NUMC improving odds for heart attack patients

By RON LARSEN

Journal Staff Writer

NEW ULM -- As a result of recent harnessing of medical and transportation technologies at Abbott Northwestern Hospital in Minneapolis, heart-attack victims brought to the New Ulm Medical Center's emergency room will be only minutes away from the most effective treatment available anywhere.

"We are partnering with Abbott Northwestern Hospital in Minneapolis to begin a way to treat people who are having a heart attack in a more efficient and more rapid manner," said Dr. Joan Krikava, NUMC's medical director.

Using patient-transport helicopters based at Redwood Falls and Mankato, NUMC staff is aiming at having eligible patients diagnosed and in Abbott Northwestern's angioplasty suite within 90 minutes of the patient's arrival in the emergency room, Krikava explained.

"The treatment of heart attacks has changed hugely in the last 15 years or so, and the newest treatment of heart attacks is to get people out of the emergency room and into a treatment center quickly in order to get their artery open and stop their heart attack."

Medical studies in both the United States and Europe in recent years are the trigger for this timed pursuit of improved medical care by getting the patient into the nearest angioplasty unit, Krikava said.

"They looked at (the) patient (that) comes in with a heart attack. Should you even use those medications, or should you take the patient right from your ER to what they call an invasive or angiogram suite? Do an emergency angiogram; open up the artery in a different way," Krikava explained.

"That was really quite a revolutionary concept when they started to look at that."

The preliminary information from the American studies were confirmed big time in the Danish and Czech studies. The Danish study -- the most recent of the four -- confirmed the mortality rate dropped significantly among patients who received angioplasty treatment within 90 minutes and no later than 120 minutes of their arrival in ER.

"There's a gray zone between 120 and 150 minutes where there is some improvement in mortality rates, but after 150 minutes there is no improvement whatsoever," Krikava said.

Obviously, as New Ulm is near the outer edge of that 90-minute zone surrounding Abbott Northwestern, time is of the essence when the ER staff is dealing with a potential heart-attack victim. Determining whether the patient is really suffering a heart attack or simply has symptoms mimicking a heart attack takes time.

"Actually, it doesn't take all that long," said Julie Halvorson, NUMC's emergency services manager. "The key is the EKG (electrocardiogram). The diagnoses is based upon the results of the EKG, and we're now set up with a fax machine which allows to fax the EKG results to Abbott Northwestern's angiogram suite."

North Air Ambulance in Redwood Falls also made a significant contribution to the program, cutting its arrival time to 20 minutes and lowering its time to load a patient and take off from half an hour to 10 minutes.

The pressure on the ER staff still is intense in keeping the patient on schedule, but it's not like the staff will be facing that situation every day, Halvorson said.

"We normally have about 20 patients, or about two a month, during the year that would qualify for this procedure."

"I want to point out, however, that we're not going to do anything that will put either the patient or staff in harm's way," Krikava said. "We're not going to have the helicopter up in bad weather. In those cases, we will treat the patient in the conventional manner."