By Rita Savard
The Lowell Sun
LOWELL, Mass. — Tim Regan is ready to run.
Because when the calls come in, lives are on the line.
At the scene of an accident or when sudden illness strikes, paramedics like Regan are the critical “in between” for patients headed to the emergency room. Now Regan and his team at Saints Medical Center are running faster and more efficiently thanks to a new monitoring device that provides a detailed picture inside a patient’s heart.
“We’ve been waiting for technology like this for 20 years,” Regan said.
In 1986, when Regan began working in an ambulance, the monitor was a small, round screen with a single green blip to measure the heart rate. But technology has come a long way with the Propaq MD monitor/defibrillator. About the size of a toaster, the ultra-rugged defibrillator — which even has a night-vision goggle mode — was designed tough for military use.
Manufactured at Zoll Medical Corp. in Chelmsford, the Propaq was approved by the FDA in late July and, until now, used exclusively by the military.
Saints paramedics are the first civilians to test-drive the device in a different kind of battlefield.
“We’re not dodging bullets, but every call is different,” Regan said. “And sometimes the situation can be physically demanding.”
In the city, emergency responders see it all. Structure fires. Car accidents. Homicides.
Calls often lead paramedics inside older tenements or houses with narrow hallways and what can seem like endless flights of stairs when carrying more than your own body weight.
While carrying patients, paramedics also cart heavy lifesaving equipment to watch vital signs at the same time. And the clock is always ticking.
In Regan’s field, that crucial window from the time a heart-attack victim is picked up to the time he arrives at the hospital is called “door-to-balloon time.”
Heart disease remains the leading cause of death in the United States, according to the U.S. Centers for Disease Control and Prevention.
Studies show that reopening clogged arteries by inflating a tiny balloon at the site of the blockage is the best way to treat a severe heart attack. The procedure, called balloon angioplasty, can cut a patient’s risk of death by 40 percent, but only if it’s done within 90 minutes of the patient’s arrival at the hospital.
In 2006, a study sponsored by the National Heart, Lung and Blood Institute showed that only about one-third of heart-attack patients get angioplasty within the 90-minute window. The study helped launch a national campaign geared to improve emergency response procedures and times for cardiac patients.
By using the Propaq monitor, Saints paramedics are also helping Zoll engineers design a prototype of the military model for emergency-responder use.
Regan leads a team of 14 full-time and 10 part-time emergency responders that serve Lowell, Chelmsford, Dracut, Dunstable, Tewksbury, Tyngsboro and Westford.
Last year, they received the highest number of calls per vehicle in Massachusetts — about 1,836, compared to 1,770 calls handled by the much-larger Boston EMS.
Despite its smaller team, operating with just two emergency vehicles daily and one at night, Saints paramedics have been recognized for outstanding work in cardiac-patient outcomes by The Joint Commission, a national nonprofit that accredits and certifies health-care organizations.
Regan said the new heart monitor is taking field performance to the next level. This is kind of like graduating from dial-up Internet to high-speed DSL.
“We can see 12 angles of the heart at once,” said Jeremy Stebbins, a paramedic at Saints. “So we can see exactly which vessel is causing a heart attack.”
Because heart damage can occur within that in-between time from pickup to ER, every second counts. The interval begins with the patient’s arrival in the emergency department and ends when a catheter guidewire crosses the culprit lesion in a cardiac lab.
Once paramedics can see where the problem is occurring, they can prep doctors who are ready when the patient comes through the hospital doors.
Before they arrive at the ER, the monitor is also helping responders more rapidly stabilize heart rhythms on their own. One patient, who needed defibrillation before the ER, was treated and walked out of the hospital the same day, said Regan.
“The heart has an electrical system just like a house does,” Stebbins said. “Now think of a power outage. This device is everything we need in one small box, like a circuit breaker; it can turn all the lights back on.”
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