By Ann Marie Barron
Staten Island Advance
NEW YORK — Richmond University Medical Center is celebrating a speed record for delivering life-saving treatment to a patient with the most urgent type of heart attack.
RUMC’s ST Elevation Myocardial Infarction Program, which recently celebrated its 10-year anniversary, treats dangerous STEMI heart attacks, caused by a complete blockage in a coronary artery, cutting off the heart‘s oxygen supply.
Each year, about 285,000 people in the United States experience a STEMI heart attack, according to the American Heart Association. RUMC cares for more than 50 STEMI patients annually, by clearing the blockage and restoring blood flow as quickly as possible.
To improve efficiency and track progress in treatment of the critical condition, the program at RUMC tracks the precious time it takes a patient to receive a lifesaving angioplasty balloon inflation — clearing the blockage — in the Cardiac Catheterization Lab, from the moment the patient arrives at the hospital. This is known as “door-to-balloon time.”
‘First contact’
And since January, the West Brighton hospital took it one step further — tracking the time it takes for the patient to receive life-saving care from “first contact” — the moment the ambulance EMTs arrive at their home, or “first contact to balloon time.”
One of metrics required by the state to certify the program is what is known as the “door-to-balloon time.” That requirement is 90 minutes or less.
Yet, the program recently recorded an all-time fastest “first contact to balloon time” of 78 minutes — saving the life of Israel Llaque with minimal damage to his heart muscle, according to Dr. Francesco Rotatori, chairman of the Cardiovascular Department at RUMC.
This was achieved despite roadblocks beyond the hospital’s control, such as difficulty accessing the patient, traffic getting to the hospital, and a patient‘s other medical conditions.
The 51-year-old patient said he was shocked by how quickly he received the cardiac care at RUMC.
“It was amazing,’' said Llaque, who started to feel chest pressure on Feb. 24, just before 7 a.m., shortly after beginning his shift at a Forest Avenue warehouse. ”When I got there, I didn’t expect so many people waiting for me.”
Intricate system in place
The intricate system now in place requires that the on-call doctors receive notification and the team becomes active before the patient arrives, Rotatori said.
“All these things, they seem to be trivial, but they make you save minutes, and there is a saying, ‘time is muscle,’'’ he said. ”Every minute counts when saving heart muscle. And that can have a tremendous impact in quality of life of a patient after the procedure.“
The STEMI patients now most often bypass the Emergency Room completely, going directly to the Cardiac Catheterization Lab, he said.
Those minutes made a difference for Llaque, a New Jersey resident who experienced very little damage to his heart muscle. He plans to return to work shortly. He’s feeling fine, he said, noting he’d never experienced chest pains like that before.
“I would say it was a good experience, though I wouldn‘t want anyone to go through it,’' he said. ”They got me very quickly from the warehouse to the hospital.”
Llaque said he was surprised to have doctors looking at him in short order, despite heavy morning rush hour traffic at that time.
An impact on the patient
“When you have a heart attack and damage is extensive, the heart may not function again as it once did,’' Rotatori said. ”But acting in a timely manner will definitely have an impact on the life of the patient.”
Since this new program began, RUMC has a 100% success rate in having all STEMI patients (without other complications) get from their location to the lab in under 90 minutes, according to the hospital.
And the 78 minutes is a particularly special moment for all involved in the program, Rotatori said.
It‘s a really a proud landmark, because it takes a significant team effort to make sure this thing is done appropriately, he said, noting that about 15 people, including emergency room staffers, nurses, the catheterization lab team, physicians and physician assistants, had to be at the top of their game to accomplish the feat.
The program was created a decade ago, because data showed that North Shore residents were experiencing high numbers of STEMI episodes, and the only hospital capable of treating them was on the other side of the borough at Staten Island University Hospital in Ocean Breeze.
The situation was dire for North Shore residents, Rotatori said, so the program was created in less than a year and certified by the New York State Department of Health. Among the requirements is having appropriate medical staff and equipment available 24/7.
Rotatori credited Drs. Bhavesh Gala, Srinivas Duvvuri and Samala R Swamy — who were already practicing cardiologists on Staten Island — with committing their time to get the program off the ground.
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