Over the last couple of years working in the Emergency Department at UnityPoint Health - Finley Hospital, Hannah Blum, RN, BSN, has heard many reasons patients don’t call 9-1-1 when they are having heart attack symptoms.
“I can get there faster than the ambulance.”
“I don’t live far.”
“It may be nothing.”
Unfortunately, not calling the professionals immediately can delay the important and life-saving care patients need.
As they say in the heart world, time is muscle.
“The quicker we can get somebody into the Cath Lab, the more likely it is we are going to be able to intervene and save heart muscle,” said Greg Simpson, RN, a nurse in the Cardiac Catheterization Lab at Finley Hospital. “The quicker we do that, the more likely the outcome is going to be better.”
When someone calls 9-1-1 when they have heart attack symptoms, their care gets a jump-start before they even get to the hospital. While on the road, paramedics are sending patient information, symptoms, and test results to the hospital ahead of their arrival.
A 12-lead EKG, which is performed by attaching 12 electrode patches to the patient’s chest, arms, and legs, shows a multi-angle picture of the heart. It allows providers to assess whether the patient is having a STEMI, short for a ST-elevation myocardial infarction, or heart attack.
“If someone is coming in by EMS with a heart attack, EMS will fax us their 12-lead EKG and once we get that we will have one of our ER providers look at that,” Hannah said. “If they see that ST elevation, they can confirm that is in fact a heart attack, we can go ahead and have the clerk page the cath lab and the cardiologist on call.”
With that information from EMS, nurses, the emergency department, cardiologist, and cath lab can all be at-the-ready when the ambulance arrives – saving precious minutes.
“Our partnerships with the area hospitals are extremely crucial and it’s for that reason of getting the patient to definitive care,” said Scott Brachman, a medical officer with Dubuque Fire Department. “If we have a good working relationship, we can rely on each other to obtain that data and more quickly activate the response.”
If a patient comes into the emergency department by private vehicle, they first check in at the triage desk and let the nurse know they are having heart attack symptoms. The nurse will get their name, birthdate, and some additional information, then they will get them into a room.
“Once that patient gets to a room, they become a very popular patient,” Hannah said. “We come at them from all different angles, one of us is working on getting them into the computer system, another nurse is working on getting them into a gown and on the heart monitor, another nurse is working on that 12-lead EKG, someone else is working on an IV site, we’re getting a provider at the bedside.”
Once the 12-lead EKG is completed and a heart attack is confirmed, the journey is similar to those who arrived by EMS – the cath lab is activated and the patient heads there for treatment.
“We have an elevator that runs from the ER to our cath lab, so it’s seamless,” Greg said.
Once in the Cath Lab, the fast pace continues, as the team hooks the patient up to monitors, sanitizes the areas they are going to work on, and begins the procedure.
“Regardless of how you got here, whether that’s by EMS or by private car, our goal here at Finley Hospital is door-to-balloon in 60 minutes, meaning from the moment you walk through the door or roll through the door to the time you’re up in the Cath Lab and that stent is being placed and all of the steps that happen in between,” Hannah said. “We like all of that to happen within 60 minutes so that we can continue to provide that best patient outcome.”