December EMS Providers of the Month

L-R Lt. Ney, Dr. Stone MCFRS Medical Director, Captain Murdock
and Battalion Chief Butsch from MCFRS EMS Section

On Tuesday, January 13 personnel from Clarksburg Fire Station 35 were recognized as EMS Providers of the Month for December.   

The recognition was a result of the crew’s rapid actions taken on December 17 that resulted in swift treatment and transport of a patient suffering a significant heart attack.  

Personnel receiving this prestigious recognition were Lieutenant/Paramedic Kirk Ney, Firefighter Roger Fails, Firefighter Greyson Brown, Firefighter/Paramedic Blaine Kring, Firefighter James Henry, Firefighter Robert Snavely.  In addition to a certificate, the EMS Providers of the Month also receive a beautiful challenge coin.

From the commendation letter:

“On December 17, 2014, you were dispatched for a 57 y/o male experiencing chest pain.  On the scene, you quickly realized the patient was a STEMI.  You performed numerous basic and advanced life support skills, quickly transported, and en-route to the hospital, continued a high level of care for the patient.  With your quick assessment, transmission of EKG, notification of STEMI, your skills, and teamwork, this patient had a door to balloon time of only 35 minutes.”

For many of you, some of the above verbiage is more than likely not clear.  Below is some background which will no doubt highlight just how impressive the crews’ actions were and the tremendous resources we have in Montgomery County. 

Background

STEMI (ST- segment elevation myocardial infarction) is a type of heart attack. 

EKG (or ECG) - electrocardiogram which is a test that checks for issues with the electrical activity of your heart.

In 2010, the department established the Emergency Cardiac Care (ECC) program which allows paramedics to transmit critical data directly and securely from remote locations to area hospitals using sophisticated technology and equipment.  This allows the hospital team to mobilize and be standing by to intervene with angioplasty, as needed, so that blocked heart vessels can be opened and blood flow to the heart restored which can ultimately make a difference in patient outcome.  

The time period from diagnosis to the opening of the vessels is known as “door to balloon” or D2B time. According to guidelines by the American Heart Association, optimal D2B time is 90 minutes or less.

 

L-R; FP1 Kring, FF Brown, Capt. Murdock, Dr. Stone and BC Butsch

New Technology Makes Diagnosis Possible During Ambulance Transport

Those with Heart Attack Symptoms Should Always Call 911

Rockville - An updated EKG (electrocardiogram) system that transmits heart rhythm data and vital signs is now available in Montgomery County advanced life support ambulances making it possible to notify Emergency Department physicians within moments of a paramedic diagnosis,  saving valuable time during transport to the hospital.

Background

The window of time from when a patient starts experiencing heart attack symptoms to the moment the patient receives treatment is a critically important period. This newly acquired equipment allows paramedics to send critical data directly and securely from remote locations to awaiting area hospitals and accelerates the diagnosis process while shaving off critical time that can ultimately make a difference in patient outcome and survival. While hospitals and first responders have many protocols in place to ensure that cardiac patients are diagnosed and treated quickly, providing this early diagnosis “en route” ensures that the hospital team will be mobilized and standing by to intervene with angioplasty, as needed, so that blocked heart vessels can be opened, blood flow to the heart restored and heart muscle (and lives) saved.  This time period from diagnosis to the opening of the vessels is known as “door to balloon” or D2B time. According to guidelines by the American Heart Association, optimal D2B time is 90 minutes or less.

“This technology is the perfect example of collaboration at work to save lives,” said Fire Chief Richard Bowers. “The technology enhances our ability to network with the hospitals, speed up care for heart attack victims and provide critical patient care and it’s already made a difference in the lives of several patients since the system was implemented.”

Problem

The signs and symptoms of a heart attack can be subtle and hard to identify. “One of the biggest challenges is that too often victims of heart attacks will ignore symptoms or choose to drive themselves to the hospital when they suspect a possible heart attack,” said EMS Chief Diane Zuspan. “The best course of action is to call 911 immediately for help. Our paramedics have the training, and now the technology, to diagnose a heart attack on the scene while working with our hospitals to provide the best chance of survival.” 

Patient Story

Mr. Kenneth Courage, age 61, experienced chest pain on July 29, 2011 and called an ambulance.  When EMS arrived at his home they performed an EKG at 10:38 am.  The EKG was transmitted electronically via the LIFENET system to the Suburban Hospital Emergency Department, where Dr. Matthew Leonard confirmed the diagnosis of STEMI (ST- segment elevation myocardial infarction) also known as a heart attack.  A heart attack is caused by a sudden, prolonged blockage of an artery that supplies blood to a large area of the heart. To ensure the best outcome, the blocked artery must be opened quickly with balloon angioplasty performed in a cardiac catheterization laboratory.

Once the diagnosis was confirmed, Suburban Hospital’s “Code Heart” team was activated. On that day the team included interventional cardiologist Dr. Yuri Deychak. Mr. Courage was transported directly to the hospital’s cardiac catheterization lab, bypassing the emergency department. He arrived in the catheterization lab at 11:07 am and his vessels were opened by the Code Heart Team 28 minutes later. The home/diagnosis to balloon catheter intervention time was 57 minutes.

LIFENET, a Web-based system, allows EMS teams in the field to send EKG readings to hospital staff digitally, with the results immediately accessible on desktop computers as well as smart phones. At the hospital, teams of cardiologists, nurses and technologists provide 24/7 coverage in the cardiac catheterization labs. 

All County hospitals which have the Cardiac Intervention Center (CIC) designation from the State of Maryland, including Suburban Hospital, Shady Grove Adventist Hospital, Washington Hospital and Holy Cross Hospital, collaborated with MCFRS to implement the LifeNet System. Each of the hospitals contributed toward the initial equipment purchase and has agreed to support ongoing expenses.   

Since July, many patients have benefited from this new technology and this new process, which applied together with state and local protocols, bypass the Emergency Department and saves valuable time. The difference in minutes can be the difference between life and death.