Pager and text message alerts beep and buzz in unison across the Penrose Hospital campus. “STEMI ALERT TO PH ER (10 MIN OUT) 59 YR MALE,” reads the message. With efficiency patterned after race-car pit crews, the medical team springs into action. A 59-year-old man is experiencing a “STEMI” — the most dangerous and time-sensitive type of heart attack — and he’s headed to Penrose Hospital. The ambulance will be here in 10 minutes. Every minute that can be saved in providing treatment is important.
Each year more than 1.2 million people in the United States suffer heart attacks. Heart attacks are a leading killer of both men and women in the United States. Those who survive a heart attack frequently experience lifelong disability.
During a heart attack, a clot blocks the flow of blood that delivers oxygen to the heart muscle. Without this oxygen, the heart begins to die. The more time that passes without treatment to restore the flow of blood, the greater the chance of damage or death.
In the past 10 years, medical professionals have been working to increase the speed with which appropriate heart attack treatment can be delivered. For “John,” our 59-year-old man in this case, the process began with him calling 9-1-1, soon after he experienced crushing chest pain. The fire department and ambulance teams quickly arrived at his home and performed an EKG — a test of the heart’s electrical activity — which confirmed he was having a heart attack. He was given preliminary treatment and loaded into the ambulance. While he was on the way to the hospital, a copy of his EKG was faxed to the Penrose Emergency Department, where the physician confirmed the STEMI diagnosis and initiated what they call a Cardiac Alert: The pager message above was sent to alert the treatment team that John would soon be arriving.
Hospitals have clot-busting drugs and other artery-opening treatments that can stop a heart attack and restore the flow of blood to the heart. If these treatments are given soon after the symptoms begin, they can prevent or limit death and damage of the heart muscle. To be most effective, these treatments need to be given within one hour of the initial heart attack symptoms.
When John arrives at the hospital, he is quickly wheeled into the emergency room where the team goes to work. In a flurry of activity, tests are done, medication administered, and in less than 10 minutes, he is rushed to the “cath lab” where a wire can be inserted to open the vessel in his heart that has become blocked.
In 32 minutes from the time he passed through the hospital door, just over an hour after his initial chest pain, John’s heart muscle is receiving blood to the area that was being starved. John was discharged from the hospital two days later with minimal damage to his heart and expectations for a full recovery.
Acting quickly to initiate treatment is key when someone experiences a heart attack.
While people tend to take action when they have crushing chest pain, too often heart attacks present with less clear-cut symptoms: pain in the jaw, neck, shoulders, back or stomach, shortness of breath, cold sweat or nausea.
Often people attribute these symptoms to something else, waiting for symptoms to pass while their heart muscle is dying.
For our patients in Colorado Springs, the typical person experiencing a heart attack waits more than two hours before seeking treatment, with one out of five waiting more than six hours.
The most important thing to do if someone may be having a heart attack is to call 9-1-1 quickly.
Activating the Emergency Medical System allows them to quickly come to the patient and to begin the treatment process on location and while en route to the hospital. As we saw in John’s case, the fire department and ambulance team are able to alert the hospital when they’re on their way, so the Emergency Department team is prepared to act quickly upon arrival.
“Time is muscle,” is the statement frequently heard about heart attack care. An entire system of medical professionals has been fine-tuned to quickly provide the treatment that can save lives and minimize permanent damage.
Setting that system in motion is easy, by dialing 9-1-1, and can only be done by the person experiencing the heart attack or by someone who cares about them. In the words of a new national education campaign, “Make the call, don’t miss a beat!”
Scott D. Campbell, who holds a doctorate of education, is the chest pain center coordinator at Penrose-St. Francis Health Services.