EKG-trained paramedics key to faster care of heart attacks

LEWISTON – New protocols next month in Maine call for training emergency medical technicians to read electrocardiograms, following pilot programs that have demonstrated faster treatment for heart attack victims.

State officials hope to build on programs including one with Lewiston’s United Ambulance, which trained paramedics to read electrocardiograms, or EKGs. Between March 2004 and June 2005, trained United Ambulance paramedics correctly identified all patients who were having a heart attack.

Central Maine Medical Center was impressed enough with the results to give EKG-trained paramedics the power to open an emergency cardiac catheterization lab with a phone call.

In the cardiac catheterization lab, doctors can perform angioplasty, opening the clogged artery with a balloon, and then use a stent to keep the artery open.

The American Heart Association says the goal during a heart attack is to open a clogged artery within 90 minutes or less to minimize damage to heart muscle. The average for a patient transported by an EKG-trained paramedic to Central Maine Medical Center is 44 minutes.

Eastern Maine Medical Center in Bangor reported similar success in its year-old program.

The hospital’s overall “door-to-balloon” time averages 72 minutes. But the time was slashed to 45 minutes for patients transported by EKG-trained paramedics.

The state’s largest hospital, Maine Medical Center in Portland, started training Portland and South Portland paramedics in EKGs last fall, and the hospital has allowed emergency medical technicians to open its cath lab since January.

Starting July 1, the state will include performing and interpreting EKGs in its protocols for paramedics. Not all paramedics will have the power to activate a cath lab, because most hospitals in Maine don’t have emergency cath labs.

But trained paramedics can still call ahead to the nearest hospital and alert doctors they’ll be getting a heart attack patient, cutting the time it takes for the patient to get clot-busting drugs or to transfer to a hospital with a cath lab.

Hebron Fire Chief Jim Trundy is living proof that the system works.

His heart stopped twice after he collapsed at the scene of a fire in 2006. Paramedics ran an EKG, confirmed he was having a heart attack, and called ahead to Central Maine Medical Center.

The cath lab was ready and secured Trundy’s blocked artery with a stent minutes after his arrival via LifeFlight helicopter.

“I think it’s probably the best thing going and critically important,” Trundy said. “I mean minutes are muscle.”