Recordpub.com - Saving lives in the field Early diagnosis of heart attacks by EMTs improves treatment

By Diane Smith
Record-Courier staff writer
BRIMFIELD - Richard Messner thought he had a sinus infection.
When he arrived at work at Brimfield Town Hall, he didn't feel well. So at the insistence of a receptionist, he reluctantly agreed for the township's emergency medical technicians to take a look at him.
Within 42 minutes, the township zoning inspector had a procedure he credits with saving his life.
Brimfield and several area fire departments are utilizing a 12-lead EKG to diagnose certain heart attacks before a patient even gets to the hospital. In Brimfield's case, the EKG results are immediately faxed to heart centers in Akron, which have a cardiologist and team ready when a patient arrives.
On-the-spot doctors can then perform a heart cathterization and angioplasty, procedures to locate and treat a blockage by inserting a tightly folded balloon into a narrowed vein or artery. The balloon is inflated when a blockage is found, effectively pushing the blockage aside.
"The goal is to get the patient to the cath lab within 90 minutes from the onset of chest pain to balloon time," Brimfield Fire Chief Robert Keller said.
The fire department will host a community forum at 10:30 a.m. Monday, April 27 to educate the community about the program, which is being offered on a limited basis.
The forum will be at the Brimfield Fire Station at the corner of S.R. 43 and Tallmadge Road. Messner will be there to discuss his experience, and light refreshments will be offered. Residents should RSVP by calling 330-678-9244.
Most fire departments have the 12-lead EKGs, said Dr. Kathryn Bulgrin, D.O., a physician in the emergency department at Robinson Memorial Hospital in Ravenna and medical director for Portage County EMS teams. While Robinson does not get the EKG results until the patient arrives, the EKGs done in the field still can be useful in diagnosing a heart attack.
Bulgrin said there are two kinds of heart attacks, known as STEMI heart attacks and non-STEMI heart attacks.
STEMI heart attacks indicate a larger blockage. In those cases, Bulgrin said, patients are immediately transferred to Akron City Hospital by helicopter, with a goal of getting the patient into the cath lab within 90 minutes of their arrival at Robinson.
Non-STEMI attacks, she said, tend to involve smaller vessels and don't cause as much damage. They may be diagnosed with more subtle changes in the EKG, or through enzyme tests. In some cases, she said, the patients are treated by cardiologists at Robinson, and may have a heart cathterization for diagnostic purposes the next day.
Brimfield fire EMTs are trained to spot particular changes associated with STEMI-type heart attacks, the most severe types of heart attacks, which involve larger arteries and create potential for more severe heart damage. Since obtaining the "Lifepack 12" EKGs, six patients have been treated using the STEMI program.
The department is staffed 24 hours, but often only two EMTs are on staff, and three are needed for the program to be effective, Keller said. If the department's EMS levy is approved in May, Keller plans to staff the department with three people around the clock.
Brimfield EMT Todd Schafer said with this program patients are treated well within the "golden standard" of 90 minutes.
"Sometimes by the time a patient gets to me, their EKG looks great," she said. "But the tests done in the field definitely alerts me that there may be some issues that need to be looked at more closely by cardiology."