In any number of accidents, illnesses, and injuries, the emergency care
you receive can have a tremendous impact on your outcome. Paramedics must
respond to the situation, provide life-saving medical attention, and decide
where to take you for treatment. For patients who call 911 with chest
pain, this decision can be particularly difficult.
First, paramedics must identify the 7% of callers who are experiencing
a heart attack. Once they rule out a heart attack, they should work to
identify the additional 20% who need specific cardiac care. If paramedics
complete this process correctly, they can take patients to the correct
facility, helping ensure patients receive the care they need right away
instead of being transported from their original destinations to facilities
that have interventional cardiology capabilities.
Studying a New and Improved Approach
In a study conducted at
Wake Forest Baptist Health, researchers showed that “on-scene use of a new protocol and advanced diagnostic equipment can help
paramedics better identify patients at high risk for adverse cardiac events.”
Previously, paramedics used a portable electrocardiogram (EKG) to look
for signs of a heart attack before using their experience and patient
preference to choose a treatment location. In the study, the research
team trained more than 150 paramedics on the HEART Pathway program, which
has been used in emergency departments for 8 years. In this program, paramedics
ask patients questions about their chest pain, age, risk factors, and
medical history – and use a handheld i-STAT device to measure levels
of troponin (a heart enzyme) in the blood and detect heart injury.
By ruling out not only heart attack but also heart injuries, paramedics
can get individuals who may be at risk for adverse cardiac events the
care they need. Using the HEART Pathway program, paramedics were better
able to predict whether patients would experience adverse cardiac events,
allowing them to receive the correct treatment. For those with high-risk
of adverse cardiac events, paramedics were able to anticipate the events
61% of the time and choose the right facility 96% of the time, and for
patients with low-risk, paramedic predictions were correct 94% of the time.
According to the researchers:
“This teamwork between emergency medicine researchers and our local EMS
agencies is so valuable. Our study showed that paramedics have the professional
clinical ability to effectively assess patients’ cardiac risk using
this protocol before the patient ever gets to the hospital. We hope this
approach will allow patients to receive faster, more focused care.”
Our Hopes for a New Standard of Care
While the HEART Pathway program is still more popular in emergency rooms
than ambulances, we think it’s wonderful that paramedics can better
identify patients who are at risk for adverse cardiac events and use this
information to save lives. We hope this program in North Carolina influences
emergency care across the nation.
Someday, we hope to see the HEART Pathway program become the standard of
care. Getting individuals with heart injuries the care they need is crucial,
and every medical provider should have the tools they need to do so.
All too often,
substandard medical care leads to injuries and deaths that never should have happened.
While treatment is improving across North Carolina and we are pleased to
celebrate it, we also want to remind you that you can call the attorneys at
Kahn Law Firm, LLP are here for you when you have concerns about your care.
board-certified lawyers can provide you with a free consultation as soon as you call us at (843)-547-0240 or
contact us online.