| County chosen as test site for new heart monitor |
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8 December 2003, for the Santa Cruz Sentinel Alec Popovich felt a tightness in his arm, then a pain in his chest. Having suffered two previous heart attacks, he feared a third was under way. Unfortunately, he had already left work at Stanford Hospital and driven to his home in the hills between Santa Cruz and Los Gatos, far from any hospital. Fortunately, though, Popovich was able to benefit from an experimental heart monitor being tested in Santa Cruz County that is designed to help heart attack victims get quicker treatment. The monitor let a doctor at the hospital diagnose Popovich’s heart attack after he had been picked up in an ambulance and was on his way there, and let the staff prepare before he arrived. For heart attack victims, immediate medical care is crucial. Getting immediate care had not been a problem for Popovich after his previous heart attacks. "The first two I had while working at Stanford Hospital, so I was able to walk over to the emergency room," Popovich said. In August, though, things were different. After feeling chest pain at his home, Popovich thought the fastest way to get treatment would be to drive to Kaiser Hospital in Los Gatos. But after driving about four miles, his condition had worsened, and he felt too faint to drive. He pulled over and got out of his truck, then collapsed on the side of the road and was barely able to call 911. He had difficulty describing his location along the rural road, and when the ambulance came, it flew past him. Soon after, a passing motorist noticed Popovich and stopped. Using Popovich’s cell phone, the good Samaritan guided the ambulance back to the site. In the ambulance, medics hooked Popovich up to the new type of heart monitor. Called a tele-electrocardiogram, or tele-ECG, the monitor measures electric impulses in the heart that show its rate and how regular it is. More sophisticated versions such as the tele-ECG can also show if the flow of blood to the heart has diminished. "Every second that ticks away without oxygen, more heart muscle dies. And when it dies, it doesn’t recover," said Barbara Drew, professor in the School of Nursing at UC San Francisco. Drew was awarded $2.5 million by the National Institutes of Health to test tele-ECG in Santa Cruz County ambulances to see if it would cut down the time it takes to treat people having heart attacks. She chose Santa Cruz County to conduct the research because the county is large and many live far from the nearest hospital. "Time is muscle" is a motto of theirs, Drew said. ECGs are standard equipment in ambulances and hospitals, but the new type uses a cell phone connection to send the patient’s reading ahead to the hospital so doctors can prepare for the patient. The tele-ECG also gives a more detailed reading than standard ambulance monitors but is easier to hook up to patients than comparable monitors. Unlike standard ECGs, the new system also continually monitors the patient in the ambulance. If the patient’s condition worsens, it automatically sends another reading to the hospital so doctors are kept up to date. Popovich’s ECG reading was sent to the emergency room at Dominican Hospital, where a doctor immediately alerted cardiologist James Glancy. Glancy determined that Popovich would need help from the cardiac catheterization lab to unblock his heart and return blood flow to his heart muscle. On Sundays, the catheterization lab is closed, Drew said. But the advance warning let the staff prepare supplies for treating Popovich. With the help of the tele-ECG, Glancy was able to unblock Popovich’s heart in 48 minutes, half the average time for the hospital. Dominican Hospital has an excellent record with this procedure, taking 93 minutes on average, meeting a goal set by the American Heart Association. Drew’s study will take about five years — the time which it will take to evaluate enough patients to tell whether the new monitor is helping. Each patient suffering from an apparent acute heart attack picked up by area ambulances will be hooked up to the equipment. The patients will be randomly sorted into two groups: the test group’s ECG readings will be sent to the hospital, while the control group’s information will not be sent, and so they will receive the standard care. "Before we ask for tax dollars to implement these special monitors around the country, we have to see if it will improve care," she said. Popovich said he thinks people in rural areas worry about how long it will take them to get to the hospital and get treated, and that he’s grateful to be part of the study. "That’s the best response that a heart attack victim can have — quick response." |