By Seven Mayer
The Bakersfield Californian
KERN COUNTY, Calif. — Hall Ambulance emergency medical technicians Jonathan Martin and Joshua Ovalle were on a call at a patient’s home.
The man described his symptoms as feeling weak and dizzy, needing to sit down. And there was more.
The two EMTs began thinking “possible heart attack.”
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“We decided to do it,” Martin said of their decision to use their new hand-held, artificial intelligence-enabled electrocardiogram, or ECG for short.
They placed five leads on the patient, one on the right arm, two on very specific spots on the chest, called the “V2” and “V4.” The fourth lead was placed on the left arm, and the fifth on the left leg.
Even though it requires only five physical leads, it processes the data as if it has the traditional 12-leads, like the larger machines the paramedics have in their toolbox.
Even if it’s a negative reading, it’s well worth it, Martin said.
“It’s just good to rule it out,” he noted, referring to the possibility of a dangerous and potentially fatal myocardial infarction, or heart attack.
In this case, however, heart attack wasn’t ruled out. It was diagnosed.
“In December, we announced the acquisition of 12-lead electrocardiograms known as ECGs for our countywide, basic life-support service delivery in our emergency medical services system,” Kern County Public Health Director Brynn Carrigan said at a news conference Monday morning.
“These devices were implemented in the system on Feb. 1 of this year. Today, we are here to share a story of a 911 response that occurred within the first few weeks of deployment of these devices, in which the use of an ECG enabled first responders to quickly identify that a patient was experiencing a heart attack.”
Because of that early identification in the patient’s home, the man was taken to the appropriate facility, which was expecting him, and the facility was aware he was actively experiencing a heart attack.
“The patient received the specialized care he needed as quickly as possible,” Carrigan told reporters. “As a result, the patient was treated at the hospital and survived his heart attack.
“This is exactly how our emergency medical services system is designed to work,” she said.
On Monday, Carrigan’s department honored the first-responder team, Martin and Ovalle, for their lifesaving actions.
They also highlighted the critical role early cardiac recognition plays in saving lives.
“Time is muscle,” said Jonathan Surface, president and CEO of Hall Ambulance Service.
“If somebody’s having a heart attack, the longer it takes them to get definitive care, the higher the likelihood of a poor outcome,” Surface said.
Indeed, every minute of delay in treatment can cause the irreversible death of heart muscle.
“One of the first things you want to do is definitively identify that person as having a heart attack,” Surface said. “And EMTs have never had that tool to work with, and now they have that tool.
“EMTs can now deliver that person,” Surface said, “knowing they’re going straight to the cath lab, no delay.
“They’re not going to be questioned by somebody,” he said. “They’re not going to be told, ‘Hey, we’re full, go wait up against the walls. It’s going to be an hour before we get to you.’ You get to skip all that stuff and go straight to the cath lab.”
Dr. Kristopher Lyon, EMS medical director and public health officer, said Kern is the first entity, the first county, the only ones in California if not the country, using this technology in the hands of EMTs or basic life support crews.
“It’s huge,” he said. “It decreases the time to the cath lab for location, which ultimately helps ... makes it so that the patient can go home to their family and survive this event with hopefully minimal, if any, long-term offense.”
This is not new for paramedics. They’ve been doing this for years, Lyon said.
But now, EMTs are able to plug that hole in the system.
Jeff Fariss, Emergency Medical Services program manager for Kern County Public Health, said 100 of the devices were purchased at $1,800 each for distribution to Hall Ambulance and to the county and city fire agencies. More may be needed, he said.
Asked why the county of Kern is paying for units going to a privately owned company like Hall, Fariss said it’s because it would be an unfunded mandate, otherwise.
“Legally, as a government official, I cannot make a private entity do something, if it costs an exorbitant amount of money. That would be unfair to them.
“So, in this case, I had a funding stream so that I could mandate that they use this, and I handed them the tools to do it, so it wasn’t a cost to them,” he said.
Meanwhile, these changes are beneficial to patients and to the larger community.
“We’re on fire for this,” Fariss said. “This thing is saving lives.”
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