Cardiac Care Standard Improves with new County System

Posted on Tue., January 6, 2009
By Dr. Joseph Barger

Keith, a longtime diabetic, was enjoying his son´s high school graduation when he felt a pulsating pain in his arm and chest. Keith´s wife became worried he might be having a heart attack and called 911.

Within 90 minutes, Keith was receiving life- and heart-saving treatment. Because of the quick response, Keith was able to return home a couple of days later with no heart damage.

Calling 911 saves lives

Nationally, someone suffers a cardiac event (serious malfunction of or damage to the heart) every 26 seconds, and every minute someone dies from one.

Last September, Contra Costa Health Services´ Emergency Medical Services implemented a countywide 911 program designed for early identification and rapid transport of high-risk heart attack patients, like Keith, to one of five local medical centers with highly specialized cardiac care.

Keith experienced a STEMI (ST Elevation Myocardial Infarction) heart attack.

A "heart attack" occurs when part of the heart muscle dies, usually as a result of a blood clot blocking an artery.

STEMI heart attacks are different from other heart attacks in that they are caused by a prolonged period of blocked blood supply that affects a large part of the heart.

Time is muscle

The primary goals of STEMI treatment are to prevent or minimize damage to the heart muscle and to anticipate and treat life-threatening complications associated with heart attacks.

Signs and symptoms of a STEMI heart attack may include:

Pressure or discomfort in the chest, back, neck, jaw, stomach or arm
Shortness of breath
Cold sweats
Nausea
Lightheadedness

Paramedics use a high-tech 12-lead electrocardiogram (ECG) machine to determine if a patient is having a STEMI heart attack. STEMI patients are then transported to the closest STEMI receiving center.

The five medical centers currently participating in this STEMI system in Contra Costa County are:

Doctors Medical Center San Pablo
John Muir´s Walnut Creek Campus
John Muir´s Concord Campus
Kaiser Permanente Medical Center Walnut Creek
San Ramon Regional Medical Center

Implementation of a STEMI system effectively improves the standard of cardiac care for the more than 1.2 million residents of Contra Costa County.

In STEMI systems, chest pain victims are evaluated by paramedics with an ECG. Once a STEMI is identified, Emergency personnel notify the STEMI receiving center to ready its specialized team while the patient is transported.

The national standard and timeline for treatment of a STEMI from 911 call to intervention is 120 minutes. Contra Costa EMS STEMI system already exceeds that standard with an average time of 91 minutes.

Call 911 — don´t drive to the hospital

Had Keith´s wife driven him to the hospital, it would have delayed life-saving care by almost an hour. That is why the American Heart Association and the American Academy of Cardiology strongly support the development of STEMI systems.

If you think you are at risk of a STEMI heart attack:

Control your risk factors (cigarettes, high blood pressure, high cholesterol, obesity, diabetes and physical inactivity)
Call 911 immediately if you have any symptoms.

Contra Costa is one of 11 STEMI systems in California. For more information, visit www.cccems.org.

Barger is an emergency physician at the Contra Costa Regional Medical Center and medical director of the Contra Costa County Emergency Medical Services.