Eastern Plumas Health Care has just taken a big step forward in emergency care for heart patients. The new technology allows 12-lead EKG’s taken in the field to be sent immediately to the emergency room where doctors there read them.
At that point, they can determine whether the patient should go to a hospital in Sparks or Reno that is capable of doing heart surgery, or if the condition is something less severe that EPHC can treat in its emergency room.
Teresa Whitfield, director of quality and operations, said the hospital is committed to providing the best and quickest cardiology care possible. A lot of time, money and creative thinking went into this project.
The hospital auxiliary had already donated new emergency room and ambulance crash carts that have a Zoll machine on top. These machines have the defibrillator paddles used to shock the heart, allowing it to resume normal rhythms. They can also be used as a pacemaker in the ambulance.
The 12 leads of the EKG attach to eight areas across the chest, with one on each arm and leg, as well. The new technology allows for the addition of a data card to the Zoll with Bluetooth that “talks” to a cell phone in the ambulance, which sends a message in three ways, simultaneously, to the emergency.
First, it sends a text message to the ER doctor’s cell phone alerting him an EKG is coming. Second, it sends the EKG image via e-mail; it can then be forwarded to a cardiologist anywhere. Third, the EKG is faxed to the EPHC emergency room.
Since “time is (heart) muscle” according to Whitfield, EPHC’s goal is to identify when a heart attack is occurring as quickly as possible to “get the patient to the right place at the right time.”
If a patient is in an ambulance in Vinton, for example, and the doctor determines the patient needs to go to Reno or Sparks for heart surgery, that patient can go there directly, rather than detouring to Portola only to turn around.
The new procedure will save the patient money, as well as time. Instead of paying an ambulance to go to Portola and then to Reno, and paying two different emergency rooms, patients will incur only one ambulance and one emergency room charge.
The hospital foundation started the project rolling when it wanted the money raised at its charity golf tournament this year to go to emergency services.
Staff started thinking about what they were doing and what they could do better according to Whitfield.
The foundation’s money paid for the research that went into determining what phone system would work best, as well as funding the updated card for the Zoll monitor in each ambulance.
The information technology team included Rick Boyd, Jason Rapacilo and Dan Rappa, who researched and tested every part of the electrical and phone systems for this project.
They discovered cell phones actually worked better than satellite phones in terms of area coverage, which also significantly cut the cost of the project. Then, Dana Tomczak, EPHC’s biomedical engineer, figured out how to make the phones and defibrillators compatible.
Finally, the Stein family, who own Walton’s Grizzly Ranch Camp, added to the total package by donating $6,000 through the Truckee Tahoe Community Foundation for a cardiology monitor system in the emergency room that receives information in real time the whole time that a patient is being monitored.
In the past, staff would get an EKG printout when they wanted one, but they couldn’t look back later and review what happened over time. They couldn’t assess changes after they performed an intervention.
That information really helps doctors determine when and where to send heart patients said Whitfield, again part of the philosophy of offering the best quality care as quickly as possible.
Now, everything’s been road tested and all the equipment is on site. The next step is a training session for EMTs and paramedics at the Nov. 18 staff meeting, so everyone is clear on how the protocol works in the field and how all the pieces come together.
“This is our Thanksgiving gift to the community,” said Whitfield, who seemed to exude good feeling, adding that the hospital is grateful for the community’s support. “We want to thank the community,” she said.
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