For cardiac patients, time is muscle.
From the time of a heart attack to the time the patient receives treatment, heart muscle that is losing blood flow is being damaged. Trinity Hospital's Emergency/Trauma Center is already noted for quick treatment times, but a new system could improve that time still further.
"The national standard is to get the patient seen and treated quickly, in what we call 'door to balloon' time, in 90 minutes," said Dr. Jeffrey Sather, medical director of Trinity's Emergency/Trauma Center. "Here, we're way below the national standard and our time is less than an hour."
Katina Tengesdal/MDN - - Dr. Jeffrey Sather reviews heart monitor data sent to the emergency room from the ambulance with the LIFENET equipment.
Katina Tengesdal/MDN - - Trinity Hospital’s cardiac catheterization lab is pictured. With the LIFENET early warning system, the lab can be prepared before the patient arrives.
Katina Tengesdal/MDN - - Dr. Jeffrey Sather, medical director of Trinity’s Emergency/Trauma Center, left, explains how data is transmitted from a 12-lead EKG machine aboard an ambulance while Lindsey Brossart, paramedic for Minot Community Ambulance, right, demonstrates.
"With this (LIFENET) system, we're alerted ahead of time if a patient has what we call an STEMI elevation. The system puts the EKG right up on a screen in the ER 30 seconds from the time the ambulance presses transmit," he added.
During a cardiac event, a patient receives a 12-lead EKG, which is a diagnostic tool used to identify a myocardial infarction or heart attack. The EKG the patient receives in the ambulance can then be quickly transmitted through LIFENET to Trinity to be read by a physician.
Sather explained that LIFENET is an Internet-based system that transmits EKG data across a cellular system. At Trinity's ER, a program is always running in the background that accepts EKG data, and an alert pops up as soon as new data is received.
Trinity claims its status as the first hospital in the country to start using the system, about two years ago with Minot Community Ambulance and Trinity's North Star CriticAir helicopter. Operators said the system worked so well that Trinity hoped to bring it to rural hospitals and ambulance services around the region.
"With this system, we can read the EKG information when the patient is still out at their farm in rural Tioga, for example," Sather said. "Knowing the information ahead of time, the rural hospitals can give thrombolic (clot-busting) medications, and we can get the cath-lab ready here. We could also dispatch the helicopter if it's needed."
Sather said that if the heart attack happens during the day, knowing the information before the patient arrives can help cardiac catheterization staff prepare the lab that may already be in use. And during the night, on-call cardiologists can report immediately after the information is received.
To fund putting the system into rural hospitals and ambulances, Trinity Health Foundation has launched a $1.7 million campaign called the North Dakota Cardiac Support Initiative. The initiative will provide cardiac monitors, defibrillators and 12-lead EKG equipment to 41 rural ambulances, 14 rural hospitals and 12 rural clinics within the 16 counties surrounding Minot.
"We knew the system had great results, and we started talking to rural ambulances about the system," said Amy Moen, Trinity Health Foundation director. "The main issue has been dollars. The (LIFENET) equipment for the ambulance and the fees to use the server cost between $25,000 to $30,000 per entity."
Moen said that she anticipates about 75 percent of the funding to come from federal and local grants, with the rest obtained via corporate contributions. Moen said that the corporate efforts have already borne fruit with Enbridge Pipelines donating the first $10,000 in support of the initiative.
The goal of the initiative is to raise the full $1.7 million by December of 2011, and to have the equipment placed in most surrounding rural hospitals and ambulances. Equipment will be purchased as funds are raised, Moen said.
"We're rolling out the equipment as we get the funding, and we'll start in key areas that have the highest use," Moen said. "We'll have four ambulances and two hospitals brought in at a time."