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Rapid heart treatment is saving lives

Dawn Fox, a registered respiratory therapist, connects a patient to EKG equipment Friday in the hospital's emergency department. (Tribune photo by Ron Adams)

WILLMAR -- It used to be that if you were a rural Minnesotan and had a severe heart attack, you didn't get the same level of care as someone who lived in the Twin Cities.

Rarely were heart-attack patients immediately transferred to another hospital for higher-level care, said Dr. George Gordon, chief medical officer and emergency physician at Rice Memorial Hospital.

"There was almost an assumption made that you didn't have any other option," he said.

Around a decade ago, a group of doctors began challenging that assumption.

Rural hospitals, after all, already knew how to stabilize trauma patients and get them swiftly transferred for more advanced care, Gordon said.

"We've done that for years and everybody knew we did it. In many cases those patients require more care than a cardiac patient did," he said.

Today it's now considered the standard of care to transfer patients with the most severe type of heart attack, the so-called STEMI or ST-elevated myocardial infarction, so they can be treated as quickly as possible at a cardiac catheterization lab.

In 2008, Rice Hospital transferred 27 patients to St. Cloud for this level of treatment. On average, it took 97 minutes from the time the patient arrived in the emergency room in Willmar to the time the patient was taken into the cardiac cath lab in St. Cloud, 60 miles away.

"Our goal in the ER is to have the patient ready to transfer in 30 minutes. We have beaten that," Gordon said. "It's been a dramatic change."

This means emergency staff have half an hour to administer a rapid EKG to the patient, identify that the patient has a STEMI, call for a helicopter, stabilize the patient with medication, and conduct X-rays and laboratory tests.

Survival rates are improving, said Dr. Norris Anderson, medical director for care improvement at Rice Hospital.

The rapid treatment means that patients also are less likely to sustain serious heart damage as the result of a heart attack, he said.

"We are saving lives and we are saving hearts. We are seeing less congestive heart failure," he said.

The hospital continues to work at shaving down its response time even further. This year, new equipment being installed in the emergency room will allow EKG images to be transmitted by paramedics before the patient even arrives in the hospital -- a move that will help speed up the diagnostic process and gain valuable time for the patient. The money for the equipment and training in how to use it was raised last year by the Rice Health Foundation and will be made available to all the ambulance services in Kandiyohi County.