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Medical pros discuss improving response time for heart attacks
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Dr. Timothy Henry, left, makes a point Friday during a panel discussion on Transporting by Land or Air during the Northeast Georgia Regional STEMI Summit. Other panel members are, from left, Ricky Mathis, Chad Black and Jason Grady. - photo by Tom Reed | The Times

The emergency medical service community in North Georgia knows that time is critical during a heart attack.

That's why they are working together to help save patients' lives by saving them time.

Paramedics, nurses and doctors from 15 surrounding counties gathered together for the fourth annual Northeast Georgia Regional STEMI Summit.

Medical personnel got the opportunity to discuss ways they can work together to increase a patient's odds of recovery and to learn from some of the nation's leading cardiologists.

"It's really important information, presented in a really clear manner, presented by really smart people. It's giving us tools to save people that 10 years ago would have been like a dream or a fantasy," Dr. Jill Mabley, deputy state medical director, said.

The summit's primary focus was on treating patients who are having a deadly heart attack known as a ST-elevation myocardial infarction, or STEMI.

"What happens with a STEMI is that areas is 100 percent blocked. The heart is not getting oxygen, so we want to get it reperfused as quickly as possible," said Jason Grady, paramedic and Regional STEMI coordinator of Northeast Georgia Medical Center.

Grady said the most important thing a person can do during a heart attack is to call 911; don't drive to the hospital.

"It takes about 20 to 25 minutes longer to treat those patients. Mainly because we don't know they're coming. By EMS, we already know they're coming," Grady said.

Transporting a patient with a heart attack by ambulance saves time in other ways. The only way to diagnose a STEMI is to give the patient an electrocardiogram.

"And the faster you get that EKG, the faster that patient gets treated," Grady said, "Well, that EKG doesn't have to be done in the hospital. EMS does that and then they transmit it over the Internet to a fax machine. And the doctor looks at it and says ‘this is a STEMI and this is how you should treat them.'"

At this point the cardiology staff at the hospital can prepare for the incoming patient, saving precious minutes.

EMS now can administer blood-thinner medications to patients on their way to the hospital, another way to help the heart and brain get the necessary oxygen.

Mike Rogers has worked as a firefighter and a paramedic for 25 years.

"The way we're working on these patients now days was 15 years ago unheard of. It's evolving very, very fast, which is great," Rogers said.

Dr. Mohak Davé, Region 2 EMS Medical Director, presented on a new, unique method that EMS crews and other area hospitals can use to increase the likelihood of a good outcome for the patient transferring to NGMC.

The process involves cooling the body, similar to hypothermia, to slow down the body so that it doesn't use as much oxygen.

"When the heart is not pumping, the brain tissue is not getting its appropriate nutrients," Davé said. "So the concept here is with hypothermia, you are basically decreasing the metabolic demand of the brain and other parts of the body so that getting a patient cooled when they have a cardiac arrest increases their chance of having a full neurologic recovery."

Cooling the patient could be as simple as using ice packs or cold IV fluids. Though the idea of hypothermia in cardiac patients is recommended by the American Heart Association, there are few facilities in the U.S. that do it.

"We've taken a lead in this region to do this the last several years with excellent outcomes," Davé said.

Grady said the success of the summit and the patient care come from EMS staffers working together. Grady said the ultimate goal is to get blood flow restored to 100 percent of STEMI patients in less than 90 minutes. The average time in 2011 was 53 minutes.

"We're not chasing numbers. We track data to show how well we're doing. But behind every number is a patient. It's a person. It's a life. People here understand that," Grady said.

 

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