There has been a tremendous change in heart attack care over the past few years. It hasn’t been the result of technological advances or any new inventions.
The change hasn’t even been highlighted in public conversations. But hospitals have been able to significantly reduce the time it takes to clear an arterial blockage and get blood flowing to the heart.
The change has been led by two well-know organizations: The American College of Cardiology, which is a professional society for heart disease specialists, and the American Heart Association.
The changes are the result of a transfer of records participation and decision-making power in the care of a heart attack victim being transferred from specialists only to the boots-on-the-ground ER doctors and paramedics who see them first.
According to the New York Times:
“From 2003 to 2013, the death rate from coronary heart disease fell about 38 percent, according to the American Heart Association citing data from the Centers for Disease Control and Prevention. The National Heart, Lung and Blood Institute, the primary federal agency that funds heart research, says this decline has been spurred by better control of cholesterol and blood pressure, reduced smoking rates, improved medical treatments — and faster care of people in the throes of a heart attack.
“It may not be long before cardiovascular disease is no longer the leading cause of death” in the United States, said Dr. Michael Lauer, the director of the Division of Cardiovascular Sciences at the National Heart, Lung and Blood Institute.”
When a heart attack occurs, the danger is in the lack of blood that is getting to the heart muscle. At first the cells are just “stunned” but after a matter of moments, they begin to die. The actions taken by medical personnel must be quick to save the heart. They do this by opening up the artery, inserting a catheter, and inflating a tiny balloon that pushes away the blockage so they can insert a tiny stent to keep the pathway open.
The American College of Cardiology and the American Heart Association had set a goal of 90 minutes for hospitals to get the blood flowing to the heart. The was a stretch for most, as the typical time was usually two hours.
The time was shaved off by making the following changes:
— Having the paramedics do the electrocardiograms and sending them ahead of time to the emergency room. This meant ER doctors and staff could be ready and waiting to jump into action with the arrival of the ambulance.
— The chain of command was minimized in terms of who had to call whom to get the approval for action. Now, instead of an ER doctor calling a cardiologist who gave permission to call a specialist, the ER doctor contacts the specialist directly. There is also a heart attack team on call ready to swarm a stretcher to immediately begin the preparations for the procedure.
— Dedicated rooms were stocked for Heart Attack care and paperwork was minimized to name, date of birth, and social security number.
The changes to these procedures have brought the time it takes to get the artery open from over 2 hours to an average of 1 hour across hospitals nationwide. While this amazing change has gone largely unnoticed by society at large, it has contributed to the lowering of deaths related to coronary heart disease by almost 40%, saving countless lives.