By GUIDON staffJanuary 15, 2015
A General Leonard Wood Army Community Hospital performance improvement project has shaved valuable minutes off the helicopter evacuation time needed to transfer patients identified as having heart attacks to a facility for specialized treatment.
The process streamlines an agreement between the Fort Leonard Wood hospital and Mercy Health Care System's Lifeline emergency helicopter evacuation service and so far is saving nearly 20 minutes in transferring heart attack victims for special treatment.
Called Stemi-hot Load, the practice decreases the overall time a patient suspected of suffering a heart attack is transferred from GLWACH and loaded on the emergency helicopter.
"Certain types of heart attacks can be identified relatively quickly by an electrocardiogram. Once conformation is obtained that a patient is having a heart attack, we activate the Stemi-hot Load protocol," said Randall Moore, Supervisory nurse, Emergency Medicine.
"Although this protocol encompasses many aspects, it most importantly includes contacting a facility capable to accept and treat the patient, administering medication requested by the accepting facility, contacting and meeting a helicopter flight services at the landing pad, reporting and transferring care of the patient at the loading site," Moore added.
According to Moore, since the implementation of the protocol, GLWACH decreased overall Emergency Department time by 19 minutes. "This is a 68 percent decrease in overall Emergency Department time and, most importantly, 19 minutes of heart muscle that we have saved," Moore said.
Moore said the American Heart Association recommends there should be no more than 120 minutes from the time of first patient contact to the time the patient is stented.
"Being in a rural setting, the closest facility capable of cardiac catheterization can be in excess of 30 minutes flight time. This leaves a narrow window for emergent care and preparation for surgical intervention. Every minute saved is a minute of heart muscle saved," Moore said.
Individuals have been educated on how to take better care of the heart, Moore said. However, Ischemic Heart Disease, which is a reduced blood supply to the heart, was still the leading cause of death from 2000-2012, according to the World Health Organization.
Moore said that, in recent years, the overall focus has been placed on prevention, but the important of treatments cannot be forgotten.
Current treatments range from life style modification, medication management, to surgery, including percutaneous coronary intervention, more widely known as cardiac catheterization or "stent placement."
This is a procedure where a small catheter is introduced in to the groin or wrist and fed up to the coronary arteries, which are the "blood vessels of the heart." If a blockage is found then a stent (small mesh tube) is placed to allow proper blood flow.
Untreated, these blockages can lead to a myocardial infarction, commonly known as a "heart attack." A heart attack is damage to the heart muscle because oxygenated blood cannot reach the tissue, of which the heart is composed.
That damage can be localized to a specific area or throughout the body. The extent of damage to the heart muscle determines the severity. The heart damage can lead to several debilitating diagnosis, the most severe being death.
"Recognizing that we are in rural Missouri, the General Leonard Wood Army Community Hospital does not have the capability to preform cardiac catheterization. Our focus must be on initial recognition, minimizing wasted time and to expedite transfer to a facility capable of providing cardiac catheterization," Moore said.
The post hospital will continue to monitor Stemi-hot Load and make changes to help improve patient care, according to Moore.
"This is just one of many projects the hospital is working on as an origination to better serve our patients and live up to our motto of 'Serving to Heal, Honored to Serve, with Compassion and Courage,'" Moore said.