One of the most difficult parts of treating a heart attack is getting the patient to admit that there’s a problem, says Cindy Fielders, RN, Administrative Director of Cardiovascular Services at Portsmouth Regional Hospital. “Often, the first thing a patient does is deny that the symptoms are anything serious,” she says. “In addition, a lot of people don’t recognize the warning signs.”
Improving the way that heart attacks are treated, from the first indication of a heart attack in a victim’s home, to a life-saving cardiac procedure is always the goal.
In its continuous pursuit of quality cardiac care, Portsmouth Regional Hospital was proudly awarded Cycle III Chest Pain Center with PCI (percutaneous coronary intervention) designation. Cycle III accreditation is the highest accreditation possible for treatment of chest pain—by the Society of Chest Pain Centers.
“Our procedures for handling suspected heart attacks were successful before,” Ms. Fielders notes, “but we felt that we could improve our management of chest pain patients by measuring ourselves against the SCPC standards. The experience made us look at our processes, gaps, equipment and other factors.”
Quick Response, Diagnosis, Treatment
Gap analysis, for example, involved measuring the time involved in every step of the process – from the time a patient calls EMS (Emergency Medical Services) where often times the first EKG is performed, to arrival at the Emergency Department where the team has already been mobilized and is awaiting EMS arrival. The hospitals internal team is on call 24/7 for exactly these purposes whose mission is to retrieve the patient from either EMS at the ED front door or if stabilization is required, from the ED patient room. Most often, the patient is taken to the Cardiac Catheterization Lab to determine if indeed the patient is having a heart attack and requires opening of any of the heart arteries. An interventional cardiologist is awaiting and performs a cardiac catheterization in the suite by inserting a tiny catheter and balloon into the patient’s coronary arteries to restore blood flow. Often times a coronary stent is also placed to maintain adequate blood flow to the heart muscle. For a small percentage of patients, surgery may be necessary. PRH’s Heart & Lung Center hosts the Seacoast’s only cardiovascular surgery service and offers state-of-the-art cardiac surgical procedures.
“An important element in successfully treating heart attack is public awareness,” Ms. Fielders notes. “Knowing the signs, recognizing their seriousness and getting treatment quickly is key. No one with a suspected symptom should wait more than five minutes before calling 9-1-1.”
She adds: “Communication is key. With all parties in contact, a patient can receive fast, coordinated, expert care throughout the process, from the moment the paramedics arrive at the scene through treatment in the Heart & Lung Center. That’s our goal.”
About Portsmouth Regional Hospital
Portsmouth Regional Hospital (portsmouthhospital.com) with its parent company, Hospital Corporation of America (HCA) has contracted with JSA, Inc., a national architectural firm with offices in Portsmouth, New Hampshire for this project. Other local and regional companies hired include Granite State Plumbing and Heating, Interstate Electric, Hiltz Construction and more. Salmon Falls nursery has been responsible for many of the external rock walls and plantings.
The entire project, which is ahead of schedule, is expected to be completed in late November 2010.