CONCORD – Residents of central New Hampshire and the Lakes Region now have a much better chance of surviving serious heart attacks without serious complications, thanks to a new collaboration between the three hospitals that serve the area and the region’s Emergency Medical Services (EMS).
Concord Hospital, Franklin Regional Hospital, Lakes Region General Hospital and the Laconia Fire Department instituted the Regional Early Activation Care Team (REACT) this summer. The goal of the collaboration is to save heart attack patients most at risk for cardiac arrest or permanent heart damage by speeding them directly to Concord Hospital, the closest hospital offering cardiac catheterization treatment that opens severely blocked arteries.
“Hours can get lost, in a world where you are measuring things in minutes,” Concord Hospital cardiologist Dr. Mark Klinker said of the previous process, in which patients were taken to LRGHealthcare’s Franklin Regional or Lakes Region General Hospital for assessment and preliminary treatment, then transferred to Concord Hospital if necessary.
The program aids patients suffering STEMI heart attacks. STEMI is short for ST Segment Elevation Myocardial Infarction, the worst type of heart attack, where severely blocked blood flow destroys heart muscle and can lead to cardiac arrest — when the heart stops beating, or beats ineffectively.
Opening the artery essentially stops the attack, and the sooner it’s done, the better.
“Timing absolutely can mean the difference between life and death, but it also can mean the difference between making a full recovery and having life-long medical issues,” said Deputy Chief Shawn Riley of Laconia’s Emergency Medical Services, and the regional EMS coordinator.
Funding from Concord Hospital and LRGHealthcare has provided new equipment and extensive training for emergency responders throughout the Lakes Region.
LRGH used proceeds from its Red Dress Gala last winter to train EMS personnel for the REACT project. LRGH is raising more to ensure that first responders have additional equipment and training necessary to properly diagnose patients who need the specialized treatment.
With funding from its Dr. Charles Parsons Endowment Fund that supports cardiovascular services, Concord Hospital purchased communications equipment that enables EMS personnel in 18 communities to transmit a heart attack patient’s electrocardiogram (EKG) results from the field to the Emergency Departments at Franklin Regional or Lakes Region General Hospital.
With that information, the Franklin and Lakes Region emergency department doctors determine whether an artery blockage is serious enough to require immediate treatment at Concord Hospital’s Cardiac Catheterization Suite, where a team on call 24 hours a day can remove a blockage by inflating a balloon or inserting a stent to open the artery to restore blood flow.
The collaboration may mean a longer ambulance ride to the hospital, but a shorter road to life-saving treatment.
“Our goal is to ensure that patients have access to the care they need, as quickly as possible,” said LRGHealthcare Emergency Medicine specialist Dr. David Strang. “For a patient having this specific type of heart attack, that means getting him or her to a hospital that provides emergency cardiac catheterization services. As with many other programs, LRGHeathcare works with our partners throughout the statewide healthcare network to provide our patients with the best standard of care.”
En route to Concord Hospital, the ambulance is a virtual emergency room. Paramedics are in constant contact with the emergency department doctors and can help stabilize a patient by administering life-saving techniques and medications that previously would have been delivered at the Emergency Departments in Franklin or Laconia.
Officials at LRGHealthcare and the Laconia Fire Department began researching better options for their STEMI heart attack patients about two years ago when they realized it was taking too long to get them to Concord Hospital’s Catheterization Suite, Riley said. They began by streamlining diagnosis and initial treatment, then turned to the regional approach with the crucial diagnosis in the field now in use in other areas around the country. It’s the most far-reaching regional STEMI program in New Hampshire.
After treatment and catheterization at Concord Hospital, patients from the Lakes Region can receive follow-up care close to home from local cardiologists in the Lakes Region and through LRGHealthcare’s Cardiac Rehabilitation program.
The hospitals and EMS personnel have been phasing in the new protocol since December. Through mid-July, 11 patients had been taken directly to Concord Hospital, including one whose heart stopped on the way. That patient was revived, then the blocked artery was opened at the Catheterization Suite, much sooner than if the patient had been taken to another hospital first.
“If there had been a delay, there is a strong likelihood that the patient would have died,” said Dr. Strang.
The life-saving collaboration has turned medical services competitors into partners, with Lakes Region and Franklin General Hospitals willingly sending patients to Concord, all for a common goal.
“It simply is the right thing to do for our community and our patients,” said Kathy Waldron, vice president of clinical services and chief nurse executive at LRGHealthcare.
The communities involved in the REACT program are: Alton, Belmont, Bristol, Center Harbor, Danbury, Franklin, Gilmanton, Gilford, Hill, Laconia, Meredith, Moultonboro, New Hampton, Sanbornton, Sandwich, Tilton, Northfield and Andover.
