Cardiac & Resuscitation, News, Patient Care

Cuting Cardiac Deaths; Expired Antidotes & ZOLL on Forbes List

Issue 6 and Volume 34.

EMS Helps Cut Cardiac Deaths
Heart disease kills more people in the U.S. than any other diseaseƒbut it has slipped to second place (after cancer) in San Diego County, Calif., thanks at least in part to the county’s EMS system and STEMI network

“In San Diego County, the flip-flop between cancer and heart disease coincided with the 2007 launch of a cardiac-response system designed to speed hospital care for people suffering heart attack or heart failure,” the San Diego Union-Tribune reported April 21. “The program directs paramedics to heart attack teams at 13 designated hospitals. Equipment on ambulances…allows emergency responders to begin diagnosing and treating heart attacks in the field and relay critical information to emergency room doctors.”

San Diego EMS Medical Director James Dunford, MD, told the paper the system has cut the time to definitive treatment in half for myocardial infarction patients. Now, if there were only a way paramedics could do the same for cancer.

Detroit Carries Expired Antidotes
The union representing Detroit EMTs and paramedics says it alerted Detroit Fire Department (DFD) EMS officials more than a year ago that the Mark I kits carried on the city’s ambulances had expired. But the DFD didn’t remove the expired nerve-agent antidoteƒeven after International Union of Operating Engineers 547 got the media involved.

WXYZ-TV Action News checked 10 Mark I kits union officials took off DFD ambulances and reported that all had expired in January 2007. In fact, Meridian Medical Technologies no longer even makes the Mark I kit, which required two injections: one of atropine and one of pralidoxime chloride. Now, after exposure to a nerve agent or an organophosphorous insecticide, medics can inject patients (and/or themselves) with DuoDote (also from Meridian), which delivers both antidotes with one injection process.

DFD officials refused to talk with Action News on camera (and didn’t return our phone calls), but they did talk off camera and “maintained that the injections are safe,” according to WXYZ-TV reporter Heather Read.

“After I started asking questions…some strange things started to happen,” Read reported. First, one day, DFD officers “sent out an order to take the so-called ‘safe’ injections off the ambulance units. A few hours later they rescinded the order.” The next day, “the fire commissioner ordered the drugs to be taken off again. They stayed off the ambulance units all weekend until Tuesday morning [when] a new order came down to put back the drugs on the trucks.”

According to Read, the fire commissioner spoke of a Department of Defense program that extends the shelf life of such antidotes for up to 13 years. But the document he cited points out that “the medications tested are maintained under tightly managed, controlled conditions, and goes on to say that using the data for Âdrugs stored by others would be inappropriate,” she says.

“As medical professionals, as paramedics, you are taught [not to] give expired medications,” says Local 547 President Wisam Zeineh. “It becomes a safety issue, not only for our people, but for the patients we’re taking care of as well.” We agree.

ZOLL Makes Forbes List
ZOLL Medical Corp. made the Forbes list of America’s 100 Most Trustworthy Companies for the third consecutive year. Only 10 companies have been listed every year since the list was first published in 2007. ZOLL is one of six medical companies listed among the approximately 8,000 companies traded on U.S. exchanges that are reviewed for the Forbes list.

Audit Integrity, an independent financial analytics company, assesses companies for accounting and governance risk: those “with the most transparent and conservative accounting practices and most prudent management,” according to

The full list of trustworthy companies can be found at ZOLL’s Web site is

Canvas on Wheels
When Blessing-Rieman College of Nursing student Beth Fuller rode in the back of an ambulance for a mock MCI drill in conjunction with Adams County (Ill.) EMS, she realized just how nerve-wracking transport can be for patients. “I felt like I was going to fall off the bench,” she said. And as for treating scared patients, Adams County’s Deputy Chief for EMS Tony Slater, NREMT-P, can attest to the difficulty of the task. “When you have a patient who’s shaking with anxiety, it’s a lot harder to get an IV started.” So when it came time for Fuller to do a senior project, she and classmates Carrie Fogle, Kaylan Barry and Amanda Thygesen, with the cooperation of Slater and his agency, affixed 1’x 1.5′ prints of abstract art on the ceilings of Adams County ambulances to help ease patients’ stress. Fuller says it was important to use abstract art, so patients would be distracted thinking about the images and look at them for an extended period. “The longer they see it, the less they think about the accident that just happened or the fall they just took,” said Slater. Throughout the project, EMS providers heard nothing but positive comments from patients. Fuller hopes that someday, art in ambulances might become a permanent fixture. So do we. JEMS