Case shows value of new 12-lead monitor in field

Your ED can be significantly better prepared for cardiac patients if you receive more complete monitor data while the patient is en route to the hospital, say sources interviewed by ED Management.

Need convincing? Consider this dramatic example from James Glancy, MD, medical director of cardiovascular services at Dominican Hospital in Santa Cruz, CA. Glancy also is assistant clinical professor in the University of California, San Francisco, School of Nursing and a co-investigator in a tele-electrocardiography study under way in Santa Cruz.

The patient was Alec Popovich, a 50-year-old man who had suffered two previous heart attacks. When he suspected he was having a third in August 2003, he hopped into his truck for the half-hour drive from his mountain home to the hospital.

A call for help

But after four miles, he pulled over, got out of the truck, and collapsed to the ground. He was able to dial 911 on his cell phone. When medics found Popovich, they hooked him to the new 12-lead cardiac monitor immediately.

Popovich’s electrocardiogram (ECG) data were sent to the ED at the Dominican Hospital in Santa Cruz. Glancy read the ECG and determined that Popovich was suffering from the kind of heart attack that requires stent placement or balloon angioplasty to open a coronary artery — procedures that are performed in Dominican’s cardiac catheterization lab.

With this advance notice, Glancy was able to prepare for the ambulance’s arrival, which included calling in the cath lab team from home.

Popovich was in the hospital only 48 minutes before a catheter was used to clear his blocked artery, 43 minutes ahead of the hospital’s average treatment time of 93 minutes.

The American College of Cardiology and American Heart Association have set a target time of 90 minutes, plus or minus 30 minutes, for performance of this procedure from the time of a patient’s arrival. The average time for California hospitals that participated in the 2002-2003 National Registry for Myocardial Infarction is 109 minutes, Glancy points out.

Popovich spent 22 hours in Dominican Hospital and then was transferred to Kaiser Hospital in Los Gatos, where he spent less than half a day before being discharged.

Source

For more information on Dominican Hospital’s experience, contact:

  • James Glancy, MD, Medical Director, Cardiovascular Services, Dominican Hospital, 1555 Soquel Drive, Santa Cruz, CA 95065. Phone: (831) 462-7700.