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Quick attention means good outcome for heart attack patientJim Wenisch, a farmer from the Lamberton area, is the kind of guy who doesn’t like to make a fuss. He has a lot of work to do – he farms over 450 acres near his farm adjacent to the Cottonwood River, and he has a fair number of beef cattle. That’s why, on the morning of October 14, 2005, he wasn’t so sure he wanted to go to the hospital after he’d had chest pains all night. Wenisch, 63, thought maybe it was heart burn. “I had eaten some pizza the night before,” he explained. His wife of 40 years, Teresa, said she didn’t care what it was and insisted they head to the New Ulm Medical Center immediately. Wenisch relented, but didn’t want to go to the emergency room. He felt an appointment in the clinic would do the trick. “I really didn’t think the pain was that bad. I would’ve bet the farm it wasn’t my heart,” he said. He would have lost that bet. By the time the couple got to the clinic for an appointment with Family Practice physician Dr. Daniel Holmberg, his jaw had started to hurt. Then the room seemed to get smaller and he started sweating. Quickly, Wenisch was taken from the clinic to the emergency department. There he was treated by Dr. Sanjay Mishra, an internal medicine specialist, and a team of nurses and technicians, where it was determined that he was suffering a heart attack. As Wenisch was being stabilized, staff was simultaneously making arrangements to immediately transfer him by helicopter to Abbott Northwestern Hospital in Minneapolis. There, surgeons performed an angioplasty to unclog arteries near his heart and placed a stent in one of those arteries. “They told us he had 90% blockage,” Teresa said. “But they said he had minimal damage thanks to the care he received in New Ulm and the quick transport to the cardiac catherization lab at Abbott.” The systematic care and quick transport for Wenisch and other patients who arrive at the New Ulm Medical Center emergency department with certain clinical symptoms is thanks to the Level I Heart Attack Program, a program the medical center has been involved in since November 2003. Heart attack patients are quickly diagnosed, treated and flown to Abbott Northwestern Hospital. If use of the helicopter is not feasible due to weather, the patient is transferred by ground ambulance. The goal of the program is to get a patient from the New Ulm Medical Center emergency room into the Abbott cardiac catherization lab within 90 minutes. Since partnering with Abbott to participate in the program, 23 patients from New Ulm have been transferred there as Level I patients. Julie Halvorson, RN, Emergency Department manager, says the Level I partnership between the medical center and Abbott Northwestern “means that for those living in our area, we have been able to neutralize geography and deliver care that in the past only those living in the Twin Cities were able to receive.” Simply put, the Level I program is a “well thought-out plan with a coordinated effort,” Halvorson said. “The Minneapolis Heart Institute at Abbott Northwestern provides the Level I protocols that include lab tests and medications and ways to streamline the process in order for us to get the patient to the cath lab as quickly as possible. The Emergency Department keeps a Level I kit assembled so that the necessary medications are quickly available when a heart attack patient comes in. Every staff person has an assignment during such a case and part of the success of the program can be attributed to the skillfulness of the physicians and staff. A call from the Medical Center emergency room activates a group pager alert to 25 staff people and two cardiologists at Abbott Northwestern telling them that a cardiac patient is on his or her way. “A security team awaits the helicopter and also holds the elevator for faster access,” said Level I Services Director Barb Unger. “Since the patient has been evaluated and treated by one of our rural hospital partners, the patient can bypass the Abbott emergency room completely and go directly to the cardiac catherization lab. Admitting staff has already pre-admitted the patient with a quick phone call, the Critical Care Unit prepares a bed for after the catherization procedure. The catherization lab staff is ready and waiting the moment the patient arrives.” “This is just part of the activity that is going on,” Unger said. “It is a big operation to be ready 24/7. We currently have an average of over 40 patients arriving each month with at least 50 percent arriving after hours.” Unger added that the Abbott Level I program has trained much of the state on how to accomplish a program like this, “however, our volume of over 1000 patients in three years, with such low mortality, is not matched.” Thanks to the recently implemented electronic medical record throughout Allina Hospitals and Clinics, from the moment the cardiac cath lab gets the page, they begin looking at the patient’s EKG, their health history, the medications they are taking and all information that is contained in their electronic medical chart. By the time the patient arrives, the catherization lab staff has a complete picture of the patient. In the catherization lab, they can do multiple things to open the artery, Halvorson said. The most common procedure is stenting. Wenisch was back home three days after his stent was inserted. He took it easy “for a while,” he said sheepishly. “But, I had to get my crop in. We were picking corn at the time.” Now he takes about nine pills a day and works hard to maintain a healthier diet. “That’s the hardest part,” he said. The Wenisches have seven children, and seven grandchildren. |
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New Ulm Medical Center
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