You At Your Best

4 | YOU AT YOUR BEST | nwAdg.cOm/YOUATYOURBEST mAY - BEST nURSES | SATURdAY, ApRil 27, 2019 SpoNSoR CoNTeNT It was an ordinary work day at LRD Construction in Springdale when suddenly an "employee" experienced chest pain. Fortunately, those nearby knew exactly what to do. While LRD's staff was actually trained in hands-only CPR, this "patient" – Hans Driessnack, in actuality, the CEO of Northwest Medical Center-Springdale – didn't need CPR as his heart was still beating. But they did encourage him to take an aspirin as they "called" 9-1-1. Driessnack then got to experience first-hand what happens to heart attack patients, as part of a drill the hospital – along with sister facility Northwest Medical Center-Bentonville – was conducting to test processes and partnerships for providing the highest level of care. This drill was specifically designed to test care provided for STEMI heart attack patients. STEMI stands for ST-Elevation Myocardial Infarction (or STEMI), which is a very serious type of heart attack during which one of the heart's major arteries (one of the arteries that supplies oxygen to the heart muscle) is blocked. Since ST-segment elevation is an abnormality that can be detected on a 12-lead EKG, paramedics take the EKG at the scene and/or in the ambulance, notifying the hospital of the patient's impending arrival. This means the patient can bypass the ER and go directly into the Cardiac Catheterization Lab for a life-saving procedure to open the blocked vessel. "I was truly impressed with every step of the process, particularly about how collaborative all those involved in providing care were," said Driessnack. "Because the first responders on the EMS team actually do the 12-lead EKG while still in the field, they make the call as to whether it's a STEMI and then immediately notify the hospital. This means all the right team members are being paged at the hospital even as the patient is in route. This saves significant time. In the case of a heart attack, time is muscle. As the heart is deprived of oxygen, that part of the muscle is dying." As paramedics initiate the early care processes, the doctors and staff needed are gathering and the Cardiac Catheterization Lab is being readied before the patient arrives. All this is happening, even as the ER physician is confirming the paramedic's interpretation of the 12-lead EKG. The need to act with speed is why something called "door-to-balloon time" is a key performance quality metric in the treatment of heart attacks. When the patient gets to the Cardiac Cath Lab, an interventional cardiologist can perform balloon angioplasty (also called percutaneous coronary intervention), a procedure that widens narrowed or obstructed veins or arteries, thus restoring oxygen to the heart. The American Heart Association's guidelines recommend the artery be reopened within 90 minutes of the onset of symptoms for best patient outcomes. When a vessel is 100% blocked, a STEMI heart attack has the greatest risk of death or disability, so it's vital the blocked artery is reopened as quickly as possible to restore blood flow. STEMI drill patient Driessnack was in the Cardiac Cath Lab at Northwest Medical Center-Springdale within 28 minutes of the call to EMS, he "received" his life-saving care, and the actual "door-to-balloon time" was an impressive nine minutes. The Bentonville hospital drill – which took place at Crystal Bridges Museum of American Art – was equally successful. "This drill shows why it is so important to have well-educated team members – from the first responders at the scene to our vital partners in the EMS to the hospital," Driessnack said. "No one piece is more important than the other. To be as effective as possible, we must work collaboratively. It all contributes to faster intervention and better outcomes for our patients." When you or someone you love is experiencing the symptoms of a heart attack, dial 9-1-1 right away. Time is muscle… heart muscle. For a free wallet- sized kit including heart attack symptoms and an aspirin or information on hands- only CPR classes for your group, email CommunityRelations@NW-Health.com Writer's Note: Special thanks to LRD Construction and Crystal Bridges Museum of Modern Art - who agreed to help with these realistic training events - as well as to the Springdale and Bentonville Fire Departments. The drills were organized by Velvet Reed-Shoults, MHA, MBA, BSN, RN, CEN, TCRN, System Trauma Program Manager and EMS Liaison for Northwest Health. Heart attack at work! Northwest Health drills test the system, improve patient care

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