Neb. fire department's EKG monitors will speed up cardiac care

By Andrew J. Nelson
Omaha World-Herald

OMAHA, Neb. — As part of its effort to make Omaha a safer place to have a heart attack, the Omaha Fire Department is adding a new tool officials say will save lives.

The department has purchased 18 advanced EKG devices at a cost of $423,000. Like older models, the devices, called 12-lead EKG monitors, identify heart rhythm abnormalities.

But the new monitors are able to gather data in the field that were once obtained in the hospital and transmit that information via cellular phone frequencies to an emergency room. That allows physicians and hospitals to better prepare for patients and treat their ailments sooner.

"There's only so much time that (heart patients) have before irreparable damage happens," said Perry Guido, acting assistant fire chief and former EMS battalion chief.

An EKG device measures electrical activity in a heart. Medical personnel use an EKG readout — an electrocardiogram — in treating patients.

The 12-lead EKG technology "is the best stuff out there to diagnose heart ailments, (or) any heart problems, in the field rather than in the actual hospital," said Joe Mancuso, a spokesman for the Fire Department.

The technology may be new to Omaha, but it has been available for some time. What is changing, though, is what is being done with the information produced by EKG devices.

"The big difference is what they do with the information while the patient is still in en route," said Blake Cerullo, director of EMS marketing for Zoll, the company supplying the machines to Omaha. "A medical professional is making a decision as to where that person should go as a result of the information that's been transmitted."

If the patient is having a heart attack, the proper place to send the person is usually the hospital's heart catheterization lab. At a "cath lab," a catheter is inserted into the blocked artery, and emergency balloon angioplasty is performed. If a hospital knows a patient is having a heart attack before arrival, the required medical personnel can be activated and ready sooner.

Faster "door-to-balloon" times make a difference in survival rates. For each 15-minute decrease in door-to-balloon time from 150 to less than 90 minutes, there are about six fewer deaths per 1,000 patients treated, according to the medical Web site Journal Watch.

"That's why every minute counts," said Dr. Wesley Grigsby, chairman of the Emergency Department at Creighton University Medical Center. "That's why we measure our success in minutes — in the number of minutes it takes us to open up a blood vessel."

Getting data up front, he said, means "we have a much higher likelihood of getting the patients opened up more rapidly."

The new EKG devices will be on all ambulances by later this month or early December.

"We are definitely excited about it," Guido said. "If you look at how much time really is available (after a person has a heart attack), a lot of that is delayed in getting them to the emergency room."

The devices have been paid for in part by local hospitals, Guido said. Alegent Health, the Nebraska Medical Center and Methodist Hospital paid a combined $240,000. The John and Ruth Scott Foundation contributed $52,000.

The Fire Department itself will pay $131,000 over the next four years, which is roughly equal to the cost of upkeep for the older EKG monitors. 

Copyright 2007 The Omaha World-Herald Company

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