Acute cardiac care is a heartbeat away

EASTON - The University of Maryland Shore Medical Center at Easton was recently designated as a Cardiac Interventional 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 interventions.

"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."

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