Kudos from the Cath Lab: Volume 19

Aetna Paramedic receives Kudos from the Cath LabSOMERS — During June 2016, ASM Paramedic Billy Schnepp and his partner Bill Gorman responded to a medical call in Somers, CT. The patient had a witnessed cardiac arrest, was defibrillated by Somers Fire Department prior to ASM’s arrival. The patient had a return of spontaneous circulation (ROSC) from Somers FD efforts and was being loaded into their ambulance.

The patient became slowly able to follow commands and answer questions in the ambulance and responded to care consistent with protocol. The EKG was indicative of a STEMI and Billy wirelessly transmitted the 12-lead EKG to [Hospital], activating their cardiac catherization lab from the field. (#16-43800). Early intervention, teamwork and technology all in play to improve outcomes.

Somers Fire DepartmentExcellent job by Somers Fire Department in their aggressive, accurate and appropriate care. Great job by Billy and Bill on deploying wireless STEMI transmission. This is a strong example of teamwork among ASM and our partners. ASM is proud to work alongside Somers Fire Department. 

Kudos from the Cath Lab: Volume 13

Aetna Paramedic receives Kudos from the Cath LabHARTFORD — During April 2015, ASM Paramedic David White and his AEMT partner, Al Pardi, responded to a medical call in Stafford with Stafford Ambulance. The EKG was indicative of a STEMI and Dave wirelessly transmitted the 12-lead EKG to Hartford Hospital, activating their cardiac catherization lab from the field. (#15-29463). The following are comments provided by Hartford Hospital’s Dr. Marcin Dada with some acronyms and patient information removed:

Congratulations everyone on a great care of this antero-lateral STEMI pt last Sunday.

STEMI Ambulance Service of Manchester Pre-hospital EKG TransmissionThis patient was brought to HH by ASM (prehospital ECG was sent and communicated to the ED attending: Dr. Herbst)

While in the ER, patient arrested with return of spontaneous circulation… and was brought to the Cardiac Catheterization Lab.

In a nut shell:

1) HH D2B Time = 77 min (off hrs, Sun 3 AM)

1) STEMI Total Ischemia Time = 115 min

In particular, we would like to recognize the teams involved:

1) HH Team – Dr Hirst, Engles and the Cath Lab team – W. Arcisz, D. Jordan, F. Natale.

STEMI Ambulance Service of Manchester Pre-hospital EKG Transmission B2) HH ER Team – Dr Herbst, and Snyder, and the ED team: M. Moquin, D, Phillips, S. Ferri.

3) and last but not least : ASM and Stafford Ambulance

Strong Work.

Regards,

Marcin Dada, MD

Co-Director, CPC

Hartford Hospital

Kudos from the Cath Lab: Volume 12

Aetna Paramedic receives Kudos from the Cath LabHARTFORD — During April 2015, ASM Paramedic Supervisor Matt Tuttle and his EMT partner, Supervisor Mike Sparks, responded to a medical call in South Windsor. The EKG was indicative of a STEMI and Matt wirelessly transmitted the 12-lead EKG to Saint Francis Hospital, activating their cardiac catherization lab from the field. (#15-24713).

Matt Tuttle

ASM’s Matt Tuttle.

“Nice job, Matt. Thanks for calling early.”

         – John Quinlavin, EMS Manager, Saint Francis Hospital and Medical Center.

Additionally the patient returned a Satisfaction Survey with every one of the 21 boxes checked Strongly Agree or Excellent. In a follow-up phone call he said that Matt should be commended, that he was “absolutely fantastic”, caring and took the time to explain everything as it was happening. Further, he said, “I have nothing but good things to say about your service.”

Vessel Angiography Findings/Treatment:  100% thrombotic occlusion of Distal RCA; hypotensive, required Dopamine, ejection fraction 55%.

Comments: onset 20 min PTA dispatched 0822; EKG transmitted on scene to ED & med control contacted prior to departure; left scene @ 0840 (South Windsor location)- in ED pt remained on EMS stretcher then to cath lab.

SFH Cath Lab Patient Follow-Up Form

EMS Agency: ASM 

Indication: STEMI

First Medical Contact (FMC) (at pt side) Time:  08:28           elapse:  00:00

EMS 12 Lead Acquisition Time:                          08:32           elapse: 00:04

EMS STEMI Alert Request Time (source: cmed):      prior to dept.       elapse: 00:01

EMS 12 Lead Transmit Rec’d Time:                  08:36           elapse: 00:04

Arrival Time (SFHED):                                        09:01           elapse: 00:25

Cath Lab Arrival Time (SFH):                             09:17           elapse: 00:16

Procedure Start Time:                                         09:26           elapse: 00:09

First Device Time:                                                09:33           elapse: 00:07

————————————————————————————————————–

SFHED Door to First Device:                                                 32 min     

FMC to First Device:                                                              65 min

Kudos from the Cath Lab: Volume 11

Aetna Paramedic receives Kudos from the Cath LabHARTFORD — During March 2015, ASM Paramedic Adam Fine and his partner David Tedeschi responded to a medical call in Coventry with Coventry Volunteer Fire Association (CVFA) ambulance. The EKG was indicative of a STEMI and Adam wirelessly transmitted the 12-lead EKG to Saint Francis Hospital, activating their cardiac catherization lab from the field. (#15-17116)

Adam Fine

ASM’s Adam Fine

“First Medical Contact to device under 90 minutes!!!”

         – John Quinlavin, EMS Manager, Saint Francis Hospital and Medical Center.

SFH Cath Lab Patient Follow-Up Form

  • 100% left posterior descending artery ballooned.
  • Re-clotted, managed medically.

EMS Agency:                   ASM (Coventry)

Indication:                        STEMI

First Medical Contact (FMC) (at pt side) Date/Time:           16:31          

EMS 12 Lead Acquisition Time:                                             16:34          elapse: 00:03

EMS 12 Lead Transmit Rec’d Time (source: Lifenet):       16:42           elapse: 00:08

Arrival Time (SFHED):                                                          17:06            elapse: 00:24

Cath Lab Arrival Time (SFH):                                               17:21           elapse: 00:15

Procedure Start Time:                                                           17:42           elapse: 00:21

First Device Time:                                                                  17:57          elapse: 00:15

————————————————————————————————————-

SFHED Door to First Device:                                                 51 min

FMC to First Device:                                                               86  min

 

Kudos from the Cath Lab: Volume 10

Aetna Paramedic receives Kudos from the Cath LabHARTFORD — During March 2015, ASM Paramedic Ted Oliver and his partner David Rice responded to a medical call in Somers with Somers Fire Department ambulance. The EKG was indicative of a STEMI and Ted wirelessly transmitted the 12-lead EKG to Saint Francis Hospital, activating their cardiac catherization lab from the field. (#15-21457)

“Another great job by our ASM partners and this time with Somers Fire. The bar has been raised now with measuring the time from first medical contact to device in the Cath Lab and this requires a strong team effort to meet the new benchmark. Rapid identification and notification are critical elements to success.”

         – John Quinlavin, EMS Manager, Saint Francis Hospital and Medical Center.

SFH Cath Lab Patient Follow-Up Form

  • 100% occlusion of the posterior left anterior descending artery.
  • 90% occlusion of the ramus artery (a division of the left main coronary artery)
  • 100% occlusion of the first through third obtuse marginal arteries
  • 80% RCA ejection fraction < 20%. IABP placed. No PCI – CABG performed.

Treatment by EMS and Direct to SFH ED

EMS Agency: ASM  (run # 21457) (Somers FD Ambulance transported)

Indication: STEMI

 First Medical Contact (FMC) (at pt side)            15:05          elapse:  00:00

 EMS 12 Lead Acquisition Time:                         15:10          elapse: 00:05

EMS 12 Lead Transmit Rec’d Time:                    15:22          elapse: 00:12

Arrival Time (SFHED):                                         15:56          elapse: 00:34

 Cath Lab Arrival Time (SFH):                             16:14          elapse: 00:18

 Procedure Start Time:                                         16:17          elapse: 00:03

SFHED Door to First Device:          to start proc.                 21 min

FMC to First Device:                        to start proc                  72 min

Kudos from the Cath Lab: Volume 9

Aetna Paramedic receives Kudos from the Cath LabHARTFORD — During August 2014, ASM Paramedic Rachel Buechele and her partner Stephanie Boutot responded to a medical call in one of the towns ASM serves. The first EKG was indicative of a STEMI and Rachel wirelessly transmitted the 12-lead EKG to Saint Francis Hospital, activating their cardiac catherization lab from the field. (#14-73447)

“An incredible job by EMS with efficient recognition, treatment and early notification. St Francis Hospital and Medical Center is excited about the partnership we have with the ASM and Aetna staff. We are grateful for the teamwork displayed toward improving care for our STEMI patients, as well as others.”            – John Quinlavin, EMS Manager, Saint Francis Hospital and Medical Center.

Comments: Cath showed 100% Mid RCA Lesion which was opened and stented.

 

STEMI 2

 

Kudos from the Cath Lab: Volume 8

Aetna Paramedic receives Kudos from the Cath LabHARTFORD — During August 2014, Aetna Paramedic Matthew Carter and his partner Kathryn Stewart, wirelessly transmitted a 12-lead EKG to Saint Francis Hospital, activating their cardiac catherization lab from the field.

“Another great job by your staff!! ”            – John Quinlavin, EMS Manager, Saint Francis Hospital and Medical Center.

Cath showed 100% LAD Lesion which was opened and stented.

STEMI Transmission 

ED Arrival 18:34 Sat
EKG Complete 18:37
Cath Lab Paged 18:17
Cath start 19:09
First PCI Time 19:17
Door to Balloon Time             43 Min
Mode of Arrival EMS Other EMS STEMI Alert Cath Lab Activated
EMS Agency Aetna Lifenet @ 18:13 Yes

Kudos from the Cath Lab: Volume 6

Aetna Paramedic receives Kudos from the Cath LabFARMINGTON — On October 21, 2013 a Paramedic Unit from Aetna Ambulance (David Noyes and Kelly Shapiro) responded to a sixty-two year old patient with a significant cardiac history, who had been having chest pain for an hour. They did a 12-lead ECG, which revealed a massive inferior infarction. They called in a STEMI Alert to the John Dempsey Hospital ED. Based on their radio patch, Dr. Sasha Gorenbeyn immediately activated the cath lab (16 minutes before patient arrival).

The patient received a heparin bolus in the ED, and then went right up to the cath lab on the EMS stretcher. The patient was found to have a 100% occluded SVG (saphenous vein graft) to the PDA (posterior descending branch). He underwent a successful thrombectomy and stenting restoring perfusion.

He is doing very well thanks to the great job by the combined EMS/Hospital STEMI Team. Kudos also to the staffs of the ICU and cardiac step down for their outstanding re-covery care. 41 Minute Door-to-Balloon time! The patient was discharged home yesterday doing very well. “Thanks again, and extend our compliments to your crew for a job well done.”

*Individually identifiable protected health information has been removed in accordance with Aetna’s HIPAA-related Privacy Policies. 

Kudos from the Cath Lab: Volume 5

Kudos from the Cath Lab

Kudos from the Cath Lab

Field Care: The story says it all… Sunday 8:00 am. According to Aetna Ambulance Service Supervisor Paramedic Joyce Valentukonis:

  1. Assigned to Aetna 201, Alpha/Monitor 6,
  2. The 12-lead was transmitted with success and then a radio patch notifying of a STEMI alert was given.
  3. Just prior to arriving the patient went into cardiac arrest.
  4. The patient was resuscitated upon arrival of parking lot (eyes open and talking). In the hallway, patient went into cardiac arrest again.
  5. As of today: patient is extubated and talking.

Percutaneous coronary intervention (PCI): EMS-to-balloon time: 61 minutes.

The patient’s spouse returned a Patient Satisfaction Survey with perfect scores and a note that says, “Thank you for saving my husband’s life.”

Kudos from the Cath Lab: Volume 4

ASM Aetna Paramedics operate LifePak 15 cardiac-monitors

MANCHESTER — On May 17, 2012, ASM Paramedic Supervisor Robert O’Neil wirelessly transmitted a 12-lead EKG to Hartford Hospital in order to precipitate a field activation of the cardiac catheterization lab.

The transmission, which flows through a purpose-specific modem stored externally on the LifePak 15 cardiac monitor, draws the attention of the ED physician, interventionalist and cardiologist and most often results in the patient being conveyed from the field directly into the care of the cardiac staff in the cath lab.

This particular patient was in cardiogenic shock as partially manifested by bradycardia.

The following is excerpted from an email from Dr. Marcin Dada, Associate Director of the Chest Pain Center, Hartford Hospital:  Continue reading

The Ultimate Lifesaver? How Aetna and ASM Ambulance Stack Up – Vol. 1

ASM and Aetna Ambulance Paramedics Operate LifePak 15s

ASM and Aetna Ambulance Paramedics Operate LifePak 15s

A recent Wall Street Journal article described cutting edge equipment, techniques and skills in Emergency Medical Services (EMS) that are changing patient outcomes, revolutionizing care and sharpening the leading edge of the EMS industry.

Read the Wall Street Journal article here…

So how do Aetna and ASM match up against The Ultimate Lifesaver?

Volume 1: Cardiac Monitors Continue reading