Adventist Hinsdale Hospital recently recognized five paramedics from the Tri-State Fire Protection District with certificates of excellence for outstanding achievement in transporting a 52-year-old victim of a “widowmaker” heart attack to the hospital’s emergency room. The patient was discharged four days later and is doing well.

The team from the fire department, which serves the communities of Darien and Willowbrook, recognized the signs of an acute myocardial infarction, or heart attack, and contacted the hospital’s emergency room. The ER staff activated a STEMI (ST elevated myocardial infarction) alert before the patient arrived. The teamwork between paramedics and the hospital staff helped get the patient to the hospital’s cardiac catheterization lab just 17 minutes after she arrived in the emergency room.

The total “door-to-balloon” time was just 40 minutes, which contributed greatly to a positive outcome. The term “door-to-balloon” time is named for the balloon used in treating the patient with angioplasty and refers to the time from when the patient leaves for the hospital and arrives in the cath lab.

The paramedics are Charles Corrao, Garrett Glynn, John Gray, John Ostrander and Mark Reynolds. The patient described the team as “absolutely wonderful.”

“I had had a heart attack the week before, and I knew what was going on,” the patient said. “It was very scary, but the paramedics calmed me down and gave me an IV.”

In the ambulance, the paramedics conducted a 12-lead electrocardiogram. The patient was treated in the ambulance with oxygen, aspirin and nitroglycerin. The STEMI alert went off before the patient and the ambulance arrived at the hospital.

“It was amazing how everyone sprang into action when I got to the emergency room,” the patient said. “The room filled up with doctors and nurses. What they do is completely amazing.”

Dr. Mark Moy, who was the attending physician in the emergency room, explained what happens when a STEMI alert is activated: “Everyone gets involved in the response and getting the patient to the cath lab as soon as possible. Minutes count. The faster you can open the blood clot to the heart muscle, the less damage to the heart. Because we have a good team, the process runs smoothly.”

Dr. Frank Saltiel, director of the cath labs at both Adventist Hinsdale and Adventist La Grange Memorial Hospitals, explained how the STEMI alert system involves the paramedics, the ER staff and the interventional cardiologists.

“When the patient gets to the emergency room and the diagnosis is established, a page goes out to the cardiac cath lab, which is then staffed and prepared for the patient,” Dr. Saltiel said. “There are clear lines of communication between the ER doctors and the interventional cardiologists. Plus, we are educating paramedics from local fire departments on how to read an electrocardiogram and recognize the signs of an acute heart attack. The earlier we can get the clogged artery open, the better the outcome.”

According to Dr. Saltiel, the American College of Cardiology recommends a “door-to-balloon” time of just 90 minutes, lowered from the previous recommendation of 120 minutes.

“The 90-minute recommendation takes a lot more hustle, but we have been very successful,” Dr. Saltiel said. “For the last six months, we have tracked our times very carefully and we have been at 100 percent or very close to it. Our goal is to continue to reduce those times even further.”

Dr. Saltiel is a member of a regional committee developing guidelines on door-to-balloon-time, which will be presented to the Illinois Department of Public Health.