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Posted: Monday, August 29, 2016

Time is Critical to Cardiac Care

If you or a loved one has experienced a heart attack, you know every minute counts. This is because every minute that blood flow to the heart is obstructed is another minute of potentially life-threatening damage the heart is taking. Each year in the United States, approximately 250,000 people experience a STEMI (ST segment elevation myocardial infarction) caused by a complete blockage of blood flow. To preserve heart tissue and prevent death, it’s critical to restore blood flow as quickly as possible by opening the blocked vessel or by giving clot-busting medication. The amount of time it takes to do so is the subject of much study and even some healthy competition among health care providers.

“The amount of time it takes to help a heart attack patient typically is measured from the time he or she enters the hospital to the moment when the cardiac care team unblocks the vessel that is causing the heart attack, usually by deploying a balloon-type device into the coronary artery,” said Blount Memorial cardiologist Dr. Jane Souther. “This is referred to as ‘door-to-balloon’ time or ‘door-to-open-vessel time.’ The American Heart Association’s target ‘door-to-open-vessel time’ for hospitals nationwide is within 90 minutes, though most hospitals around the country have gotten that time down to about 60 minutes. Currently, Blount Memorial’s STEMI team performs well-above the national average with ‘door-to-open-vessel’ times under 40 minutes, which puts the hospital in the top 10 percent in the nation,” Souther explained. “The American Heart Association also has started looking at ‘first-medical-contact-to-open-vessel times,’ which begin from the time an ambulance arrives on the scene to the time that the patient’s blocked vessel is open. They are asking that that number also be under 90 minutes. At Blount Memorial, our ‘first-medical-contact-to-open-vessel time’ currently is 78 minutes,” she added.

“Being in a smaller community helps us with those times,” Souther continued. “It allows us to mobilize our staff faster. We’ve also put into practice a process that allows paramedics and first responders to call a heart attack from the field if they notice signs or symptoms. They can literally call the emergency department from the field to activate our STEMI team before the patient ever arrives at the hospital. Doing this helps us to be there and be ready faster than ever before, so it’s been a huge collaborative effort,” she said. “Sometimes, we don’t even stop patients in the emergency room. We take them straight to our cath lab after they arrive in the ambulance,” she added.

Earlier this month, Blount Memorial was recognized for outstanding heart attack treatment, receiving the 2016 Gold Recognition Award from the American Heart Association’s Mission: Lifeline® quality improvement program. “That was a huge accomplishment for our STEMI team,” Souther said. “We’ve worked very hard over the years to try to improve a process that is life-threatening for people. We have worked as a team to try to give the people in this community excellent care, and we’re very proud of that accomplishment. That said, we never stop. We’re always looking for ways to improve things so that we can provide excellent care to our patient population. Part of that requires educating people that they need to activate the medical system faster if they believe they or their loved one is experiencing a heart attack. We need to get people more accustomed to recognizing symptoms and contacting 911 as quickly as they can. It doesn’t matter how quickly we can get a vessel open if the patient has been sitting at home for six hours denying symptoms,” she explained. “It’s also important for people to realize that the ambulance is not just a ride to the hospital. There are a lot of things that are going on in the back of an ambulance – such as defibrillation for arrhythmias, starting blood thinners and transmitting an EKG – that can save a life before a person gets to the emergency department. This is why it’s often better to call 911 as opposed to coming to being driven to the hospital by a loved one,” she added.

Blount Memorial previously received Bronze Recognition and Silver Recognition Awards in 2013 and 2015, respectively. In addition to Souther, Blount Memorial’s team of cardiologists includes Dr. Andrew DeNazareth, Dr. Michael Gallagher, Dr. Bhavin Patel, Dr. Peter Scott, Dr. Alan SmucklerDr. Aiswarya Sundaram and Dr. Taylor Weatherbee.

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