EKG Readings Sent while patient is en route to Charleston County hospitals

EKG readings sent while patient is en route to hospital let doctors make quick decisions

BY JONATHAN MAZE

Of The Post and Courier Staff

When a person has a heart attack, doctors say, time is muscle, meaning that the longer it takes to get a victim into treatment, the more damage is done to the heart and the less chance he or she will survive.

Now, a group of Charleston-area hospitals and ambulance services have joined forces to establish a system designed to begin treating heart attack patients even before they get to a hospital.

"What we're trying to do is save lives," Dr. Blount Ellison, a cardiologist at Roper Hospital said at a press conference Wednesday announcing that the system is now fully operational in ambulances in Charleston, Berkeley and Dorchester counties.

"When a person has a heart attack, the clock starts," Ellison said. "The longer the artery is closed, the more damage gets done to the heart and the more people die."

The system allows emergency workers to transmit heart-monitor readings via wireless modem directly from an ambulance to one of three Charleston hospitals with open-heart surgery programs.

That will allow doctors to determine whether the patient is having a heart attack, as well as its severity. For years, doctors had to wait until the patient arrived at the hospital, where they would take electrocardiogram readings and then diagnose the problem.

Transmitting the readings while the patient is en route to the facility will allow doctors to make the determination sooner, giving them a jump on preparing for treatment.

The best treatment for a heart attack involves a cardiac catheterization, in which doctors insert a balloon at the end of a tiny tube called a catheter that is snaked to the heart through a large blood vessel, usually starting in the leg.

The balloon is inflated to open the blocked artery, and then doctors prop it open using a tiny mesh tube called a stent. That treatment must begin as quickly as possible, officials say.

"There's no question this system will save lives," Ellison said.

The effort to set up the system originated among a group of nurses and other staffers at Roper Hospital. That group received a $60,000 grant from the Medical Society of South Carolina to place the devices into Charleston-area ambulances to transmit EKG readings. The society is a nonprofit group of doctors that holds a large interest in Roper St. Francis Healthcare, owner of Roper and Bon Secours St. Francis hospitals.

The three hospitals that can do catheterizations -- the Medical University of South Carolina, Roper Hospital and Trident Medical Center -- each agreed to pay for a computer server to receive the readings.

The three EMS services began equipping their ambulances with the devices about a month ago, said Don Lundy, executive director of Charleston County EMS. Already, EMS officials say, it has begun saving lives.

Doug Warren, director of EMS for Dorchester County, said one recent heart attack patient arrived at the EMS station in Ridgeville at midnight after deciding against driving himself to Trident.

Paramedics were able to transmit the EKG reading directly to the hospital. During the nearly 20 minutes it took the ambulance to get to the hospital, doctors were able to determine the patient was having a heart attack.

The cath lab was ready by the time the patient arrived. He was treated that night and went home the next day.

Warren said the system will be especially beneficial for patients in rural areas that are much farther away from a hospital.

Tuesday, April 18, 2006 - Last Updated: 8:06 AM

BY HOLLY AUER

The Post and Courier

Downtown Charleston's health care complex officially gets bigger this week as Roper St. Francis Healthcare unveils its new $77.4 million Heart and Vascular Tower on Calhoun Street.

The seven-story expansion, which will house all of the hospital system's heart and vascular care facilities, plus an outpatient surgery center and 147 private patient rooms, is expected to begin admitting patients in early May. It is the first all-new facility to open its doors in the area in nearly 20 years.

The tower's construction follows a national building trend, as treatment for heart disease and vascular problems becomes increasingly technology-driven.

As baby boomers age, often saddled with hypertension, high cholesterol and diabetes, the nation is expected to be burdened like never before by sick hearts and circulatory systems. These patients will need an arsenal of drugs, stents, bypass surgeries and implantable pacemakers and defibrillators.

In South Carolina, heart disease is the leading cause of death, and stroke ranks third. About a third of the state's population has high blood pressure and high cholesterol, two problems that fuel heart disease. And 60 percent of Palmetto State residents are obese, which adds strain to their hearts and circulatory systems.

"There's an enormous need for the treatment and education around this disease, so it made sense that we'd focus on this," said Roper Hospital Chief Executive Officer Matthew Severance.

He and other hospital leaders and physicians also are banking on the Heart and Vascular Tower as a way to boost Roper's national reputation and, by offering specialized, one-stop-shopping care, pull in more patients from the area's competitive health-care market.

Construction began last year on the Medical University of South Carolina's new hospital, a multiphase project that's expected to cost more than $1 billion. East Cooper Regional Medical Center and Roper St. Francis received state approval last month to build new facilities in Mount Pleasant. East Cooper plans to put a 140-bed hospital next door to its existing facility on Johnnie Dodds Boulevard, and Roper will build an 85-bed facility farther north on U.S. Highway 17.

Trident Health System completed a $60 million renovation to its North Charleston hospital within the past year. It also plans to build a $10 million diagnostic imaging facility and put physician offices and diagnostic and rehabilitation facilities on a 20-acre parcel at Cane Bay Plantation, a 5,000-home community under construction in Berkeley County.

The main goal of the Roper Heart and Vascular Tower is to streamline patient care. It houses inpatient and outpatient testing and procedures under the same roof and is designed to move patients seamlessly between, say, the cardiac catheterization lab and the operating room. For the sick and elderly, and especially people from rural areas who have trouble getting into Charleston, doctors say that's helpful for ensuring they get recommended care and follow-up.

"Currently, things are set up where we're still a cottage industry," said Roper vascular surgeon Edward Morrison. "You can go to one place to get this, one place to get that, to the physician's office for this, back to the hospital for that. It's a huge nuisance for the patient."

The facility's layout also aims to make the patient's in-hospital experience less complex and confusing. The driveway to its main entrance on Calhoun Street, for instance, connects to a parking garage, so patients or their families don't wind up circling downtown's maze of one-way streets while trying to park.

Among other aesthetic and "comfort" touches in the hospital:

--Rooms 1 1/2 times the size of standard hospital rooms, each with a flat-screen TV;

--More than half of the rooms in the new tower offer views of the Charleston Harbor, as do several operating and recovery rooms;

--Nurses will be stationed in small pods rather than large central stations, to be closer to patients; and

--Small, private waiting rooms will allow families to have space to themselves, as well as a place to confer with physicians.

Then there are the things patients probably won't notice but doctors say are vital to providing top-notch care.

Each room, for instance, is hardwired for telemetry monitoring, and the operating room equipment is suspended on ceiling booms, which makes for easy cleaning and clutter-free floor space. Rooms for less-invasive cardiac and vascular procedures are built the same way, allowing the rooms to be reconfigured for emergency surgery if something goes wrong.

The new tower will replace services now housed in Roper's 1940s-era west wing, where many rooms are small and lack showers. That space eventually might be converted to offices.

No equipment or furniture will be moved from the existing hospital to the new tower.

"Roper, no matter what building it has been in for generation after generation, has had the reputation of a hands-on staff that's available to their patients," said Dr. William Grossman, chairman of Roper St. Francis Healthcare's cardiology division. "The building is only an item that allows ease of providing that best care by giving us the tools to provide what we know we want to do."

Lowcountry residents are invited to tour Roper St. Francis Healthcare's new Heart and Vascular Tower from 1 to 4 p.m. Sunday at Roper Hospital downtown on Calhoun Street. Roper will offer stroke- and cancer-risk assessments, blood pressure checks and tests for blood sugar and bone density. Health information will be on hand, and refreshments and giveaways will be provided.

The seventh floor will be dedicated to Dr. Julian Buxton at 11:30 a.m. Thursday at the Bennett House, 69 Barre St. After a short program, the family will unveil the portrait commissioned to hang in the entrance to the floor's Surgical Pavilion. Buxton was on the Roper Hospital board for 20 years.

The Heart and Vascular Tower will feature food that is light and low-cholesterol. A black-tie gala showcasing the food will be Friday. Get all the details, In Food.

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