New Equipment Means Faster Heart Attack Treatment

Heart attack patients who call 9-1-1 will receive faster treatment as the result of upgraded ambulance equipment and further training for paramedics.

All of Nova Scotia's ground ambulances are now equipped with defibrillators capable of performing the same type of electrocardiogram test on a patient at the scene as a patient with chest pain would normally receive in the hospital.

An electrocardiogram measures the electrical activity of the heart and records any problems with the heart's rhythm, or other signs that may indicate heart disease. Doctors need electrocardiogram results before they can begin treating a heart attack.

In many cases, the new equipment will allow treatment to begin an average of 36 minutes sooner, improving outcomes for people having a heart attack.

"This is a great advancement that will benefit people with chest pains who call 9-1-1," said Health Minister Chris d'Entremont. "Calling 9-1-1 is critical. We know that Nova Scotians are waiting hours before going to the hospital for chest pains, and about 50 per cent are not travelling there by ambulance. This is putting lives at risk."

The upgraded defibrillators use a 12-lead process that transmits the electrocardiogram report through special cell phone transmissions. The report is sent directly to one of 19 receiving hospitals throughout Nova Scotia via fax. This allows emergency room doctors to view the test results and prepare for the patient prior to them arriving at the hospital.

The 19 hospitals capable of receiving the results via fax were selected based on the number of ST-Elevation Myocardial Infarction(STEMI),-- a particular type of heart attack -- they treat. Paramedics will print the test results for remaining hospitals and provide it to the receiving team in person, eliminating the time it takes to run the test in hospital.

Clinical trials in Cape Breton and Capital Health since 2003 indicate that 12-lead defibrillators in ambulances contributed to significant decrease in mortality rates for people having a ST-Elevation Myocardial Infarction (STEMI).

There are 2,500 hospital admissions for heart attacks in Nova Scotia each year. Half of the Nova Scotians having a heart attack arrive in the emergency department more than 2.8 hours following the onset of chest pain. Twenty-five per cent arrive more than 12 hours after the onset of chest pain.

"This new capability should be a very compelling reason for anyone having chest pains to call an ambulance," said Mr. d'Entremont. "In fact, by calling 9-1-1 for any medical emergency, callers receive medical advice immediately over the phone and patients receive treatment as soon as paramedics arrive."

The cost to Nova Scotians of paramedic care and transportation to a hospital is usually $120. If a paramedic assessment indicates that a patient does not need to be taken to hospital (such as a case where chest pain is caused by heartburn), the patient can choose not to go to hospital and the fee will not be charged.

"If someone needs emergency medical care, calling 9-1-1 is the best way to get that. If cost is an issue, a payment plan can be arranged for only a few dollars a month," said Mr. d'Entremont. "No one should hesitate to call an ambulance for a medical emergency. With heart attacks, every second counts."

"The bottom line is that when someone has a heart attack time is muscle. The shorter the time to treatment, the more lives saved," said Dr. Andrew Travers, EHS medical oversight physician and QEII Health Sciences Centre staff emergency physician. "Nova Scotians with electrocardiograms completed by paramedics will have the fastest diagnosis and treatment of heart attacks, which will lead to more saved lives than if they drove themselves."

Although chest pain or pressure is the most common symptom of a heart attack, heart attack victims may experience a variety of symptoms, including shortness of breath, nausea, vomiting, indigestion, sweating, pain in the chest, neck, jaw, shoulders, arms or back and anxiety.

In November 2004, the province's ground ambulance system became the first Canadian ambulance service accredited through the Commission on Accreditation of Ambulance Services. It recognizes Nova Scotia's ground ambulance system as the best in Canada and one of the best in North America.