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Protocol saves heart attack patients

Published July 17. 2018 12:25PM

Keyna Lundy is living proof that minutes matter. She was the first patient to benefit from the St. Luke’s Monroe Campus’ new “Direct to Cath Lab” program, which saves valuable time for patients who need catheterization by allowing them to bypass the emergency department.

On May 3, Lundy was five minutes into her drive to work when something started going very, very wrong.

“Before leaving the house, my lungs were sore, but I thought it was my asthma,” says Lundy, a resident of Tobyhanna. “I used my inhaler, but as I was driving, I became very nauseous, stared feeling sharp pain and my vision got blurry. Then, everything started to go dark.”

Lundy pulled off the road and used her phone’s personal assistant to call 911. Lundy told the operator that she was in a silver Jeep and that she was near the local fire station.

The response team — which included paramedic Damian Ober and EMT Javier Cruz of Pocono Mountain Regional EMS — was on the scene within minutes. Stroud Area Regional Police officer and Coolbaugh Township Volunteer Fire Company assistant Chief George Dobson also arrived to assist.

“I remember the team saying that they were starting the procedure for someone who is in cardiac arrest,” Lundy says. “The paramedics had already contacted the hospital to let them know my condition and symptoms. They had all my personal information inputted and in the system.

“Once I made it to the hospital, I went right from the stretcher to a bed in the operating room. I was in and out of consciousness. They couldn’t find a pulse in my left arm. They went through the groin on my right side to implant the stents. They had to resuscitate me. I had had a massive heart attack and Dr. K saved me.”

Dr. K is Vinod Kudagi, a board-certified interventional cardiologist with St. Luke’s Cardiology Associates in East Stroudsburg. Kudagi says that the Direct to Cath Lab program is designed for patients who are experiencing St-elevation myocardial infarction, which is a severe heart attack caused by a major artery that is clogged and prevents blood from reaching the heart.

“Every second we wait, the patient is losing heart muscle that will never be regained,” Kudagi explains. “By taking the patient directly to the cath lab instead of to the Emergency Room to be checked in and assessed, we can save 20 or 30 minutes.”

In this case, Lundy’s “door-to-balloon” time through St. Luke’s Monroe Campus’ new Direct to Cath Lab program was only 12 minutes, which is much quicker than the recommended practice guideline time of 90 minutes.

“This means that we managed to open her blocked artery — which was causing her heart attack — in only 12 minutes after she presented to the hospital,” Kudagi said.

After her emergency care, Lundy stayed in the hospital for several days and had open-heart surgery in late May.

Ober said that for several years, EMS workers have been doing 12-lead EKGs in the field on a pre-hospital basis.

“With the ‘Direct to Cath Lab’ concept, we’re able to identify the likelihood for a patient to need percutaneous coronary intervention at the cath lab,” Ober said. “We can identify that based on EKG abnormalities that we see and we send a copy of that to the receiving hospital and consult the hospital to give them a summary of the patient’s condition. It’s a time-sensitive procedure and you don’t have much leeway. You don’t want to delay it at all by taking any unnecessary stops.”

Cruz said key components of the success of the program are communication and trust between EMS and the hospital.

“The communication with St. Luke’s Monroe is excellent,” Javier said. “They are waiting for us at the main door and we go right to the cath lab. Work on the patient begins when we arrive on the scene and continues without interruption at the hospital.”

That seamless coordination and transition saves minutes and, ultimately, can save lives. Through programs such as Direct to Cath Lab, St. Luke’s Monroe Campus provides outstanding heart care in the region so patients can stay close to home while receiving the best and highest quality heart care possible.

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