Acute car­diac care is only a heart­beat away

UMSRH re­ceives MIEMS des­ig­na­tion

Times-Record - - Front Page - By DENAE SPIERING dspier­ing@ches­

EAS­TON — The Univer­sity of Mary­land Shore Med­i­cal Cen­ter at Eas­ton was re­cently des­ig­nated as a Car­diac In­ter ven­tional Cen­ter by Mary­land In­sti­tute for Emer­gency Med­i­cal Ser­vices Sys­tems.

Thanks to its new state of the art Car­diac Ca­theter­i­za­tion Lab­o­ra­tory that opened last March they have been able to per­form 150 to 180 elec­tive and pri­mary an­gio­plasty pro­ce­dures. Since be­ing des­ig­nated as an CIC on Feb. 27, they have per­formed nine emer­gency in­ter ven­tions.

“Within the first eight hours, we had three,” said Dr. Gary Jones, regional di­rec­tor of Car­dio­vas­cu­lar and Pul­monary Ser­vices for Univer­sity of Mary­land Shore Med­i­cal Cen­ter at Eas­ton.

Jones said one of their first CIC pa­tients was brought in by am­bu­lance from St. Michaels. He said the gen­tle­man was in “full-blown car­diac ar­rest.” Once they were able to get the pa­tient into the cath lab doc­tors found a clogged artery and were able to open it up.

“I think in this case he would not of made it across the bridge, Jones said. “With his con­di­tion and what we found — if that had pro­longed in time, I don’t know if he would of made it to a dif­fer­ent CIC cen­ter.”

Jones said on Mon­day, March 12, alone they were able to treat two pa­tients who would of oth­er­wise been taken to other fa­cil­i­ties in Mary­land or even Delaware.

Over the past year, the hos­pi­tal has been able to as­sist pa­tients that had walked into in the Emer­gency De­part­ment with symp­toms of chest pains, in­clud­ing com­plete an as­sess­ment, per­form di­ag­nos­tic test­ing and in­ter­ven­tions elec­tively when nec­es­sary.

“So it was in­ter­est­ing to be in the cath lab and see an iso­lated lit­tle le­sion in some­body’s coro­nary artery and say 20 min­utes from now that could be done,” Jones said. “But be­cause we couldn’t do it here we had to load the pa­tient and some­times the car­di­ol­o­gist to Bal­ti­more and fin­ish the pro­ce­dure there.”

Ad­di­tion­ally if a pa­tient had called 911 from their home and needed im­me­di­ate car­diac care, the paramedics were able to take the pa­tient to the near­est CIC, by­pass­ing Eas­ton hos­pi­tal all to­gether.

“So for Eas­ton that could of meant Sal­is­bury or Anne Arun­del. For Caro­line it could of meant Nan­ti­coke or even Dover. Up in Kent County it could of meant Dover or Chris­tiana and in Dorch­ester – most likely meant Sal­is­bury,” Jones said. “The con­se­quence of that is just the ge­og­ra­phy of get­ting a pa­tient with an acute ob­struc­tion of a coro­nary artery to a cen­ter that is far away ge­o­graph­i­cally had some po­ten­tial for heart mus­cle dam­age.”

Trena Wil­liamson regional di­rec­tor of com­mu­ni­ca­tions and mar­ket­ing for UMSH ex­plains the re­al­iza­tion of that hur­dle.

“So if you were hav­ing an ST el­e­vated heart at­tack across the street, they would of taken you from across the street and driven you to an­other place,” Wil­liamson said. “That is all that time you are los­ing.”

“It re­ally is about — time is mus­cle,” Jones said “All the EMS agen­cies are well aware of the travel time from where ever they are pick­ing up a pa­tient to the clos­est CIC cen­ter, and they are go­ing to make that de­ci­sion and it will be the right one.”

He said there are still go­ing to be pock­ets on the Mid-Shore where go­ing to a dif­fer­ent fa­cil­ity will be closer than com­ing to Eas­ton and that is de­ter­mined by the pro­to­cols of MIEMS.

“MEIMS has a great deal of im­pact on pre­hos­pi­tal care,” Jones said. “For years they have des­ig­nated trauma cen­ters, more re­cently stroke cen­ters and car­diac in­ter­ven­tional cen­ters.”

Jones said over the past sev­eral years he and ad­min­is­tra­tors from the hos­pi­tal met with of­fi­cials from the MIEMS to re­view ex­actly how many pa­tients have suf­fered heart at­tacks in the area and the in­cred­i­ble num­ber of pa­tients who needed to have these pro­ce­dures done.

He said then un­for­tu­nately

they looked at how many of them had to be trans­ferred some­times 60 to 90 min­utes away for those timely acute heart at­tacks.

But those find­ings alone are not enough to earn the des­ig­na­tion. In order for MIEMS to des­ig­nate the hos­pi­tal as a CIC they had to un­dergo an ex­ten­sive ap­pli­ca­tion and re­view process. The ap­pli­ca­tion alone was over 460 pages.

“There is a very exacting process on how to go about get­ting re­viewed and then ap­proved and then des­ig­nated,” Jones said. “We sub­mit­ted the ap­pli­ca­tion in Oc­to­ber, had a site sur­vey in De­cem­ber. and then they had 45 days to make a de­ter­mi­na­tion on the ap­pli­ca­tion and on Feb. 27 the hos­pi­tal be­came des­ig­nated.”

Cur­rently there are two teams head­ing up the CIC lab, with hopes of adding a third team in the near fu­ture. Dr. Jef­fery Ether­ton, and Dr. Gabriel Sardi are the lead car­di­ol­o­gist for the pro­gram.

Jones said the Univer­sity of Mary­land Health Sys­tem is al­ways eval­u­at­ing their stan­dards in order to keep ahead and ap­praised of changes within the de­liv­ery of health­care and what in­flu­ences that has.

“There is a con­stant evo­lu­tion of im­prove­ment on stints and bal­loons and al­ter­na­tives to open­ing up coro­nary ar­ter­ies,” Jones said. “Those things rep­re­sent possibilities. We are part of the Univer­sity of Mary­land Sys­tem — there is a phe­nom­e­nal amount of shar­ing in­for­ma­tion and col­lab­o­ra­tion.”

Jones said ev­ery other month they hold a qual­ity con­fer­ence call with other in­ter­ven­tional car­di­ol­o­gist who are also part of the sys­tem.

“It is an open aca­demic dis­cus­sion on what we are do­ing ver­sus other ar­eas,” Jones said. “It is a great col­lab­o­ra­tive ef­fort.”


Dr. Jef­fery Ether­ton and Dr. Gabriel Sardi are the lead car­di­ol­o­gists for the Car­diac In­ter­ven­tional Cen­ter.

Dr. Gary Jones is the regional di­rec­tor of Car­dio­vas­cu­lar and Pul­monary Ser­vices for Univer­sity of Mary­land Shore Med­i­cal Cen­ter at Eas­ton.

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