.
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 three 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 Gold award have demonstrated at least 75 percent compliance for each of the following criteria:
- Patients over 35 years old with non-traumatic chest pain 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.
"Our paramedics and EMTs are dedicated to making our ambulance service among the best in the country,” said Eric Evenson, ambulance manager at WMC. "This is a clear representation of how great our EMS team is, and I'm very proud to be a part of it."
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 James Jollis, M.D., Chair of the Mission: Lifeline Advisory Working Group. “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.”
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.