Level One Heart Attack Program
As soon as a patient is identified to have ST elevation myocardial infarction, emergency departments can call this 24-hour hotline:
A team effort by Med Flight and UW Hospital's Heart Attack Team staff will expedite transfer of patients experiencing a STEMI heart attack to UW Hospital. This Level One heart attack care is just a hotline away.
"The concept of the golden hour, long associated with trauma care, is now applied to regional cardiac care. The new process allows the referring physician to activate the airmedical transfer system and interventional cardiology team within the first 30 seconds of the phone call," according to Darren Bean, MD,* an emergency and Med Flight physician who co-directed the Level One Heart Attack Program at UW Hospital.
24-Hour Hotline: 1-877-MI2-UWHC
As soon as a patient is identified to have ST elevation myocardial infarction, emergency departments can call 1-877-MI2-UWHC, a 24-hour hotline in UW Hospital's Access Center. The call immediately activates Med Flight and UW Hospital's cardiac catheterization lab to prepare for the patient.
The activation is similar to Med Flight's rapid response to a trauma scene.
"We don't know all the specifics about the patient when we leave for flight," Dr. Bean says. "However, we do know that patient outcome is absolutely dependent on how quickly blood supply is restored to the starving heart muscle."
Simply put, time is myocardium. By minimizing transfer time, more patients are eligible for primary angioplasty, a strategy that has been shown to reduce major complications and death from STEMI if performed in a timely manner.
Even those patients who have received thrombolytics benefit from the rapid transport model, as many require rescue angioplasty.
Referring Emergency Departments
Knowing that the patient will be transferred, referring EDs prepare the patient for rapid transport. By using pharmacotherapy strategies that minimize IV infusions, airmedical ground times can be further reduced.
Once the patient is en route to UW Hospital, the referring ED faxes critical information to the UW's cardiac cath lab so staff can further prepare for the patient's arrival.
Modeled after a heart attack response program developed by Abbott Northwestern Hospital in Minneapolis, this Level One protocol saves critical time, with a goal of getting patients the most effective care within 90 minutes, the "golden window" recommended jointly by the American Heart Association and the American College of Cardiology to preserve heart function.
Emergency Department Partnerships
Dr. Bean has been visiting referring emergency departments to discuss the Level One heart attack protocols and provide EDs with necessary forms to partner in the program.
Until then, if a referring ED calls the general UW Access Center phone number, when referring a heart patient, the first questions asked is whether the patient has ST elevation. If the answer is "yes," UW's Level One heart attack protocol begins.
According to studies in Europe, Level One heart attack protocols reduce rates of death, recurrent heart attack, or disabling stroke for patients who are transferred faster for angioplasty. Dr. Bean says the protocols have already reduced transport time to benefit these critical patients.
* Note to readers: This page includes quotes from Dr. Darren Bean, who tragically died in the UW Health Med Flight crash Saturday, May 10, 2008. A passion for emergency services was at the core of Dr. Bean's compassionate commitment to the health sciences and for this reason, his quotes are included in tribute to this passion. He will be missed by all who knew, respected and loved him.
Video: Critical Care in the Golden Hour