Paramedics hoisted Michael Gordan into an ambulance shortly after 3:30 a.m. An electrocardiogram showed the Arvada man likely was suffering a heart attack. By 5:37 a.m., two cardiologists at Exempla Lutheran Medical Center were unblocking a clot lodged in Gordan’s aorta and inserting a life-saving stent.
Gordan’s “door-to-balloon” time – how long it took medical staff to get him from the emergency-room entrance to catheterization lab – was an hour and a half, 30 minutes faster than the recommended federal guideline for heart-attack patients.
The rapid response prevented lasting damage to Gordan’s oxygen-starved heart muscle and possibly saved his life, physicians said.
“Time is muscle,” said Dr. Scott Valent, a cardiologist at Lutheran Medical Center in Wheat Ridge. “The more time (without treatment), the more heart muscle that can die.”
Lutheran is among more than a dozen Denver-area hospitals that in 2004 began requiring paramedics to alert hospital ER staff when a heart-attack patient is on the way. Based on paramedics’ recommendations, hospital staff can ready the cardiac catheterization lab, where doctors find and treat the blocked arteries of heart patients.
“The goal of this is to bypass the emergency room,” said Dr. Steve Resnick, a Kaiser Permanente cardiologist who practices at Exempla Good Samaritan Medical Center in Lafayette.
The Institute for Healthcare Improvement recommends that no more than 90 minutes pass before doctors open a heart-attack patient’s blocked artery. The federal Centers for Medicare and Medicaid Services calls for 120 minutes. In less than two years, the cardiac- alert program has cut the average wait time for heart-attack patients at Exempla’s three hospitals from 90 minutes to one hour, said Mary Shepler, director of cardiovascular services at Lutheran Medical Center.
Before the cardiac-alert system, heart-attack sufferers could wait in the emergency room for half an hour or more while undergoing tests and waiting for a cardiologist, Valent said.
Denver-area paramedics for years have had the ability to read electrocardiograms, or EKGs, which measure patients’ heart rhythms, on the way to the hospital. But now, by phoning the case in as a “cardiac alert,” medics ensure that hospital staff are ready to whisk the patient straight to the cath lab, shaving critical minutes off the clock, said Will Dunn, director of medical oversight for Arvada-based Pridemark Paramedics.
“This is a completely different level of trust in the paramedics’ assessment,” Dunn said. “We’ve been mobilizing surgical resources from the field for a long time. … Now, we’re doing it with (heart-attack) patients.”
Denver-area paramedics are exploring with neurologists the possibility of expanding the alert system to stroke cases, Dunn said.
When Gordan arrived at Lutheran, the cath lab was ready and two cardiologists were waiting, he said.
“It was amazing how quick they were,” Gordan said. “By having the cardiologists there, they were able to go into the aorta, clear out the blockage and put a stent in. … There was no damage to my heart.”
Staff writer Marsha Austin can be reached at 303-820-1242 or maustin@denverpost.com.
