Heart Association Honors Chatham Fire For Cardiac Care

By: Alan Pollock

Topics: Police, Fire And Harbormaster News , Health

Chatham rescue squad.  FILE PHOTO

CHATHAM — There’s no good place to suffer a sudden cardiac emergency. But if it happens in Chatham, take heart: you’re likely to get the best possible emergency cardiac care.

The American Heart Association has awarded the Chatham Fire/Rescue Department its Life Line Silver Plus Achievement Award for taking certain specific steps to improve care for victims of severe heart attacks.

The annual designation was recently made for 2020, said Captain Mark Heller, the department’s emergency medical services officer.

“It means that, of the patients that we’ve seen that meet the criteria who are having chest pain and may be having a heart attack, we took at least 75 percent of them directly to a primary cardiac center,” Heller said. The number was probably close to 100 percent, since Chatham’s ambulances almost always bring patients to Cape Cod Hospital, which meets that requirement.

While the hospital provides a high level of service, their response begins with trained paramedics and EMTs from local fire departments. In Chatham, as with other towns in the region, medics follow protocols that include the rapid use of a 12-lead electrocardiogram, which provides a high-resolution representation of how the heart is functioning.

“It’s imperative when it comes to trying to figure out if somebody’s having a myocardial infarction in the field,” Heller said. To meet that standard, that EKG, along with notification of the hospital’s cardiac care experts, must be done within 10 minutes after EMS workers first contact the patient.

Heart attacks occur when the blood flow to the heart muscle is disrupted or halted, usually because the blood vessels supplying the heart become blocked by fatty plaques. The longer the artery is blocked, the greater the damage. While the onset of symptoms can be sudden and intense, it can sometimes occur over the course of days or weeks, becoming more intense with time. According to the American Heart Association, heart attacks account for one in seven deaths in the United States each year.

The key to surviving a heart attack is getting help quickly, Heller said.

“Time is muscle, as they say, when you’re dealing with cardiac issues,” he said. The more time that the heart is deprived of oxygen, the greater the chance of permanent damage or death.

Heller, who’s been a paramedic for many years, said he’s seen a revolution in cardiac care.

“It certainly has changed,” he said. Early EKGs had only two or three leads and provided only a rudimentary picture of heart activity. Today’s equipment uses sophisticated algorithms to identify certain types of heart activity, though the initial interpretation of those signals is still ultimately up to trained paramedics, Heller said.

In the early days, emergency cardiac care was a kind of trial-and-error affair, he said.

“For years it was, one doctor would try something that would work, and he’d tell another doctor,” Heller said. “Now, everything’s data-driven.”

When it comes to treating a heart attack, there have been some relatively new developments.

“We found out not that long ago that aspirin, given at the onset of chest pain, is huge,” Heller said. When responding to a possible heart attack, crews ask if a patient has already taken an aspirin, and if not, they have them chew up several tablets right away.

“It reduces the chances of a total occlusion of a coronary artery multi-fold,” Heller said. The use of aspirin is not indicated if a patient is allergic or has gastrointestinal bleeding.

Anyone experiencing the signs of a heart attack should call 911 immediately. They include pressure, squeezing or other pain in the chest that comes and goes; pain or discomfort in the arms, back, neck, jaw or stomach; shortness of breath; and a cold sweat, nausea or light-headedness.

So why didn’t the Chatham Fire Department receive the American Heart Association’s gold designation? Heller said it wasn’t about any shortcoming in care, but rather a requirement that a department achieve silver for at least one year before earning gold.

“Our intent is to have gold next year,” he said.