Making minutes count: Carilion trains to quickly respond to heart attacks

Speed in treatment is so critical in heart attacks, because minutes could mean the difference between life and death.

February is Heart Health Month.

Minutes can mean the difference between life and death if you’re having a heart attack.

All month long, 10 News has been sharing tips from doctors on warning signs to look for, ways you can stay heart healthy, as well as the reason behind a higher prevalence in cardiovascular disease in Appalachia.

But now, we want to show you how your local doctors at Carilion are training to respond to a heart emergency. Carilion is nationally recognized for the way they respond to heart attacks. Their approach is called the Carilion Clinic Heart Alert program. Based on national standards, the Heart Alert program speeds up the amount of time it takes to deliver life-saving care to people having heart attacks.

In a 10 News exclusive, we got the chance to go along on a Heart Alert and see firsthand what happens behind the scenes when 911 is called for a heart attack, and how your medical team is making critical minutes count.

The streamlined approach is designed to deliver coordinated care by everyone at every step of the way, including EMS providers, physicians, and Carilion’s heart care professionals. Carilion said EMS providers in western Virginia have been trained to work closely with its medical technicians, doctors and nurses. Starting while heart attack victims are on the way to the hospital, the Heart Alert program provides simultaneous and comprehensive care with the goal of minimizing heart damage.

Time is a battle Carilion Clinic’s flight paramedic Taylor Powell fights every day.

“Time is absolutely of the essence. One thing we say in medicine, is ‘time is tissue.’ Whether that is a stroke or a heart attack, or even for a limb with a loss of a pulse. Time is tissue,” Powell said.

Every day, she’s working in the sky on Life-Guard 10, providing lifesaving care to patients who need to get to the hospital as quickly as possible.

Speed in treatment is so critical in heart attacks because minutes could mean the difference between life and death. When medical care is delivered faster and more efficiently, lives are saved, and damage is reduced to the heart muscle, improving patient outcomes.

That’s why Carilion trains and runs what they call heart alerts, simulating responding to a 911 call for a heart attack.

“Often that involves an ambulance going out in the field,” Powell said. “They call us, our dispatch, so we can provide extremely timely transport and initiate critical care and get them to the Cath lab very quickly.”

Powell explained their goal is to provide lifesaving care with a scene time of only 10 minutes from the time the Lifeguard 10 helicopter touches down, to taking back off.

For this Heart Alert simulation, they are taking CRMH Cath Lab Medical Director Dr. Ayoub Mirza with them.

”We are hoping he can see our process,” Powell said. Usually, Dr. Mirza only sees heart attack patients in the cath lab.

”Patients need to understand that Carilion Clinic is one of the high-volume centers taking care of patients who come in with a heart attack. We have tremendous experience,” Dr. Mirza said. He said at CRMH alone, they get about two Heart Alerts a day.

”The volume is still very high. That’s why we are so experienced that we can work within minutes to open the artery that’s causing a heart attack,” Dr. Mirza said.

According to Carilion Clinic, a national initiative to improve heart attack care measures how quickly hospitals perform heart-saving procedures on heart attack patients. Beginning the moment a patient arrives at the hospital, the “door to balloon time” (referring to how quickly percutaneous coronary intervention, also called PCI, is performed to clear obstructions from the arteries and restore blood flow to the heart) should be within 90 minutes or less, according to the American College of Cardiology.

Carilion’s average response time is approximately 30 minutes faster than the national standard.

Dr. Mirza said the biggest delay they see is patients ignoring heart attack symptoms and waiting to call 911.

Read more about the difference between heart attack symptoms in men and women here.

“The longer the patient waits before calling 9-1-1, the more there is muscle damage. The more the muscle damage is, the higher the outcome of subsequent heart failure, and likelihood of death,” Dr. Mirza said.

Like most patients who fly on Lifeguard 10 in a medical emergency, it was also Dr. Mirza’s first ride in a helicopter. He was excited for the opportunity. If he was nervous, he definitely didn’t show it.

“I think it is important for us to see what the challenges are, for the patients, as well as the EMS,” Dr. Mirza said.

The simulation involved first responders from Roanoke County, Heart Net, and the team of doctors at Carilion. It took weeks to coordinate the simulation.

Dr. Mirza was able to observe firsthand what happens when a patient is taken by ambulance for a heart attack, how they are treated, and the process in which paramedics airlift them back to CRHM.

”I think it was very eye-opening for him that he could see how we interact with the patient on scene,” Powell said.

“I was surprised at how smoothly the whole process worked. The coordination was effortless,” Dr. Mirza said.

And that coordination is all thanks to drills like that. It takes a team of people and coordination between agencies to get patients treated and moved as quickly as possible. Dr. Mirza said the experience was invaluable.

He wants to keep cross-training doctors in the field, so that when minutes mean the difference between life and death, our local doctors are prepared to save lives.


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