Iredell Memorial Hospital's heart attack treatment response ranks among nation's best

Posted at 5:46 PM on Apr 1, 2019

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Dr. Charles Deberardinis (left) and Cardiac Cath Lab Manager Larry Morrisette play critical roles in helping Iredell Memorial Hospital achieve better-than-average door-to-device times.

Special to SVLfreenews.com

In emergency treatment of heart attacks, “door-to-device time” refers to the interval from when a patient is present in the emergency department to when that patient's artery is opened in the cardiac catheterization lab.

The National Cardiovascular Data Registry reports the median door-to-device time for U.S. hospitals to be about an hour.

The 90th percentile is about 45 minutes. In 2018, Iredell Memorial Hospital’s door-to-device time was less than 30 minutes.

“When the best providers in the country are doing it in 45 minutes and you’re doing it in less than 30, you’re doing something pretty well,” said Dr. Charles Deberardinis.

Deberardinis, an interventional cardiologist, is the medical director for the Iredell Heart & Vascular Center. Dr. Jips Zachariah of Piedmont Healthcare Cardiology is the other interventional cardiologist at Iredell who helps make sure patients receive the critical care they need.

The first step to achieving efficient door-to-device time is for emergency medical services (EMS) to recognize that a person is having an acute heart attack. Iredell County possesses the necessary technology to enable a paramedic or emergency medical technician (EMT) to perform an electrocardiography (EKG) on-site before transmitting the results to the hospital emergency room. The EKG helps diagnose heart attacks by recording electrical signals in the heart to determine heart rate, heart rhythm, and other information indicating the heart's condition.

Once the hospital receives the assessment from EMS, the emergency room physician and cardiologist confirm whether the patient is suffering a heart attack and if the artery needs to be opened immediately.

Prepared hospital employees then aim for patients to hardly touch the ground in the emergency department. A doctor or nurse practitioner performs a swift assessment to ensure the patient isstable enough to get to the catheterization lab before being moved there. Once there, aninterventional cardiologist inserts a catheter, uses an x-ray to create images to see the blockage,and then opens the artery.

“I characterize it as a dance,” said Skip Meador, Iredell Health System’s director ofcardiovascular services. “There is extraordinary collaboration between EMS, the emergencydepartment, and the cardiac catheterization lab, and emergency room personnel arecommunicating with EMS from the get-go. Then once the patient arrives, we get them treatmentand make sure they’re stable with very fast times and great outcomes.”

Iredell Emergency Department providers and directors emphasize creativity in collaborating withEMS teams. And initial EKGs are completed in the field, enabling patients to go directly to thecatheterization lab, bypassing the emergency department and saving critical time.

“A real success is us getting the EKGs done on the patients very quickly,” said Dr. Brian Beaver, medical director of Iredell Memorial Hospital’s Emergency Department and medicaldirector for Iredell County EMS. “We are aware and prepared even before the patient is here. They can be 20 minutes away somewhere in Iredell County and come right on in.”

Iredell Memorial remains loyal to the motto “time is muscle,” emphasizing that door-to-devicetime correlates with the amount of damage to the heart muscle. Shorter door-to-device timestypically result in better patient outcomes.

“There has been a lot of scrutiny across the country in improving the timeliness of heart attack care, and providers have done a lot of work to streamline that process,” Zachariah said. “If you truly believe that time is muscle, and it is, then for the person in an acute phase of a heart attack, getting care quickly is critical. We have heart-saving and lifesaving capability and we’re doing ittruly world-class.”

About Iredell Health System

Iredell Health System includes Iredell Memorial Hospital, Iredell Home Health, Iredell Wound Care &Hyperbaric Center, Community and Corporate Wellness, Occupational Medicine, and the Iredell Physician Network. Iredell Memorial Hospital is the largest and only non-profit hospital in IredellCounty. The comprehensive healthcare facility has 247-beds, more than 1,500 employees, and has 260 physicians representing various specialties. Centers of excellence include Women’s and Children’s, Cardiovascular, Cancer, Surgical Services and Wellness & Prevention. Iredell Memorial has also been named as a Blue Distinction Center+ for Hips and Knees, as well as Maternity Care, by Blue Cross Blue Shield. The mission of Iredell Health System is to inspire wellbeing. For a comprehensive list of services and programs, visit www.iredellhealth.org

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