By John Snell
The Oregonian
Copyright 2007 The Oregonian
All Rights Reserved
PORTLAND, Ore. — Getting medical help during a heart attack would seem like a priority.
But it’s not always.
People suffering a heart attack will wait hours to get help, thinking they’re feeling a muscle strain or indigestion.
“Heart attacks can begin slowly or mildly enough that a person is unaware of what they’re experiencing,” said Karen Eubanks, spokeswoman for Tualatin Valley Fire & Rescue.
The fire district is helping heart attack sufferers get medical help faster by equipping its rescue units with 12-lead electrocardiographs, or EKGs. The equipment replaces the three-lead EKGs the district formerly used.
Each of the district’s 21 first-response units has the equipment, which records electrical activity in the heart. The 12-lead EKG “looks” at the heart from 12 angles and is the gold standard for diagnosing heart attacks and other heart problems.
Having 12-lead equipment in the field lets doctors treat patients more quickly. An early, accurate diagnosis gives doctors time to prepare treatment in the emergency room and cardiac catheterization lab before the ambulance arrives.
“Heart muscle that’s being damaged by a heart attack does not conduct electricity well,” explained Battalion Chief Mark Stevens, who heads the district’s emergency medical service. Stevens said three leads gave paramedics enough information to suspect a patient was having a heart attack. With 12 leads, they know.
“Imagine electrodes surrounding the heart,” said Dr. Michael Wilson, interventional cardiologist at Providence St. Vincent Medical Center. “We can tell if the damage is to the front of the heart, the back of the heart. It’s more accurate to have a better look.”
With the confidence and data the 12-lead EKG provides, Wilson said St. Vincent is able to have specialists ready and drugs drawn to treat patients as soon as they come through the hospital door.
Eubanks said in early April, a 60-year-old man loading a truck stopped to ask for an aspirin and an antacid.
When he said he was having chest pain, co-workers called 9-1-1. Eubanks said he repeatedly refused help, but after a 12-lead EKG showed he was having a heart attack, he let an ambulance take him to the hospital, where he was treated.
In late March, a 73-year-old woman called paramedics and said she had been suffering arm pain for about an hour. A 12-lead EKG taken in the field showed she was in the early stages of a heart attack.
Eubanks said she, like the man who asked for the aspirin while loading his truck, was successfully treated in St. Vincent’s cardiac catheterization lab.
Tualatin Valley serves a 210-square-mile area that includes nine cities and unincorporated areas of Washington, Multnomah and Clackamas counties. Most of the 418,000 people served by the agency live in eastern Washington County.
It was one of the first rescue organizations in the country to use 12-lead EKGs when it began working with them in the 1990s, Stevens said. Since that time, they’ve been in use in the Ashland area, as well as Clackamas and Multnomah counties.
Hillsboro Fire Department relies on the lower resolution of 4-lead EKGs, said agency spokeswoman Connie King.
“We’re ahead of some,” Stevens said. “The rest are catching up.”