Medics use Technology to Identify Cardiac Patients in the Field

On Monday, March 1st, 2010, Lakeside Station #3 units (Johnstown) were dispatched to a local supermarket for a "non-specific" medical assist call. On our arrival we made contact with a very pale and anxious patient that described a simple episode of feeling "faint." But given the appearance of the patient, and the concern of his wife, we suspected that this episode might not be as simple as a case of "fainitng."

The attending Paramedic, Bryan Peters, made the decision to run a 12-lead EKG in the store. A 12-lead EKG gives medics a multi-lead summary of the current electrical activity of the heart and provide key information as to the possibility of cardiac injury, which requires immediate care in the field.

As the paper coiled out of the monitor the suspicions were confirmed, this was not a case of simple fainting but rather a silent myocardial infarction. The medics quickly called the Sharp-Grossmont base station (medical control for paramedics in the East County) and received a barrage of initial treatment orders.

As ominous as this might sound, recent advances in cardiac care now minimizes loss of cardiac muscle, and have significantly decreased hospital stays with the early introduction of treatments designed to restore blood flow to the cardiac muscle. In this situation the patient was appropriately transported to the Sharp-Grossmont Chest Pain Center were the emergency room MD confirmed the diagnosis and the patient was swiftly sent to the "Cath Lab" where circulation is quickly restored to the affected portion of the heart.

A key ingredient to this success story is the introduction of advanced electronics into devices taken into the field by today's paramedics. Not only are these devices able to monitor multiple angles of the heart, but the on-board computer is going to give you a pretty accurate diagnosis of any irregularities. Not too long ago medics were using primitive "switching boxes" to trace these different leads. There was no computer analysis of the rhythm, only the sound judgment of the paramedic to analyze the rhythm.

The other point we need to make is simply this, not all heart attacks present with classic chest pain. Some, as in this case, present with simple fainting, vertigo, or an episode of trouble breathing. If you, or a loved one, experience any unexplained medical event that concerns you then you need to activate your local EMS provider by calling 911 immediately.

Currently in Lakeside all ALS ambulances, and engine companies, carry this technology and are capable of initiating advanced cardiac care.

Submitted By: Captain Mark Grow, Lakeside Fire District