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Tele-medicine system speeds heart-attack diagnosis, treatment

A tele-medicine system to recognize heart attacks is improving both the quality and speed of treatment for five or six patients a month in Curry County.

And a similar system is gearing up to provide the same kind of improvement for stroke victims.

With the STEMI-Alert program, says Cal-Ore General Manager Joe Gregorio, the partners are “able to determine if a patient is having a true heart attack, get them started on the right medication, and taken to the right facility as quickly as possible.”

In August 2007, Sutter Coast Hospital, Cal-Ore Life Flight and Rogue Valley Medical Center (RVMC) began the system to recognize, treat and transport heart attack victims as quickly as possible. It uses special equipment and training to recognize STEMI (ST-Elevation Myocardial Infarction) victims as soon as Cal-Ore ambulance paramedics can connect patients to a 12-lead EKG.

The STEMI-Alert system has cut more than an hour out of the time it took to get patients to a cardiologist, according to Sutter Coast Emergency Department Director Beth Brown, R.N.

Before STEMI-Alert, a patient had to arrive at Sutter Coast for assessment, then Sutter Coast had to find a cardiologist willing to treat the patient before they could be administer care and transport the patient.

With STEMI-Alert, assessment begins when Cal-Ore paramedics transmit the results of the 12-Lead EKG. Once Sutter Coast has confirmed a STEMI heart attack, treatment can begin, geared toward getting the patient to RVMC – which has agreed to accept STEMI patients – as quickly as possible.

“The goal is to make arrangements to transfer the patient by air ambulance to RVMC within 10 minutes of the patient’s arrival at the Sutter Coast emergency department in Crescent City.

The early treatment usually involves establishing an IV and administering oxygen. The right treatments to assist the heart can decrease pain, control nausea and stop the heart attack so that there is less damage to the heart muscle.

The flight itself, Gregorio says, is 17 minutes. Door-to-door, from Sutter Coast to RVMC, is about an hour.

At RVMC, the team is ready for the STEMI-Alert patient based on the EKG readings and Sutter Coast assessment. Most patients go straight to the cardiac catheterization lab, where the blockage is opened in the clogged artery and a stent is surgically placed.

Most STEMI-Alert patients are out of the hospital in a day or two, rather than a week or more that a larger heart attack would require, according to Sutter Coast officials. Patients are back to normal activities sooner, and have a much better quality of life after returning home.

Gregorio says a similar system of assessment by Cal-Ore, stabilization at Sutter Coast, and rapid transport to specialized treatment is being  developed with California Pacific Medical Center for stroke victims.

So far, he reported, six patients have been transported in about three hours’ time.

“The STEMI-Alert program has changed the face of local emergency cardiac care,” says Cal-Ore President Dan Brattain. “Cal-Ore is proud of its role in improving access to high-quality cardiac care for our community.”

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