Program brings quicker treatment for heart attack patients

Those suffering from heart attacks have traditionally been brought to Sudbury Regional Hospital’s emergency room, where they received clot-busting drugs to break up obstructions in their arteries.

But a program put in place at Sudbury Regional Hospital in April, called the ST - Segment Elevation Myocardial Infarction (STEMI) Bypass protocol, is allowing some heart attack patients to avoid the emergency room altogether.

When EMS workers arrive at a patient’s house, and suspect the patient is having a heart attack, they perform electrocardiograms. The City of Greater Sudbury has outfitted all of its emergency vehicles with electrocardiogram machines, and all EMS workers have been trained on the device’s use.

If the test confirms the patient is having a heart attack, they are transported directly to the hospital’s cardiac catheterization lab. They are then treated with a balloon catheter and stent to restore the flow of blood through the artery.

Those who instead receive the clot-busting drug treatment in the emergency room also eventually receive the balloon catheter treatment, but usually after a few days of hospitalization.

The results of the intervention are remarkable, Grace St. Jean, administrative director of the hospital’s critical care program, said.

“If you see the patient coming into the cath lab, they’re having chest pain, their colour looks awful, they’re sweaty and they don’t feel well,” she said.

“As soon as you inflate that balloon, and unclot that vessel, just right in front of your eyes the person’s colour gets better, and they feel better. Usually, the patients have a shorter length of stay because (the balloon catheter treatment) is done right away.”

However, those who think they might be having a heart attack can’t access the STEMI program if they decide to drive to the emergency room instead of phoning 9-1-1, St. Jean said.

So far, only about 12 patients have been diverted from the emergency room because of the STEMI program. However, these patients have received speedy treatment.

The provincial benchmark for emergency catheterization treatment for heart attack victims is 90 minutes. The average time for patients treated under the STEMI program is 20 minutes. The hospital’s emergency room staff are expected to give heart attack patients clot-busting drugs within 30 minutes.

The program was developed through a partnership with the hospital, the City of Greater Sudbury Emergency Services, the Northeastern Ontario Prehospital Care Program and the Central Ambulance Communications Centre.

Similar programs are in place in southern Ontario, St. Jean said, but this is the first of its kind north of Barrie.

“You have to have an interventional cath lab in order to initiate it. We’re the only (hospital) in northeastern Ontario (with an interventional cath lab).”

St. Jean said although only a small number of patients have been diverted through the STEMI program so far, she thinks the program will make a difference in helping to reduce overcrowding in the emergency room.

“It’s a small portion of the patients they have in a day, but they’re the sick portion (and require a lot of resources to treat),” she said. “It does help in emergency room overcrowding.”