Three local hospitals are collaborating to significantly cut the time it takes for people suffering severe heart attacks to receive treatment. This summer, Concord Hospital, Franklin Regional Hospital and Lakes Region General Hospital instituted a program in which patients most at risk of going into cardiac arrest are sped directly to Concord Hospital without stopping at a regional hospital for evaluation.
Concord Hospital is the only one of the three that performs cardiac catheterization treatment, used to open severely blocked arteries. Only patients suffering ST segment elevation myocardial infarction -- the worst kind of heart attack -- are sent directly to Concord Hospital.
Previously, those patients would first be taken by ambulance to their regional hospital for tests to determine whether they should be sent to Concord, resulting in crucial treatment time being lost, according to Concord Hospital cardiologist Gerard Dillon.
"Time is a key element" in preventing death or permanent heart damage from a severe heart attack, Dillon said. "Among all medical problems, there are probably few that are so time-sensitive."
In the worst attacks, severely blocked arteries cut off blood flow to the heart muscle, which can lead to cardiac arrest. To determine whether a patient with chest pains is experiencing a mild attack or one that could lead to the heart stopping, medical teams perform EKG tests, which measure the electrical activity of the heart over a period of time.
EKG tests are critical in determining whether a patient needs cardiac catheterization, Dillon said. Now, emergency responders will do the tests immediately, rather than transporting the patient to an emergency room first. Patients with milder attacks will still be taken to their regional hospital, but those in danger of cardiac arrest will no longer experience lag time.
The new protocol, said Dillon, will take advantage of the "golden hour that we really have to make the biggest difference in preventing patients from having a lot of damage to the heart or a fatal heart attack."
Dillon spoke of the "door-to-balloon time," referring to the amount of time that passes between a patient's being picked up and undergoing emergency procedures to open up the arteries around the heart.
"There's a lot more to the care of these patients than what happens once you get to the hospital," Dillon said. "A lot of the delays happen before that."
Of people picked up by ambulances for chest pains, only about 10 percent are having a "full-blown heart attack," Dillon said.
Since the hospitals started phasing in the program in December, over a dozen patients have benefited from immediate transportation to Concord Hospital, according to Dillon.