LEADING EDGE
Taking Initiative
T H E N E W S T E M I A L E R T S Y S T E M I S I N C R E A S I N G
S U R V I VA L R A T E S F O R R U R A L H E A R T A T T A C K P A T I E N T S
By Andrea Kalas-Nagel
FOR YEARS HEART ATTACK PATIENTS IN RURAL
communities had to be taken to an emergency room
before being taken to the cardiac catheterization lab (cath
lab) to be treated. Because of this, patients had a much
longer wait before being treated, which means a slower
healing time and a smaller survival rate.
“The longer it takes to get patients treated, the longer
their recovery,” Ronald Jenkins, M.D., said. “When I took
over as the medical director for Bonner General Hospital
in Sandpoint, I wanted to change treatment patterns.
There’s a more effcient way to treat heart attack patients.”
O N T H E A L E R T
Dr. Jenkins, along with several hospitals and EMS
specialists, worked together to create the STEMI (ST-
segment elevation myocardial infarction) Alert system.
The new system allows EMS staff to bypass both Bonner
General and Kootenai Health
emergency departments and
take patients to the cath lab
at Kootenai. After months of
planning, the STEMI Alert
system started in November
of 2010.
First, EMS providers were
trained with the new proto-
cols and all paramedics were
required to complete critical
care transport courses. Dr.
Jenkins also needed Bonner General emergency physi-
cians to agree to provide medical support and direct
EMS providers to take patients directly to the Kootenai
cath lab rather than transporting the patient to Bonner
General for the usual emergency evaluation.
The current goal is to have an artery opened within
120 minutes of the arrival of EMS. From the far reaches
of the county, such as Clark Fork, Priest Lake or even
Schweitzer, the goal is 150 minutes. So far the team has
averaged a remarkable 109 minutes. The time saved has
averaged about 89 minutes since the new protocol was
started in Bonner County.
“That 89 minutes saved can take days off of the pa-
tients’ overall hospital stay,” Dr. Jenkins said. “So far it
has changed from 4.5 days to 2.8 days. It makes a huge
difference in the outcome of their procedure and what
their lives are like for the next 20 years.
A S T O R Y O F S P E E D
Jerry Krantz is a prime example of how well the system
works.
Jerry, a Montana Rail Link engineer, was picking up
a disabled train in Hope, Idaho, when he felt a strong
pressure in his chest. As he realized the symptoms were
getting worse, he called his co-worker over and instructed
him to call 911.
“That was the best thing he could have done,”
Dr. Jenkins said. “By calling 911 instead of going directly
to the ER, he saved his own life.”
Bonner County EMS responded to the call and imme-
diately began an EKG, which was sent to Bonner General
Hospital for review and approval to bypass both the Bon-
ner and Kootenai emergency facilities. After receiving
approval, the paramedic called Dr. Jenkins to seek further
instructions and to relay the patient’s vital signs.
During the time it took for the ambulance to reach
Kootenai Medical Center, Dr. Jenkins had assembled a
team from the Kootenai Heart Center for an emergency
angioplasty procedure.
“I was told that it only took 107 minutes from the time
the ambulance arrived until I was in the cath lab,” Jerry
said. “It was impressive. Even though it seemed like a
long ride to me, I know it was really quick.”
The STEMI Alert system saved Jerry’s life.
“Dr. Jenkins called my heart attack a ‘widow-maker,’”
Jerry said. “The ambulance crewwas great, and the doc-
tors took great care of me—I owe them a lot. I’m alive
today because of them.”
M O V I N G F O R WA R D
Dr. Jenkins said the group will be tracking the results of
the STEMI Alert System over the next few years.
“If it works here, we can spread the program through-
out northern Idaho,” he said. “This is themost progressive
program that I’m aware of.”
Currently, Dr. Jenkins said, there is a nationwide push
to put programs like this into practice.
“Of course, the whole reason for these efforts is to
save lives,” he said. “Every minute makes a difference.”
Ronald Jenkins, M.D.
KOO T E NA I
H E A L T H
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