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Your Healthy Family: How NCH cut time to treat STEMI heart attack in half

Posted at 2:58 PM, Mar 15, 2022
and last updated 2022-03-15 14:58:01-04

NAPLES, Fla. — If you have a heart attack, you want to know that you're getting the best, most effective treatment as quickly as possible. The NCH Healthcare System has been working hard to cut down the time between when a patient comes in with a heart attack to receiving treatment by more than half.

A STEMI, or S-T Elevation Myocardial Infarction, is a serious heart attack in which a blood vessel in the heart is blocked.

When a person has a STEMI, they call 911.

"Normally people call with chest pain. The dispatchers have a set list of questions that they follow that relays information to us through our CAD System. We're getting all of that information in real time," Lt. Andrew Steger, a Flight Medic with Collier County EMS, said.

"That's when we're already starting our treatment evaluation in our heads. What we're going to do, where they're going to go, how fast we're going to go," Lt. Christine Crato, another Flight Medic with Collier County EMS, said.

She said within 6-8 minutes, they're on scene.

"When we show up, we have a slew of medications, interventions, knowledge and experience that happens right there. With a lot of these STEMIs, we start the treatment, the medications, oxygen before you get to the hospital," Lt. Crato said.

Right on scene, they'll do an EKG, which measures the electrical signals in the heart, to determine if the patient is having a STEMI.

"They'll send us a copy of the EKG and give us a heads up that they're coming in with a STEMI," Dr. John Zelahy, a staff physician in NCH's Emergency Department, said.

Dr. Zelahy said the charge nurse calls a STEMI Alert, which gives everyone involved in treating the patient time to get ready.

"We immediately deploy the team that's going to take that patient to the Cath Lab and open up the artery effectively," Dr. Robbert Cubeddu, the President of the NCH Heart Institute, said.

"We can mobilize everybody in the Emergency Department and we can have the ER techs, your secretaries, nurses, everybody on board for when that patient hits the door," Dr. Zelahy said.

Once the patient gets to the ER, Dr. Zelahy said they get right to work.

"hey get another IV and an EKG. Blood work is all drawn in probably less than two minutes," he said. "It's like a pit stop."

The patient is then handed off to the Interventional Cardiologist.

"We as cardiologists come in, we access the femoral artery or the radial artery, we canulate the artery and make it up into the heart with a catheter. And then we negotiate wires and balloons to open up the artery," Dr. Cubeddu said.

"At that point, the heart is contracting well, the muscle is getting oxygen. Most patients recover quickly and they're discharged home within 24 to 36 hours," he said.

The NCH Healthcare System team — from the Emergency Department to the Cath Lab — has worked with Collier County EMS to cut down the "Door to Balloon" time to just 28 minutes. That's the amount of time between when the patient comes through the ER doors to the balloon relieving the artery's blockage. Dr. Cubeddu said that time has put NCH at the 99th percentile in performance for the abrupt treatment of heart attack, and well above the national guideline of 90 minutes.

"Every minute that you save will translate to improve survival," Dr. Cubeddu said. "We want our patients to come to NCH if they're having a heart attack because we know we can take care of it immediately."

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