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Collaborating to Improve Cardiac Care


EMS CollaborationCrouse Hospital has partnered with Rural/Metro Medical Services and the Central New York Emergency Medical Services Program to improve early detection and treatment of patients who suffer the most serious form of heart attack, referred to as a ST-Segment Elevation Myocardial Infarction (or “STEMI”). 


Over the past year, the partners have studied factors involved in the diagnosis and treatment of heart attack patients through the entire patient experience – from the start of emergency care and beyond. 


Each year, thousands of people suffer heart attacks, with the most commonly reported symptom being chest pain.  Current emergency medical services (EMS) protocols use that symptom as an indication to obtain a 12-lead diagnostic electrocardiogram (EKG) in the ambulance, prior to hospital arrival.  Rural/Metro participates in the LifeNet program, which transmits these important tests to the hospital electronically from the ambulance.  In 2011, Rural/Metro transmitted over 10,000 EKGs to area hospitals through LifeNet.  This action provides a base for collaborative care between the hospital and paramedics prior to a patient arriving at a hospital ER.


Research shows, however, that only 67 percent of patients experiencing a heart attack actually complain of chest pain as a symptom.  This means that nearly one third of those suffering a heart attack may not experience chest pain.  Other symptoms can include shortness of breath, fatigue, nausea, heartburn, dizziness, or pain in other areas of the body. 


Research conducted by the teams analyzed relationships between patient symptoms, how the patient got to the hospital (ambulance or otherwise), as well as the timing of the first EKG.  Results showed that limiting pre-hospital EKG testing only to patients who complain of chest pain can significantly delay diagnosis and negatively impact treatment time.


“Not everyone having a heart attack has chest pain,” says Troy Hogue, Rural/Metro’s Syracuse Area Manager, one of the lead researchers on the project.  “The goal here was to identify ways to incorporate those other signs and symptoms into guidelines that can ensure the most appropriate use of an EKG in the field as a diagnostic tool.”


“This type of collaboration between emergency medical services, the hospital and governing agencies is the partnership of the future,” said Michael Jorolemon, DO, Senior Quality Officer, Crouse Hospital.  “Focusing on doing the right thing for the patient in the field and streamlining the transition of care is really putting the patient first.”


The organizations involved in the project would like to work with the Regional Emergency Medical Advisory Council to establish new protocols for patient care.  In collaboration with Crouse Hospital, the effort can be analyzed long-term through the transition from field to inpatient care. Over time, these new protocols could be further evaluated and considered for broader use throughout the region, state and beyond.


More News Coverage: MSNBC; Syracuse Post-Standard



Cheryl Abrams
Crouse Hospital
Communications Department
Phone: 315/470-7123
Fax: 315/470-7232

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