Heart-attack victim David Rubin recalls a cardiac team was waiting and “ready to go” when he arrived by ambulance at Alexian Brothers Medical Center’s (ABMC’s) emergency room.
“I hit the door, and they just said, `Hello. You’re having a heart attack,’ ’’ says Rubin, who was 48 when he suffered the heart attack after delivering a presentation to a group of attorneys at a Schaumburg hotel.
The team went to work immediately, conducting a physical exam, collecting information about his medical history, setting up an intravenous line, giving him medication, drawing blood for lab work, and taking a chest X-ray.
Rubin, the owner of a men’s custom clothing business, then was rushed to ABMC’s cardiac catheterization laboratory. Forty-eight minutes after arriving at the hospital, he underwent successful balloon angioplasty, with stents implanted in two blocked arteries.
The cardiac team assembled after paramedics used a Rosetta™ device to send Rubin’s EKG results by cell phone to ABMC as he was rushed by ambulance to the Elk Grove Village, Ill., hospital. Alexian Brothers Health System (ABHS) has purchased Rosetta devices for paramedics to give doctors a head start on diagnosing and treating heart-attack patients.
As an early adopter of the American Heart Association’s Mission: Lifeline system of “STEMI” best practices for heart-attack care, ABHS has implemented protocols to ensure coordinated and consistent care for heart-attack victims, beginning with the moment a 911 call is received and continuing through treatment and recovery.
The STEMI system includes methods for measuring performance, which helps ABHS continually improve the quality of the care provided by its hospitals. The Rosetta device plays a key role in D2B, a core measure of quality in the treatment of heart attacks. D2B, which stands for “door to balloon” time, is the time from a patient’s arrival in the emergency room to the inflation of a tiny balloon to open a blocked artery during angioplasty. National quality standards for heart-attack care call for D2B of 90 minutes or less. ABHS routinely records D2B times of 90 minutes or less, with ABMC beating the mark in 100 percent of heart-attack cases. From January 2010 through June 2010, the hospital averaged D2B of 59 minutes.
The Rosetta device contributes to ABHS’s strong D2B performance by providing a “heads-up” to cardiac teams, which allows patients to be treated faster, says Nikki Manuel, R.N., A.P.N., Clinical Nurse Specialist for Cardiovascular Services at ABMC.
After receiving an EKG transmission through a Rosetta device, emergency-room physicians evaluate the EKG, and if they determine the hospital-bound patient has suffered a heart attack, a cardiac alert is issued and the cardiac team is paged.
The team, including cardiologists, nurses, a radiologic technologist, a phlebotomist, an IV therapist and a chaplain, gathers in the emergency room and awaits the patient’s arrival. In Rubin’s case, a cardiac alert was issued a few minutes before his ambulance arrived at ABMC. “That doesn’t seem like a lot, but it helps us get everything prepared quicker,” Manuel says. “Any time you can get a few minutes heads-up, it has a positive impact.”
Without a Rosetta device, paramedics must verbally communicate a software program’s interpretation of EKG results to emergency-room personnel. Because such interpretations are subject to error, an emergency-room physician cannot formally diagnose a potential heart-attack patient before reviewing the EKG results presented by paramedics when they arrive with the patient. Potentially valuable treatment time is lost.
Rubin, who is married and the father of a teenage daughter, says the Rosetta device was a “huge” factor in his successful treatment. “That thing should be in all ambulances,” he says. “It is a wonderful piece of equipment. (Without it,) I would imagine when I got there, they would be relaying information and scrambling around to gather people.”
Instead, doctors quickly pinpointed the cause of his heart attack: His right coronary artery and circumflex artery both were 100 percent blocked. Using balloon angioplasty, a minimally invasive procedure, doctors opened both arteries and implanted a stent in each one.
Thanks to the Rosetta device and the care he received at ABMC, his heart suffered no lasting damage, Rubin says. He spent two days in the hospital, took on a lighter work schedule for the next month, and then returned full-time to his business.
Rubin, who didn’t have any heart problems before his heart attack, says stress and his Type A personality were the likely causes. “There was nothing indicating that anything was brought on by eating habits or lifestyle or anything like that,” he says.
Nonetheless, he has modified his diet, consuming lower-fat foods, reducing his consumption of red meat and eliminating fried foods. He also has been exercising more often, an extension of a cardiac rehabilitation program he entered after leaving the hospital.
Rubin says he was fortunate that he was close to ABMC when he suffered his heart attack. “I’ve been feeling awesome,” he says. “The hospital personnel took great care of me.”