Houston Healthcare Launches New Lifesaving Heart Attack Emergency Response System

Houston Healthcare's Emergency Medical Services (EMS) recently implemented a new countywide emergency response system that could save or improve the lives of patients experiencing a form of high-risk heart attack called STEMI, or ST Elevation Myocardial Infarction.

"STEMI heart attacks are considered very serious because there is a total obstruction of blood supply to that area of the heart," explains John A. Shivdat, DO, Medical Director of Houston Healthcare's EMS and Chairman of the Emergency Departments for Houston Medical Center and Perry Hospital. "The heart muscle begins to die immediately and without intervention, these patients have a very high death rate. The goal standard is for these patients to undergo emergency cardiac catherization immediately."

During a STEMI heart attack-which is caused by a clot or a loose piece of plaque from an artery wall-the immediate goal is to restore blood supply to the affected area of the heart. Both the American Heart Association (AHA) and the American College of Cardiology (ACC) recommend this be done within 90 minutes of the first sign of chest pain. The AHA estimates 400,000 people in the United States experience a STEMI heart attack each year with only 32 percent receiving lifesaving cardiac treatment in the 90-minute timeframe. For those individuals, an on scene diagnosis by emergency responders can significantly reduce delays in treatment and improve survival rates.

According to David Borghelli, Director of Houston Healthcare's EMS, that is the primary goal of the nationally recognized STEMI emergency response system. "Time is an essential component of cardiac catherization," he says. "The sooner it is done, the greater the overall outcome of the patient because in a heart attack, time is muscle-in this case, heart muscle. The goal of the STEMI system is to prevent or minimize damage to the heart muscle by reducing the length of time from when the first chest pains are felt to when medical intervention begins."

Houston County's new STEMI emergency response system begins when paramedics with Houston Healthcare's EMS, who respond to more than 1,000 chest pain calls annually, arrive on scene and use a 12-lead electrocardiographic (EKG) unit to determine if the patient is experiencing a STEMI heart attack. The paramedics then transmit the EKG results via wireless remote technology to a Houston Healthcare emergency physician for diagnosis. Communicating via radio, the physician and paramedics work to stabilize the patient for direct transport to the most appropriate medical facility-the nearest emergency department or a specialized cardiac center-for immediate treatment. Knowing in advance the patient's diagnosis, staff at the receiving medical facility are prepared to provide the necessary interventional treatment without delay to the arriving patient.

"Prior to the STEMI system, patients experiencing a suspected heart attack were transported to the closest emergency department where the actual diagnosis of a heart attack would be made," explains Borghelli. "Then, if specialized cardiac procedures were needed, the patient would be transported to a second facility for further treatment. With this new system, patients who are experiencing a STEMI heart attack can be quickly diagnosed on scene and then transported directly to the closest and most appropriate cardiac specialty center for immediate treatment, thus saving valuable time and, possibly, their life."

With an entire fleet of ambulances equipped with 12-lead EKG units, wireless remote technology and emergency personnel highly trained in advanced cardiac life support, Houston Healthcare's EMS is one of the few in Georgia to provide the new STEMI emergency response system, says Grady W. "Skip" Philips, Chief Executive Officer for Houston Healthcare. "The ability of our EMS to transmit clear diagnostic EKGs from the scene in real time helps our ER physicians determine the best path of treatment for the STEMI patient, thus saving precious time," he continues. "This new emergency response system will set a new standard for cardiac care in Houston County."

That new standard was put to the test within the first 10 days of implementation when Houston Healthcare's EMS responded to a 911 call for a possible heart attack. Using the new technology, EMS personnel successfully identified the STEMI heart attack on scene and transported the patient to a cardiac specialty center within 47 minutes. "This was the first real time 90-minute direct transport for our EMS using the new STEMI system, and it worked wonderfully with outstanding results," comments Borghelli. "We were able to get the patient to the appropriate facility where he received immediate cardiac treatment under the 90-minute timeframe."

Linda Harris, a Warner Robins native and Houston Healthcare employee, credits the life of her children's father to the quick actions of their 14-year-old son, Ben, who called 911; the advanced training of the EMS personnel who responded; and to the new STEMI emergency response system, which enabled her ex-husband to undergo emergency cardiac catheterization within minutes upon arriving at the hospital. "If EMS had not done everything they did, he would not be alive today," she says. "He survived this massive heart attack because of his direct transport."

Despite this initial success of the new STEMI system, Borghelli adds that ultimate success-and survival-of a heart attack begins with education. "We can have the latest technology in our ambulances, highly trained EMS personnel skilled in recognizing STEMI heart attacks, and transport patients as fast as possible, but none of that matters if we don't get the call because someone doesn't know the symptoms of a heart attack," he says.

Symptoms of a heart attack include, but are not limited to, discomfort in the center of the chest that lasts for more than a few minutes, or that comes and goes; pain or discomfort in one or both arms, the back, neck, jaw or stomach; shortness of breath; cold sweat; nausea; or lightheadedness.

"It's critical that anyone experiencing symptoms or who thinks they may be experiencing symptoms of a heart attack call 911 immediately," urges Borghelli. "It could, literally, make the difference between life and death for that person."