Lake Regional, EMS teamwork saves valuable time during heart attack care

Lake Regional Health System recently achieved a milestone in heart attack care. Throughout the past year, Lake Regional patients with certain types of heart attacks were treated 40 minutes faster on average than the national guideline.

“Time is muscle, and every minute counts,” said Willie Maxwell, R.N., director of Lake Regional Health System’s Cardiac Catheterization Lab. “If you’re having a heart attack, quick intervention not only increases your chance of survival, it also helps minimize the damage to your heart.”

Door-to-balloon time is the interval between when a patient with ST segment elevation myocardial infarction (STEMI) arrives in the emergency department and when a catheter guidewire is inserted to open the blocked vessel in the cardiac cath lab.

Since November 2012, Lake Regional’s average door-to-balloon time is 50 minutes; the national guideline recommends this process be completed within 90 minutes of a patient’s arrival at the hospital. According to the American College of Cardiology, the national average door-to-balloon time is 64.5 minutes.

The Lake Regional team attributes much of their success to working closely with local EMS providers. During the past two years, the groups have worked to improve communication between the ambulance services and emergency department physicians, including the quality of the diagnostic information transmitted from the ambulances.

Lake Regional receives patients from seven ground ambulance services and one air ambulance.

“The EMS teams are our eyes and ears in the field,” said Alan Wilson, M.D., assistant medical director at Lake Regional Emergency Department. “They are instrumental in documenting ST segment elevation during transport. That helps ensure we get patients the care they need in the fastest time possible.”

Vinny Loyd, division chief of EMS at Lake Ozark Fire Protection District, said EMS personnel use a 12-lead electrocardiogram in the field to detect abnormalities in heart rhythms. Until about three years ago, this information was faxed to emergency departments using Bluetooth technology.

“The result was not diagnostic quality,” Loyd said. “Now, 12 leads are emailed to physicians, producing a quality image they can use to make decisions.”

Loyd, who has 21 years of experience providing emergency medical services, including 12 years in St. Louis, knew that improving the data physicians receive from the EMS teams could mean better patient outcomes.

“The quicker we can confirm a STEMI the better,” Loyd said. “If the ED physician can confirm the STEMI while the patient is en route, the doctor can alert the Cath Lab and cardiologist so everybody is ready when the ambulance arrives.”

That preparation means patients can bypass the emergency department and go straight to the Cath Lab for intervention, another time saver.

“That’s what’s happening at Lake Regional, which has an exceptional cardiac program,” Loyd said. “The difference in time is saving major heart tissue.”

Emergency cardiac services are available 24 hours a day, seven days a week at Lake Regional. These services are part of the health system’s comprehensive cardiovascular program, which includes cardiac catheterization, open heart surgery and cardiac rehabilitation.

Lake Regional’s Cardiac Cath Lab treats 1,500 patients annually, including an average of 70 STEMI patients per year. To learn more about cardiovascular services available at Lake Regional, visit