St. Mary Medical Center beats national average for key heart attack measures
By Samantha Bambino
Robert Scott Elborn’s family was all set to drive him to the hospital.
He was sweating and feeling sick after finishing up yard work at his Newtown residence. But then he collapsed. His breathing stopped and he quickly began to turn blue. He was having a heart attack. As his son-in-law started chest compressions, another dialed 9–1–1, a simple action that ultimately saved his life.
According to Dr. George Heyrich, St. Mary’s structural heart program director, minutes equal muscle.
“The longer a heart goes without blood, the worse the outcome,” he said.
If Elborn’s family had followed through with the initial plan to drive him, the end result could’ve been catastrophic. So why did calling 9–1–1 make all the difference? According to Heyrich, as soon as an emergency call comes through, the local EMS squad and his ST Elevation Myocardial Infarction Alert team are poised and ready to take action.
“If Robert’s family had gotten him in the car and he stopped breathing on the way to the hospital, we would have seen a much different outcome,” Heyrich said. “Instead, with a single phone call, his family mobilized a whole team of first responders, cardiac surgeons, cardiologists and nurses who instantly began working behind the scenes to save his life.”
In mere minutes after placing the call, EMS were at Elborn’s home trying to get his heart pumping again. They also performed an EKG, instantly sending the data electronically to the STEMI Alert team. By the time Elborn arrived at St. Mary, the team was already prepared to perform a cardiac catheterization, a procedure in which a balloon is inserted through the clogged artery, then inflated to open it.
The recommended average door-to-balloon time — the span of time from when a patient enters the emergency department to when they receive a balloon angioplasty — is 90 minutes, according to the American College of Cardiologists. While many hospitals have improved that time to 59 minutes, St. Mary has gone beyond expectations to reach an average of fewer than 53 minutes.
Decreasing door-to-balloon time has been an ongoing project both locally and nationally for about five years. According to Heyrich, continuing to lower this average is dependent upon a number of factors, but first and foremost, EMS. Currently, he and his team are working with local first responders to improve “first-medical-contact-to-balloon” time, or EMS-to-balloon time. The national goal for this metric is less than 90 minutes, with St. Mary beating the average once again at 75 minutes.
“We’ve been able to improve the door-to-balloon times at St. Mary to where we can regularly get patients the care they need for a heart attack in as little as 20 minutes,” Heyrich said. “Now we’re working with our EMS partners to determine how we improve times from the moment EMS arrives on the scene.”
To help improve these metrics, St. Mary offered free EKG training to local first responders, which educated them on the technology and how to send results back to the team at St. Mary.
According to Heyrich, in addition to advanced training, a strong emphasis is placed on accountability. Each week, all of St. Mary’s heart attack cases are reviewed to see where improvements can be made. Report cards containing data metrics of arrival time and EMS-to-balloon time are also sent to the managers of the EMS squads so first responders can determine areas for adjustment.
While EMS, Heyrich and his STEMI Alert team can perform their jobs flawlessly, all of their training is for naught if the patient doesn’t dial 9–1–1. Week after week, this continues to be Heyrich’s biggest challenge. Why aren’t people calling for help? Over the years, he has found three core answers.
First, many local residents fear they’ll be taken someplace other than St. Mary if they request an ambulance. Second, they’re in denial. They don’t think they’re actually having a heart attack, and therefore don’t need an ambulance. Finally, they believe having a loved one drive them is quicker and more convenient, and neighbors won’t be burdened with the sound of sirens.
While Heyrich understands the reasoning behind each one, he still encourages people to call 9–1–1. To help educate the public, St. Mary has been promoting the “Arrive Alive” campaign. By requesting an ambulance, travel time is decreased to about eight minutes, there is less stress on loved ones and the STEMI Alert team is able to treat the patient the instant they come through the front door.
Elborn’s family is living proof that St. Mary’s efforts are working.
“Everyone from the dispatcher who walked us through how to do the chest compressions to the team of doctors who were already waiting for my husband were simply great,” said Elborn’s wife, Gaye. “Scott had a massive heart attack, but he was out of the hospital in two days and back lifting weights in less than a month.” ••
St. Mary Medical Center is located at 1201 Newtown-Langhorne Road in Langhorne. For more information, visit stmaryhealthcare.org.
Samantha Bambino can be reached at firstname.lastname@example.org