New East Jefferson protocols for paramedics credited with saving life

By Erik Hidle
Peninsula Daily News

PORT TOWNSEND -- Karen Nelson said she can't thank East Jefferson Fire-Rescue enough for what they have done for her family.

"My father was the first one to be helped by the new heart-attack program," Nelson said at the fire district's board meeting last Tuesday.

"Without the new program, he might not be here today.

"Thank you all so much."

Nelson's father, 88-year-old Norman Johnson, was the first one to benefit from new protocols for paramedics in East Jefferson County to administer a host of drugs, including "clot busters" -- which can destroy a blood-clot blocking blood and oxygen to the heart -- and provide immediate treatment during heart attacks.

The kits issued to paramedics beginning June 1 include blood thinners such as heparin, intravenous nitroglycerin and thrombolytics -- or clot busters -- that can lessen the long-term damage from a heart attack.

Pomeroy said that the kind of heart attack -- a STEMI, which is short for ST-Segment Elevation Myocardial Infarction -- that Johnson suffered is common.

It is a severe heart attack caused by a prolonged period of blocked blood supply that affects a large area of the heart.


Quick response

Pomeroy said the attacks carry a substantial risk of death and disability and call for a quick response.

The new protocols come into play after a patient is taken to Jefferson Healthcare and diagnosed as suffering from a STEMI heart attack, and the drugs are administered in the ambulance while the patient is transferred to Harrison Medical Center.

Johnson was the first to receive that treatment -- one of six who have benefited from the new procedure.

"The procedure is saving lives," Pomeroy said.

"But there is a window there for us to administer the drugs and get them into the catheterization lab."

The nearest lab is in Kitsap County at Harrison Medical Center.

"It is important to note that patients who go directly to the emergency room at Jefferson Healthcare will be assessed rapidly and, if appropriate, [the drugs] will be administered to the patient before they are transported to Harrison Medical Center," said Jim DiCianne, director of emergency services for Jefferson Healthcare.

But in case the time line gets tight, the paramedics have the ability to multi-task.

Pomeroy said this saves precious time.

"There is a 90-minute window in which to diagnose a patient and administer the drugs," Pomeroy said.

"Key to the success of this whole process is how fast the patient calls 9-1-1.

"Patients who have previously experienced similar chest pains frequently just try to 'tough it out' and don't call 9-1-1 until it's too late to administer the drugs that could save the heart muscle from permanent damage."

Pomeroy said his paramedics have embraced the new procedures and have followed through on all six occasions when the drugs were required.

He said he hopes the new treatment goes beyond the borders of Jefferson County.

"In rural counties that don't have access to a lab close by, this is critical," Pomeroy said.

"I think there is a chance this could take on a statewide flavor."

Pomeroy is planning to meet with regional emergency services groups in the next few weeks to discuss the results of the first six STEMI patients -- all of whom have survived.

Nelson said as far as she's concerned, the procedures should be introduced statewide tomorrow.

"As soon as possible," Nelson said.

"It will save lives; I know it will. I've seen it work here."

Also participating in the program are Jefferson Healthcare hospital, Port Ludlow Fire & Rescue, Harrison Medical Center, Kitsap Cardiology and the Poulsbo Doctors Clinic.

According to East Jefferson Fire-Rescue Public Affairs Officer Keppie Keplinger, Dade County, Fla., is currently the gold standard for the program. Keplinger said out of 1,100 cases in Dade County in the last 12 years, there has been only one fatality from a STEMI, thanks to the new protocols.

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Reporter Erik Hidle can be reached at 360-385-2335 or at erik.hidle@peninsuladailynews.com.

Last modified: July 25. 2009 10:07PM
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