Subject: [NEXTEL-1] New machines save time during 'golden hour' after heart attack

From: [email-masked]
Date: Mon, 02 Jun 2003 18:58:21 -0400

New machines save time during 'golden hour' after heart attack
Source: New Orleans CityBusiness
Publication date: 2003-05-26
Arrival time: 2003-06-02

The 60 minutes after heart attack victims feel the first tingling in their arms
and pain in their chests matter most. Doctors refer to it as the patient's
"golden hour."

Heart attacks stifle the muscle's blood flow, and fragile vascular tissue
dies quickly without oxygen. Since diagnosing a heart attack quickly can
mean life or death, two area hospitals recently installed some new
equipment to cut down on treatment time.

Louisiana Heart Hospital in Covington and East Jefferson General Hospital
in Metairie installed Medtronic Lifenet receivers that will accept
electrocardiogram transmissions from incoming ambulances. Louisiana
Heart Hospital spokesman Denis Bechac said the Lifenet receivers cost
as much as $15,000 each.

The new systems will reduce the "door-to-needle time" by 15 to 30
minutes, said Jim Bergeron, vice president of clinical services at Louisiana
Heart Hospital.

If emergency department staff know before the patient arrives at the
hospital whether a heart attack has occurred, they can have a catheter
laboratory prepared and a cardiologist on hand, said Robert Chadborn,
EJGH director of emergency services.

Even without the newest technology, New Orleans-area ambulances
routinely send EKG readings from the field. All ambulances in Orleans
Parish, as well as most other major providers in the metro area, use EKGs
and can fax the reading to a hospital while en route.

But fax machine printouts are often low quality, and doctors complain that
they can't always diagnose a heart attack using the faxes.

Ambulance technicians who use the Lifenet transmitter can send the EKG
information to any hospital with a fax machine. Only the hospitals with the
special receivers can get more extensive information while the ambulance
is still on the road.

After the Lifenet hardware receives the new EKG reading, it matches the
test with any previous EKGs or related information stored in the patient's
medical files. Doctors can then compare the current EKG with the heart's
normal reading.

By comparing EKG readouts, "the physicians have a pretty good idea of
what they need to do," Chadborn said.

EJGH started testing the system last year, and Chadborn expects it to be
free of bugs by June 1. EJGH had to work out a few kinks in the
communication system to make the Lifenet system work with every EJGH
ambulance. His hospital worked with Nextel Communications to design
a special wireless system for sending EKG information back to the
hospital. Louisiana Heart Hospital collaborated with Verizon
Communications.

The EJGH fleet includes 13 ambulances that serve every hospital on the
East Bank.

Some New Orleans hospitals use a similar product made by Burlington,
Mass.-based Zoll Medical Corp., a Medtronic competitor. It receives the
EKG reading from the incoming ambulance, but it doesn't automatically
pull the patient's old EKG records.

All of American Medical Response ambulances use Lifenet equipment.
The Greenwood Village, Colo., company operates ambulance services in
36 states with 18,000 employees. Last year, AMR made more than 4
million transports nationwide.

Alan Ashley manages the company's southern Louisiana operations,
which includes provider contracts with EJGH, Touro Infirmary in Uptown
New Orleans and Tulane Medical Center downtown. It also serves most
other regional hospitals.

"Time is muscle," Ashley said.

Nationally, 13 to 15 of every 100 patients who come into a hospital
complaining of chest pain are having heart attacks, Bergeron said. He said
New Orleans' ratio might be worse since residents aren't known to be
overly health conscious.

According the Centers for Disease Control and Prevention in Atlanta, the
mortality rates for heart disease in the Orleans, Jefferson and St.
Tammany parishes ranged between 571 and 682 deaths per 100,000
people age 35 and older. The national average for the same 1991 to 1995
timeframe was 520.

Ashley said he expects more New Orleans hospitals to buy the Lifenet
system because doctors will grow accustomed to having the information
so early. Then they'll expect it from every hospital.

Keeping up with technology is expensive.

"Louisiana Heart Hospital had the opportunity to build from the ground up
with all the latest technology. It's something else to retro-fit an eight-story
hospital," Ashley said.

Health care officials say the new technology does help ease their own
minds.

"They're precious minutes. I know I'd like to shave them off if it were me,"
Bergeron said.
http://cnniw.yellowbrix.com/pages/cnnmoney/Story.nsp?story_id=39197349&ID=cnnmoney&scategory=Business+and+Finance&
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