The Pulse Early Treatment for a heart attack can prevent or limit damage to the heart muscle A quarterly publication of Cardiovascular Services at Advocate BroMenn Medical Center In this issue: • Early treatment for a heart attack • Radial Artery Approach to Cardiac Catheterization • Key practice guideline measures • Ask the Expert – Q & A • Upcoming CME Opportunities
Advocate BroMenn Medical Center is one of the first hospitals in Illinois to receive the American Heart Association’s Mission: Lifeline® Heart Attack Receiving Center Accreditation. This recognizes centers that meet or exceed quality of care STEMI measures. “This exceptional care can only be achieved with strong teamwork and processes—with everyone from 911 dispatchers and first responders, to our physicians and ED, Cath Lab, CVCU and other staff working effectively together,” says James McCriskin, DO, cardiologist with Advocate Medical Group – Illinois Heart and Lung. Quick recognition of a STEMI and opening the culprit artery is key to saving heart muscle. As a top performer in the nation, BroMenn’s average “door-to-balloon” time for the past 12 months is 46 minutes. National standards call for opening the culprit artery with 90 minutes. Calling the Code STEMI from the field for early activation of the Cath Lab team is key to achieve this.
The accreditation also includes relationships with our STEMI Referral Centers (outlying rural hospitals, such as Advocate Eureka, Gibson City Area Hospital, and Dr. John Warner Hospital). BroMenn collaborates with these hospitals to provide information on practice guidelines and STEMI case reviews. The use of our hospital’s Priority Line helps expedite the “Express STEMI” process. Call 9-1-1 if you or a loved one experiences any of the following warning signs of a heart attack: • Chest discomfort, like uncomfortable pressure, squeezing, fullness or pain • Discomfort in other areas of the upper body, including pain or discomfort in one or both arms, the back, neck, jaw or stomach • Shortness of breath with or without chest discomfort • Other signs, such as breaking out in a cold sweat, nausea or lightheadedness. To learn more, visit advocatehealth.com/bromenn/heart.
Radial Artery Approach to Cardiac Catheterization
Key Practice Guideline Measures The Advocate BroMenn team does a great job with the key practice guideline measures shown below. One initiatives is to reduce heart failure readmissions, a nationwide concern in the health care industry as the aged population increases. BroMenn’s rate is 19.4 percent (unadjusted). Efforts are being made to trend this downward. Please stay in tune for future updates.
Darren Sawyer RN, Charge Nurse Cath Lab In the United States, the most common approach for cardiac catheterization is through the femoral artery in the groin. While femoral artery procedures are safe, data shows that bleeding complications from femoral artery puncture may be more significant than previously believed. To reduce the potential for complications, cardiologists are now beginning to utilize the radial artery in either the right or left arm. Robert Braastad, MD and Siddharth Gandhim, MD of Advocate Medical Group – Illinois Heart and Lung, have been using the radial approach for nearly two years with great success. While the average utilization rate for the radial artery approach nationwide is 15 percent, the utilization rate at Advocate BroMenn is 34.5 percent.
Cardiac Care October 2011 – September 2012 100% 100%
AMI Perfect Care
Heart Failure Perfect Care
ICD Implants meeting Guideline Indications
Open Heart Patients Discharged Alive
According to the Mortality benefit Of Reduced Transfusion after percutaneous coronary intervention via the Arm or Leg (MORTAL) study, patients undergoing radial artery access for cardiac catheterization required half the number of blood transfusions as those having procedures using the femoral artery. In addition, the MORTAL study concluded that patients undergoing cardiac catheterization through the radial artery experienced a significant reduction in 30 day and one year mortality.
Patients also benefit in other ways from radial artery approach. With no femoral artery puncture site there is no bed rest required for patients who have had radial approach. Patients are allowed to use the restroom (instead of using the bedpan as for femoral artery access) and are more comfortable eating while sitting up either in a chair or on their cart.
Ask the Expert—Q & A
Upcoming CME Opportunities
Do you have questions or future topics that you would like more information on related to the cardiovascular services at Advocate BroMenn Medical Center? The CV team would like to provide information that is helpful to you. Please submit any questions or topic requests for future publications to one of the following listed below by email, or you can call Lynda Rhinehart, at 309.268.5318. James McCriskin, DO, FACC Medical Director, CV Service Line firstname.lastname@example.org Lynda Rhinehart, RN Director Cardiopulmonary Services email@example.com
January 15, 2013 at 0700 in Heart Center Conference Room—Echo Conference January 22, 2013 at 0700 in Heart Center Conference Room—Heart Failure Standards of Care: A Practical Update
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The Pulse, Winter 2012-13