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OLYMPIA, Wash. - Reducing the time it takes for people having a heart attack or a stroke to get medical care is the goal of Washington's new Emergency Cardiac and Stroke System. The system, being launched in phases across the state, is modeled on our state's trauma system.
"Each minute is critical to get the right treatment for stroke, heart attack, and cardiac arrest," said Secretary of Health Mary Selecky. "The new system speeds up access to life-saving treatment."
The Department of Health is working with Emergency Medical Services (EMS) to identify when each county is ready to use the new system. To be ready, hospitals that want to participate must be designated as stroke and/or cardiac centers, and EMS providers must be trained on new procedures for assessing, treating, and determining the appropriate hospital for their patients. In the past year, 73 of 91 hospitals have been categorized as cardiac centers, stroke centers, or both. Many EMS providers have already been trained on the new procedures, and several counties are now up and running with the new system.
People get emergency care for heart problems and stroke in all counties now, but the new system will improve that care by sending them to the best facility for their condition, speeding up the process. Faster treatment can significantly reduce the risk of death and disability.
"The goal of the new system is to get the right patient to the right hospital in the right amount of time," said Dr. Kathleen Jobe, University of Washington Medical Center's Emergency Department and chair of the state's Emergency Cardiac and Stroke Technical Advisory Committee. "We need a well-coordinated system to make that happen."
Together, heart disease and stroke are the leading cause of death in Washington. Many people who have a heart attack, cardiac arrest, or stroke die or are disabled because they don't get treatment in time. Fewer than four percent of people who suffer the most common kind of stroke get the best treatment for that type of stroke because they don't get to a hospital that can treat them in time. Less than half of all people who have a heart attack receive the most effective heart attack treatment. And, like most of the nation, cardiac arrest survival rates are very low in Washington.
Last year the state passed a law to create a formal cardiac and stroke system of care to improve our ability to get people to life-saving treatment in time. This new system is especially important to our state's rural communities. When compared to urban areas they have fewer resources and specialists, such as cardiologists and neurologists, to respond to and treat heart attack and stroke. They also have fewer paramedics qualified to do electrocardiograms in the field. Electrocardiograms help diagnose heart attack before getting to the hospital, so a cardiac team can meet the patient in the emergency department.
Without this new system, heart attack and stroke patients are often taken to the closest hospital then transferred to another hospital when the first hospital isn't able to provide specialized care. With the new system, standard guidelines for EMS call for patients to be taken directly to a hospital that can provide specialized care. If there isn't one close by, patients will be rapidly assessed by the local hospital and transferred immediately to the treating hospital.
The public can help by learning heart attack and stroke symptoms and calling 9-1-1 immediately when they or someone they're with have these symptoms. They can also help by learning to do CPR (cardiopulmonary resuscitation). New CPR guidelines only require chest compressions - mouth-to-mouth contact is no longer recommended.
A report published (http://www.doh.wa.gov/cfh/heart-stroke/For-Healthcare/ECSreport.htm) by the state health department led to the creation of the new system. A list of counties that are using the new system is available online (http://www.doh.wa.gov/hsqa/hdsp/default.htm).
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