Dukes Memorial Hospital in a joint effort with Lutheran Hospital, Ft. Wayne, IN, has developed and implemented a Level 1 Heart Program. Level 1 Heart is a chest pain system that enhances the level of care for acute heart attack patients.
When a patient is recognized to be having a heart attack, the Level 1 Heart process is activated. The activation can take place from the scene of an emergency, by the paramedic or in the Emergency Department. The goal is to activate, stablize, transport and have the blocked vessel open in less than 90 minutes. When a patient is identified, the ED staff at Dukes Memorial Hospital pick up a phone that automatically connects the hospital with Lutheran Hospital, the first accredited chest pain center in Fort Wayne. The call activates established protocols for acute heart attack patients, prior to patient's actual transfer. Prehospital emergency personnel, cardiologists, ED Physicians, staff at Lutheran, staff at Dukes and the cardiac catheterization team at Lutheran all play an intregal part in the system.
"We know that the best treatment of a heart attack (acute myocardial infarction) is in the cardiac catheterization laboratory even when delayed by hours over other treatments such as clot buster medicines (thrombolytics)," said Steven Orlow, MD, medical director of the cardiac catheterization lab, Lutheran Hospital. "We also know that the very best outcomes are achieved when the treatment is provided as soon as possible after the heart attack begins. That is why we have been working so hard to develop transportation systems to get the patients to the cath lab as soon as possible."
Editorials in major cardiology journals have called for the development of a system of rapid transfer to centers of capable treating heart attacks in cardiac cath labs. Numerous U.S. and international studies have shown the superiority of transferring patients to an advanced heart catheterization center for treatment of a heart attack. According to the medical journals such as the "New England Journal of Medicine," even with the increased time for transportation to a different hospital, patients transferred to and treated in a cath lab have better outcomes than patients treated with a clot-busting medication at a community hospital.
"Level 1 Heart provides the region with access to state-of-the-art cardiac care in a timely way that's never been as consistent and steamlined as it is now," said B.P. House, MD, medical director, Emergency Services, Lutheran Hospital. "Patients from outlying communities can recieve the necessary advanced care in the same, or nearly the same time, as nearby patients."
Level 1 Heart has been utilized at Dukes Memorial Hospital in Peru, IN since January 2008. Miami County EMS and Lutheran Air play a key role in transferring patients from Dukes to Lutheran. If inclement weather grounds the helicopter, the transferring EMS responds. Thanks to advanced technology with 12-lead monitors and additional training, paramedics in the field are able to recognize a certain type of heart attack, notify local medical control and receive direction from the emergency physician, who can trigger the system.
"With Level 1 Heart, there's already been a marked improvement," said Matthew Sutter, MD, medical director, Lutheran Critical Care Transport. "We're mobilizing teams faster, so we're better able to care for patients the moment they arrive."
The Map below shows where all the Lutheran Network Hospitals are in relation to Dukes Memorial Hospital.
