SLIDESHOW | Getting patients to safety when seconds matter
March 3, 2010
By Laura Geggel
0305-hospital-drill_10a
NEW — 1:37 p.m. March 3, 2010
Murray Lorance said he didn’t feel so good. Pale and disoriented, he wandered into the Snoqualmie Valley Hospital emergency room, complaining of chest pain.
Actually, Lorance was faking his heart attack, and for good reason. The retired firefighter has helped many a heart attack patient, and he knew just how to act like one for a drill at the hospital.
Every year, the hospital sees more patients experiencing heart attack symptoms, said Kim Witkop, a hospital physician and vice president of medical affairs. Every month, an average of one or two patients come in complaining of heart attack symptoms — chest pressure, difficulty breathing, discomfort that radiates up into the neck or into the arm, nausea and sweating, Witkop said.
Snoqualmie Valley Hospital doctors have to send any patient suffering from a heart attack to Overlake Hospital Medical Center.
The reason?
The hospital does not have a cardiac catheterization laboratory, called a cath lab for short. Cath labs can save patients who are having a heart attack (when the heart muscle is damaged) before the patient goes into cardiac arrest (when the heart stops pumping blood).
Only three hospitals on the Eastside have cath labs, including Overlake in Bellevue, Evergreen Hospital Medical Center in Kirkland and Valley Medical Center in Renton.
Snoqualmie Valley Hospital was practicing the drill to see if it could get a patient from Snoqualmie to Overlake’s cath lab in 90 minutes or less, a national goal, Witkop said.
The hospital’s drill was almost a year in the making. Before, if a patient were having a heart attack, hospital staff would call Overlake and ask if it could admit the patient.
Now, Overlake has agreed to streamline the process with Snoqualmie Valley Hospital. Plus, the hospital has made a medical form that goes with the patient en route to Overlake, so no time is lost when the patient gets to the cath lab.
“Our goal is to get this choreographed,” Snoqualmie Valley Hospital Emergency Systems Coordinator Rick Green said.
Carolyn Holmes, nurse manager of invasive cardiovascular services at Overlake, said the coordinated effort was important. Before the coordination, the hospital would have to call several numbers at Overlake to get the ball rolling. Now, they just have to call one.
“The faster you go, the more muscle you save,” Holmes said.
As soon as Lorance entered the emergency room, doctors, nurses and technicians jumped into action. Within four minutes, they had run an electrocardiogram, a test measuring the heart’s electrical activity. They called 911, recorded his vitals and gave him a pretend dose of morphine to ease the pain.
At 20 minutes, Bellevue Fire Department Medic One arrived to take part in the transport. If the situation demanded it, the hospital would call Airlift Northwest for helicopter removal, Witkop said.
Lorance, playing the confused sick patient, spoke up and asked why he couldn’t stay in Snoqualmie.
“I wish you could, but we don’t have the facility here,” Dr. Duane Anderson said, talking about the cath lab.
By 55 minutes, Lorance was at the Overlake emergency room, although that time would have been slightly faster if the ambulance driver had turned on the sirens, which he didn’t for the drill, Green said.
“As you can see, our times are well within those limits (of 90 minutes), so we are very pleased,” Green said.
After the drill, hospital staff convened to discuss how they could make the process even better.
John McNeill, with Bellevue Medic One, commended the hospital for orchestrating the drill, but he advised people to call 911 if they think they are having a heart attack.
Often, people who are in denial or who don’t understand the gravity of the situation will come to Snoqualmie Valley Hospital, which can waste time they could be using getting to the cath lab.
“We can get there quicker,” McNeill said.
Laura Geggel: 392-6434, ext. 221, or lgeggel@snovalleystar.com.
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Hmm, either the caption for photo 0305-hospital-drill_05 is wrong or the doctor was wrong in asking for an ambulance. It wasn’t an ambulance that showed up, it was an aid car, i.e. the fire department. Two very different responses.
Don.
You are correct that we used an aid car for the purpose of the drill, since we would not want to take a Medic Ambulance out of service for a drill. In an actual STEMI situation, however, an ambulance is ordered, (Medic 3 out of North Bend being closest), for the patient transport. These patients need to be under paramedic care during this transfer. Bellevue Fire was gracious enough to allow the use of one of their reserve aid cars to more closely simulate the actual procedure. Good eye!
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