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North Carolina Speeds Up Heart Attack Care

North Carolina Speeds Up Heart Attack Care

North Carolina are one of many states in the nationwide project to speed up heart attack care response.

In an ideal world every heart attack would be treated like Willard “Ziggy” Hill’s, within 90 minutes of arriving at a small community hospital in North Carolina, he was having a blocked artery reopened at Duke University Medical Center 25 miles away.

“It was like being a car in a pit stop at NASCAR,” he said. “I thought ‘I am in really good hands.”

2 years ago Mr. Hill might not have been that lucky. North Carolina used to rank below national norms of heart attack care response, now it may be one of the best.

The reason is a nation project to redo how serious heart attacks are handled. Paramedics, doctors and 65 hospitals put aside powerful individual interests like money and control, and focused on giving faster care.

Speed is paramount when dealing with heart attacks as drugs, devices and doctors can do no good if they do not reach people quickly, before the heart attack suffers permanent damage.

heartattack North Carolina Speeds Up Heart Attack Care

Heart attack occurs as a result of blocked arteries that cripple critical blood supply. The first choice of treatment is angioplasty; this procedure involves inserting a tiny balloon in to the vessel, which is then inflated to flatten the clog.

Many small hospitals however lack the specialized cauterizations labs needed for angioplasties. Instead, they sometimes give clot-dissolving drugs, which do not always work.

In the North Carolina project, 55 small hospitals agreed to send appropriate patients to 10 larger ones for angioplasty, even though it meant giving up thousands of dollars of revenue. Mayme Roettig, the nurse who coordinated the project said,

“If this is your Aunt Bess and she comes in to your emergency department and you offer her a level of care that’s not the best, and you have to go to that funeral in that small community, that’s what they think about - not cost,”

Big hospitals also had room to improve, too, said Dr. Christopher Granger, the Duke cardiologist who led the project.

Statewide, “up to 40 percent who should get clot-busting drugs or angioplasty were not getting it, and when it was being given it was being given too slowly,” he said.

The project has already proved its worth for many patients like Willard Hill. Researchers compared the care of more than 2,000 patients before and after the project and found:

  • More patients got care at top-tier cardiology hospitals, and more quickly than similar patients did before the project began. Helicopter transfers rose and more paramedic’s diagnosed heart attacks from EKGs done in ambulances.
  • The number of patients receiving angioplasty rose, and the portion of eligible patients not receiving artery-opening procedures dropped.
  • Every single measure of time improved. Examples: the average time it took a small hospital to evaluate and refer patients to a larger one dropped from two hours to 71 minutes; average transfer times plunged more than half an hour.

“This has been a pretty spectacular effort,”

Said Dr. Harlan Krumholz, a Yale University cardiologist who is leading a national campaign to speed up heart attack care.

Nearly 1,000 hospitals have now joined a nationwide campaign that began a year ago to have hospitals give angioplasty treatment faster.


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