Medical response to cardiac arrest speeds up

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A heart attack patient is rushed from an ambulance into Utah Valley Regional Medical Center. There is no time to lose. The patient was diagnosed with a severe heart attack by paramedics using a machine that can identify severe heart attacks caused by a prolonged blocked artery.

The machine, called a STEMI machine, which stands for ST-elevation myocardial infraction, allows paramedics to diagnose severe heart attacks while in the field, giving hospitals the ability to shorten their “door-to-balloon” times and save more lives.

“Having the STEMI machines in the ambulances is very beneficial and vital to having the most efficient care possible,” said Janet Frank, spokeswoman for Utah Valley Regional Medical Center. “In some cases, we can bypass the emergency room altogether and go straight to the cath lab.”

Patients are taken to cath labs to diagnose how well their hearts are pumping blood. Clogged arteries are found using equipment in the lab. Once the clog is found, a balloon-tipped tube is threaded through an artery to the clogged artery and inflated to restore blood flow.

The time between when a heart attack patient arrives at the hospital to when the balloon is inflated in the blocked artery is called “door-to-balloon” time. The National Heart Association recommends an average time of 60 minutes. Utah Valley hospital’s average time is 48.5 minutes.

The National Heart Association is pushing for all hospitals to use the STEMI system. While not all of Utah County’s ambulances have the machines, Provo City has supplied them for all of its ambulances. The effort has helped the Utah Valley hospital treat cardiac arrest, but not all of its patients come from Provo.

“We’re actually a referral center for all of Utah County as well as most of central Utah, so we get ambulances from all over,” Frank said.

Not every hospital has the ability to run a cath lab. There are some areas of Utah where patients have to be transported for a few hours to get to a cath lab, especially in southern Utah.

Ten to 15 people a year have a heart attack while at BYU, according to EMS director Sam McKnight. On-campus EMTs respond to all medical emergencies during most of the day, so they are usually the first responders on scene.

“To get certified, (EMTs) get 12 hours of training in cardiology,” McKnight said. “Once they’re certified they get more training, but it’s not a specific number of hours.”

When a person calls University Police complaining of chest pain, initial response is by BYU and Provo emergency responders. The BYU responders, who are volunteers and cannot transport patients, take vital signs, get a medical history and check signs and symptoms before the Provo paramedics arrive. They can give patients aspirin and in some cases nitroglycerin and oxygen.

When Provo paramedics arrive, patients are evaluated using the STEMI machine. The paramedics then transport the patient to the hospital.

“Any chest pain is a code three response (lights and sirens) by paramedics — they get to campus pretty quick,” McKnight said.

With the low number of heart attacks on campus, the EMTs get additional cardiac training every couple of weeks to stay trained in heart-related emergencies, McKnight said. There are also a few EMTs that work in hospitals.

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