Current Policy Works for the Heart Patients

A recent article in the Kenosha News documented Kenosha Fire Chief Matthew Weber’s intention for reevaluating an existing policy that directs pre-hospital patients with chest pain to United Hospitals.  The evaluation would involve mock patients at Aurora on Highway 50 and United Hospitals to evaluate response time to mobilization of a catherization lab team to opening closed coronary arteries.  The mock patient at to Aurora on Highway 50 would be transported by helicopter to a cath lab at St. Luke’s Hospital (there are no cath labs at Aurora Highway 50) in a time race against the local on-site cath labs used routinely at United Hospital Systems.

The fire chief and the administrator of the Aurora Highway 50 facility are planning to use the results of this mock patient drill to change the existing policy.  Emergency Room physicians in consultation with cardiovascular experts developed the current policy several years ago.  Standards of the American Heart Association and the American College of Cardiology were reviewed.  Years of data on patients with heart attacks treated in the United Hospital cath labs, which included risk-adjusted mortality and response times was evaluated.  This scientific peer-reviewed data supported the existing policy of transporting the suspected heart attach victim to the closest facility with cath lab intervention capabilities.

The Aurora administration assertion that other fire departments in Kenosha Count bring potential heart attack victims to Aurora Highway 50 facility only raises further concern for public health.  Intuitively, transporting a patient away from the local highly capable facilities treatment at a distant highly capable facility while heart muscle damage is occurring is irrational and inconsistent with national guidelines.  In fact, the current policy was drafted based on not only the state-of-the-art science, but also related to the unfortunate experiences of those who died in transport to Milwaukee or suffered delays due to aborted attempts at transfer because of adverse weather.

Some 18 years ago I teamed up with the fire chief to develop a paramedic program and improve pre-hospital care.  What an odd feeling to now have to tell our present fire chief his direction foolhardily endangers Kenoshans’ lives.

Kevin Fullin, M.D.

Taken in its entirety from the Voice of the People in the September 9, 2005 edition of the Kenosha News