Cardiac Alert® Program at Swedish Medical Center
New Philosophy & Cooperation Among Healthcare Providers Key to Cardiac Alert® Success
"Our Cardiac Alert® system is saving lives," said Mark Kozlowski, M.D., medical director for Swedish's Emergency Department. "The Cardiac Alert® system works because we have 100 percent commitment from our paramedics, Emergency Department team and Catheterization Lab staff."
Given the prevalence of heart disease in today's society, the chance of surviving a heart attack often comes down to the speed and quality of care received by emergency medical professionals. Swedish Medical Center is taking that idea to heart with its Cardiac Alert® program that coordinates a heart attack patient's care from ambulance to Emergency Department to Cardiac Catheterization Lab to give the patient the best chance of immediate and long-term survival.
Cardiac Alert® requires sophisticated equipment and expertise from paramedics; streamlined processes and advanced preparation from Emergency Department staff; and commitment and quick response from cardiologists and Cardiac Catheterization Lab staff to conduct catheterization lab procedures at any time of day or night.
Door-to-Open Vessel/Balloon Time Far Below National Average
The goal with the Cardiac Alert® system is to open the blood vessel in a patient with a "true" heart attack (myocardial infarction) within 90 minutes of his/her arrival in the Emergency Department to give the patient the best chance of immediate and long-term survival.
Due to the Swedish Cardiac Alert® team's ongoing improvement evaluation of the system, they have been able to reduce the door-to-open-vessel time to 48 minutes on average; regardless of what time of day the patient arrived. And in some cases, patients have gone straight to the Cardiac Catheterization Lab and had their blocked vessel opened in as little as 11 minutes.
"Door to Open Vessel/Balloon Time," as it is commonly known, represents a change in philosophy nationwide within the medical industry. Previously, heart attack patients would be treated with clot busting drugs until a catheterization procedure could be scheduled. However, medical studies in the late 1990s confirmed that patients treated immediately by a cath procedure experienced fewer complications, had less heart damage and were less likely to suffer a related stroke.
The Importance of Coordinated Care
Many hospitals are working toward a Cardiac Alert® program, but the challenge remains coordinating across different spheres of care, most notably with paramedics. Swedish has been dedicated to offering education to paramedics in eight different agencies to read 12-lead EKGs, recognize myocardial infarctions versus other heart conditions, and implement a new system of notification from the ambulance to the hospital.
"It is imperative that the first paramedics on scene be trained and equipped to identify the symptoms and to act quickly and appropriately," said Marilyn Bourn, EMS division chief for South Metro Fire Rescue. "That requires a substantial amount of training and financial commitment from EMS agencies. But I'll tell you this - it makes a huge difference in saving lives, and that's what we're here for."
Paramedics are empowered to initiate Cardiac Alert®, activating the Emergency Department staff, on-call cardiologists and on-call technicians. This process saves valuable minutes by allowing the team at Swedish to prepare while the patient is en route to the hospital.