New Technology Can Cut Heart Attack Treatment Time

Lifenet instantly transmits EKGs from ambulance

During a heart attack, lost time means lost heart muscle. Every minute is crucial when paramedics respond to a patient experiencing heart attack symptoms.

With the help of new Lifenet technology, emergency
physician Dr. David Dierks views the EKG of a patient
that has been transmitted from a MEDIC-EMS ambulance
to the Genesis, East Rusholme St. Emergency Dept. If
the EKG indicates a heart attack is in progress, the
hospital can mobilize staff before the patient even
arrives at the hospital. In this instance, the EKG is normal.

Now MEDIC-EMS ambulances are equipped with new technology that instantly transmits a patient’s electrocardiogram (EKG) to the Emergency Department at Genesis Medical Center, Davenport as the patient is en route to the hospital. Doctors there can view the diagnostic-quality results on a large screen and determine if a heart attack is indeed in progress. If so, they can call the alert that mobilizes a heart attack response team to be ready for the patient’s arrival.

The Lifenet EKG System went live June 11 and has the potential to shave minutes off what the health care industry calls “door-to-balloon time.” National care guidelines give doctors a 90-minute window from the time a patient arrives at the hospital to the time a balloon should be inserted into the blocked artery during angioplasty.

“During a heart attack, time is muscle,” said Craig Sommers, Executive Director of the Genesis Heart Institute. “The sooner we can open up the blocked artery with balloon angioplasty in the Cath Lab, the sooner we can save heart muscle and increase the patient’s chances of survival.

“With the new Lifenet technology, we can diagnose a heart attack sooner. Our cardiac team can prepare for a patient’s arrival, and he or she can be immediately treated in the Cath Lab upon reaching the hospital instead of spending additional assessment time in the Emergency Room.”

At Genesis, Davenport, the average doorto- balloon time over the past six months was 54 minutes--meaning from when the patient entered the hospital to when the blocked artery was opened. That's considerably faster than the national standard of care of 90 minutes.

Now, before an ambulance leaves the scene of a call, the patient’s EKG is sent to the Emergency Department at Genesis, East Rusholme Street via the Lifenet system.

“It’s a really big step in patient care,” said Jerry Williams of MEDIC-EMS. “Whenever we respond to a patient having chest pain, we automatically do a 12-lead, or a diagnostic EKG. We’ve all been trained to read it and tell the doctor what we see.

“But with this new Lifenet technology, the EKG transmission is almost immediate. The doctor can make the diagnosis; give medication orders in the field; and, doesn’t have to wait for us to arrive at the hospital with a hard copy of the EKG. The doctor can actually see what we’re seeing, even if we’re 10 minutes away from the hospital. It will help speed the process of getting the patient definitive care at Genesis and ultimately improve outcomes.”

The Lifenet EKG can also be sent to a cardiologist’s smart phone or computer, he added. If the cardiologist is being called in from home or another location, the physician can look at the EKG prior to arriving at the hospital.

“What this does is allows us to have is an advanced start in the race to open the blocked artery,” said Steven Bashor, D.O., Medical Director of the Emergency Department, Genesis Medical Center, Davenport.

MEDIC-EMS critical care paramedic Robert Frakes
shows how the Lifenet technology looks from
inside the ambulance.

“Before the Lifenet technology, paramedics would view the results and interpret or describe them over the phone to the Emergency Department. With LifeNet, physicians actually get to see the EKG with their own eyes. Paramedics can tell us over the phone whether someone looks sick or not...is sweaty, short of breath...having chest pain, but a 12-lead EKG is very difficult to interpret correctly all of the time without all the proper information.”

Dr. Bashor added, “Sometimes that proper information involves comparing the new EKG to a previous EKG the patient may have had. If we have the patient’s first initial, last name and date of birth, we can go to a hospital database that all Emergency Department physicians have access to and compare the patient EKG that was transmitted to us through LifeNet with an earlier one in the record.”

Fast response times

In 2004, Genesis was at the forefront of developing the heart attack alert system as unfolding research showed the critical importance of rapidly opening the artery during a specific type of heart attack called a STEMI, or “ST-elevation myocardial infarction.”

Such a reading on the EKG indicates the most serious kind of heart attack and an urgent need for emergency angioplasty.

Once the emergency physician determines a heart attack is in progress, the alert goes out to everyone involved in the patient’s care -- from the emergency physicians and nurses to the cardiac catheterization lab team so that preparation for the heart procedure can begin.

Heart attack alerts are also conducted at Genesis Medical Center’s Illini and DeWitt campuses.

”The sooner you intervene in the race, the less damage there is to the heart muscle. Lifenet improves our chances to beat the 90-minute window of time to open the blocked artery,” Dr. Bashor said. “This earlier view of the EKG results is especially important at times when the Cath Lab is closed at night or on weekends, and we have to call staff in from home.”

It’s quite an orchestration as various health care disciplines -- from paramedics in the field to the E.D. staff to the Cath Lab team -- respond, he concluded. It means gathering information and tests; assembling staff; transporting the patient to the Cath Lab; and, getting him or her on the table before beginning the catheterization.

“This requires a diagnostic angiogram to pinpoint the blockage; then passing a wire across the blockage; and, inserting a balloon inside a tiny artery of the heart to restore blood flow,” Dr. Bashor said.

“When you consider everything that needs to happen, it’s amazing that we can do this so fast.”