Hospital's ER team recognized

By Jo Chiparo HONORED: Tim Hale, RN, is the nurse manager for the Greene County General Hospital emergency room, and Lea Ann Camp, RN-MSN, is the director of nursing. The local ER was recognized recently. [Order this photo]

For the recognition, Emergency Room Nurse Manager Tim Hale, RN was asked to speak at a meeting in Indianapolis to kick off the American Heart Association: Mission Lifeline.

The recognition began after a representative from the American Heart Association visited GCGH to discuss care of heart patients.

"Basically, they said we did a good job preparing patients and sending (heart attack patients) to a larger hospital," explained Hale. "They said we do what should be done while the patient is here."

While speaking in Indianapolis at the meeting for Mission: Lifeline, Hale said he gave a synopsis of Greene County General Hospital's emergency room routine when a patient is admitted who is having chest pains.

"From the time the patient comes in the door, we have 10 minutes to give an EKG," Hale said. "Once it (heart attack) is identified, we have to arrange transport, whether it is helicopter or ambulance. We also need to contact a physician and a hospital on the receiving line."

Hale went on to explain that, because GCGH is quite a distance from a larger hospital, usually a clot buster is administered to dissolve the clot.

"That clot is just sitting there blocking oxygen," noted Hale, "and that part of the heart would die."

The allotted time to administer the drug (clot buster) from the time the patient is brought to the emergency room is 30 minutes. Hale said GCGH averages 23 minutes.

Next is a time frame to get a heart catheterization, which is 90 minutes from the time the patient enters the hospital emergency door.

"By helicopter we can almost hit that time frame (to Indianapolis)," noted Director of Nursing, Lea Ann Camp.

She said if weather is bad, patients can be transported by ambulance to Terre Haute within the time frame. Patients are also transported to Bloomington Hospital.

"I'm not sure some patients would be here or would have done as well if not for the care received in the specified time frame," Camp said.

She added that patients with chest pains are better off going to GCGH and having the clot buster administered than taking time to drive to a larger medical facility.

"Our success is also attributed to having a good relationship with the larger hospitals," explained Camp.

"We have standard orders from cardiologists," explained Hale. "When we call a patient's cardiologist, the doctor usually knows the patient from seeing him or her here and says, 'Do this and this or this.' "

Camp emphasized that people should know signs and symptoms of a heart attack such as pain in the jaw, neck or shoulder, shortness of breath, nausea, dizziness and sweating.

"As humans we tend to deny that that is what is happening," Camp said, "and call it heartburn. The denial could cost lives."

According to the American Heart Association, nearly 865,000 people suffer heart attacks each year. About 400,000 of those patients suffer a severe type of heart attack, an ST-elevated myocardial infarction, or STEMI, cause by the sudden, total blockage of a coronary artery.

Mission: Lifeline creates a system of care whereby every STEMI patient will receive improved quality of care and improved outcomes. Regional and statewide plans will be developed that provide pre-hospital identification of STEMI-type heart attacks, alert the nearest most appropriate hospital and activate the catheterization lab to treat the patient immediately upon arrival.

Hale said on a typical day at GCGH, two or three patients visit the emergency room with chest pains. However, on an average, the emergency room only sees two or three patients a month who are actually having heart attacks.

Two registered nurses and one doctor are on duty in the emergency room at GCGH on each shift.