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For Jersey Shore Hospital, Treating Heart Attacks is a "Team Effort"
Jersey Shore, PA (May 30, 2008) - When a patient is suffering from a serious or potentially fatal heart attack or STEMI (ST-elevation myocardial infarction), there is a 90-minute window of opportunity established by the American Heart Association's "5 Million Lives Campaign," and the Medicare & Medicaid Quality Improvement Organizations' national project to get the patient to a Cardiac Catherization Lab. It is the goal of every hospital, nationwide, to rapidly identify, respond and treat all STEMI patients. The ultimate goal is to reestablish the blood flow to a blocked coronary artery. The restoration of blood flow to the cardiac muscle is accomplished by performing a cardiac catherization. This procedure not only allows the cardiologist to identify the areas where the blockage has occurred, but also enables him to initiate medical intervention which can open and maintain the blocked vessel. This rapid intervention minimizes damage to the heart muscle and improves the patient's outcome.
Being a rural healthcare provider, Jersey Shore Hospital is faced with the challenge of caring for and stabilizing these patients and then transferring them to a site offering catherization services. By utilizing the recommended guidelines from the American College of Cardiology for management of STEMI patients, the Hospital strives to identify, stabilize and transport these patients as efficiently and effectively as possible to meet the goal of establishing an open artery within the "90-minute window." According to Dr. Aaron Kolb, Director of Emergency Services at Jersey Shore Hospital, "Jersey Shore Hospital views these situations from a 'time is muscle' standpoint, where a patient experiencing a STEMI can have more cardiac muscle preserved with quicker treatment."
When a patient is experiencing heart attack symptoms and arrives at Jersey Shore Hospital, the absolute first step in care is getting an electrocardiogram (EKG) of the heart. Stabilizing and obtaining crucial health information on the patient from family and loved ones is the next priority. Following patient stabilization, JSH then determines if the patient is a candidate for a cardiac cath. In most cases, top priority is shifted to transferring the patient to a healthcare facility offering the cardiac caths. In general, the patient is transferred to either Williamsport Hospital & Medical Center or to Geisinger Medical Center and their Level I Heart Attack Center. Recently, Geisinger presented Dr. Thomas Forker, a Jersey Shore Hospital Emergency Services physician, with a certificate of achievement for direction in preparing and transporting a STEMI patient to that facility. The 90-minute goal was met and the patient had received the cardiac catherization within 82 minutes of arrival in Dr. Forker's care. "Geisinger follows a very strict, streamlined protocol so that transport takes minimal time for the patient," says Karen Tompkins Weber, RN, Level I Heart Attack Coordinator for Geisinger. "Jersey Shore Hospital is very much aware of that protocol and their doctors and nurses have really 'stepped up' to make sure the patients receive great care."
According to David Rothrock, BS, RCIS, Manager of Cardiology Services at Williamsport Hospital, there are three, 30-minute interval steps that Jersey Shore Hospital consistently competes to achieve the 90-minute window of opportunity for the patient. "I have to compliment the Emergency Services staff at Jersey Shore Hospital," says Rothrock. "They do an excellent job at stabilizing and facilitating patients out of their Emergency Room and arranging transport to the catherization lab." Dr. Mohammad Shafique is a member of Susquehanna Cardiology in Williamsport who practices at Jersey Shore Hospital each week. Dr. Shafique agrees saying, "When we have a STEMI patient arriving from Jersey Shore Hospital, we can be confident that the patient will be stabilized and prepared for the cardiac cath."
With the cooperation from local paramedics, Life Flight, the Hospital Laboratory, Radiology and Nursing staff, the ER staff has been able to establish a team that focuses on the STEMI patient so that the maximum benefit is accomplished. In order to maintain efficiency while being treated and stabilized, many times that patient does not even leave the ambulance transport bed. To constantly be prepared for STEMI patients, "The staff has developed tools to help meet our goals," says Barbara Kozlowski, RN, Director of Ambulatory Services. "STEMI kits provide our staff with everything a STEMI patient requires. It's about being prepared and providing the most benefit to our patients."
To alleviate fear, Dr. Kolb says they constantly inform family members of any details available that he can confirm. Kozlowski added "I am proud to say that our nurses and physicians do not treat these patients as just a STEMI case. They do everything they can to incorporate the family into any decision making process. It's a very frightening time for our patients and their family and we try to make them as comfortable as possible."
Since Jersey Shore Hospital does not offer cardiac catherization, the focus is preparedness. The staff at JSH, the local EMS providers and the regional cardiologists all work together as a team to provide the best care possible. To continue to provide that care and to offer better timelines and efficiency, the Hospital receives a report from the cath lab about each case. This report provides both healthcare facilities with information on each STEMI patient and allows for feedback and discussion on the process. When speaking about Jersey Shore Hospital and their efforts, Dr. Shafique says, "I am very pleased with the process between our Cath Lab and Jersey Shore Hospital. As I continue to review these STEMI cases, I consistently note that JSH is achieving the 90-minute goals. Patients are very lucky to have the Hospital there so that their travel time does not further risk the condition."
Currently, the Jersey Shore Hospital Emergency Department treats over 12,000 patients annually. "Our staff really embraces the effort to treat all of our patients and meet any goals that have been established to ensure the best care is given. It is a true team effort," says Kozlowski. The Hospital ER Department staffs three full-time and three part-time physicians, along with nurses certified in Emergency Care.
This summer, the Department will be relocated into the new 45,000 square foot addition of the Hospital. Patients will continue to receive care in private rooms with state-of-the-art technology.
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