Ready in a Heartbeat

Tulane Medical Center's emergency and cardiac staff have worked diligently to establish procedures to minimize the time required to identify heart attacks and to expedite treatment for patients. The efforts were rewarded in December when the Society of Chest Pain Centers fully accredited the hospital as a chest pain center.

Tulane Medical Center, located in downtown New Orleans, has Louisiana's only cycle II chest pain center.

The patient care policies that Tulane Medical Center has established have been approved and recognized as exceeding the rigorous first-level standards set by the national Society of Chest Pain Centers.

“We can diagnose a heart attack in less than 10 minutes and initiate treatment to reverse the coronary artery blockage soon thereafter,” says Dr. James Moises, a medical director of Tulane Medical Center's emergency department.

When someone has a heart attack, every second counts. Like all muscle tissue, when the heart is without oxygen, it will begin to die. A patient suffering a heart attack should receive a cardiac catheterization within 90 minutes of arriving at a hospital, according to the American College of Cardiologists.

Emergency room staff must make a rapid diagnosis in consultation with a cardiologist before the patient is transferred for treatment to a cardiac catheterization laboratory, which is required to be functioning 24 hours a day.

Cardiologists Dr. Lawrence O'Meallie and Dr. Patrice Delafontaine, chief of cardiology at the Tulane School of Medicine, spearheaded the accreditation, guided the direction of the pre-hospital and emergency department care, assessed the cardiology consulting process, and identified ways the hospital could more efficiently provide definitive treatment for patients.

“Time is muscle — heart muscle, that is,” says O'Meallie, medical director of the chest pain center and the cardiac catheterization lab. “This is what we are trying to salvage, to limit the insult to the heart. This greatly improves the outcomes for patients with heart attacks.”

Moises and Dr. Michael Kolinsky, emergency department medical directors, streamlined procedures for diagnosing and treating patients in the emergency department. “We have the most qualified physicians treating patients experiencing chest pain,” Moises says.

Understanding the importance of every minute, Tulane established a way for paramedic crews to immediately notify the hospital staff when they identify a heart attack in patients so that the hospital can make ready a catheterization lab, explains Merry McSwain, chest pain center coordinator and emergency medical services liaison at Tulane Medical Center. “With this system, we are preparing for the patients' treatment before they even arrive.”

The hospital will be starting a community outreach program to educate the public about recognizing the warning signs of a heart attack.

“It is safer to dial 911 or go to an emergency room immediately, have a medical screening and not be having an attack than to ignore the signs,” McSwain says. “When in doubt, check it out.”