PORT TOWNSEND — An 88-year-old man suffering a heart attack was the first to benefit from new protocols for paramedics in East Jefferson County.
The fire department, Jefferson Healthcare hospital, Port Ludlow Fire & Rescue, Harrison Medical Center, Kitsap Cardiology and the Poulsbo Doctors Clinic have created the protocols that allow paramedics to administer a host of drugs, including “clot busters” — which can destroy a blood clot blocking blood and oxygen to the heart — and provide immediate treatment during heart attacks.
The kits issued to paramedics beginning June 1 include blood thinners such as heparin, intravenous nitroglycerin and thrombolytics — or clot busters — that can lessen the long-term damage from a heart attack.
On Friday, East Jefferson Fire-Rescue used the new drugs for the first time, said Gordon Pomeroy, assistant chief in charge of Emergency Management Services for East Jefferson Fire-Rescue.
An 88-year-old Kala Point man suffered a heart attack. Paramedics hooked him up to an electrocardiogram machine and transmitted his EKG to an emergency room.
The paramedics, under the guidance of an emergency room doctor, administered heparin — a blood thinner, intravenous nitroglycerin, and a beta blocker to the man, who Pomeroy declined to identify.
Improved after kit
“We opened the kit, used the protocols and he is currently admitted to Harrison Medical Center’s Catheterization Lab,” Pomeroy said Friday.
The man’s EKG reading of his heartbeat pattern improved after he was given the drugs, Pomeroy said, and paramedics did not administer the clot buster drugs.
Clot busters, by quickly destroying blood clots, can prevent some damage to cardiac muscle during a heart attack. They also are used in a hospital setting on some stroke victims to minimize permanent damage to the brain.
Although the clot busters weren’t used, the Kala Point man benefited from the new protocols, Pomeroy said.
“All those blood thinners and other drugs we gave him did help him. It changed the EKG by the time we got to the hospital,” Pomeroy said.
On Saturday, Pomeroy said that he didn’t know the man’s condition.
Pomeroy said that the kind of heart attack — a STEMI, which is short for ST-Segment Elevation Myocardial Infarction — that the man suffered is common.
It is a severe heart attack caused by a prolonged period of blocked blood supply that affects a large area of the heart.
Pomeroy said the attacks carry a substantial risk of death and disability and call for a quick response.
The new protocols come into play after a patient is taken to Jefferson Healthcare and diagnosed as suffering from a STEMI heart attack.
The drugs are administered in the ambulance while the patient is transferred to Harrison Medical Center.
“It is important to note that patients who go directly to the emergency room at Jefferson Healthcare will be assessed rapidly and, if appropriate, [the drugs] will be administered to the patient before they are transported to Harrison Medical Center,” said Jim DiCianne, director of emergency services for Jefferson Healthcare.
But in case the timeline gets tight, the paramedics now have the ability to multi-task.
Pomeroy said this saves precious time.
90-minute window
“There is a 90-minute window in which to diagnose a patient and administer the drugs,” Pomeroy said.
“Key to the success of this whole process is how fast the patient calls 9-1-1,” he added.
“Patients who have previously experienced similar chest pains frequently just try to ‘tough it out’ and don’t call 9-1-1 until it’s too late to administer the drugs that could save the heart muscle from permanent damage.”
The protocols were developed in April among all the agencies.
“Everybody was at the table,” Pomeroy said. “We got done in a week something that would have taken years.”
Dr. Sandra Smith-Poling, Jefferson County Medical Program’s director of paramedics, signed off on the program.
“This procedure will save lives,” Pomeroy said.
“Bottom line–don’t delay in calling 9-1-1,” he said.
“While your symptoms may turn out to be a simple case of indigestion, for example, you need to be evaluated — something East Jefferson Fire Rescue paramedics are very qualified at doing.”
According to Easy Jefferson Fire-Rescue Public Affairs Officer Keppie Keplinger, only Dade County, Fla., has more experience with paramedics delivering clot busters in the field. She said out of 1,100 cases in the last 12 years, there has been only one fatality in Dade County.
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Reporter Erik Hidle can be reached at 360-385-2335 or at erik.hidle@peninsuladailynews.com
