Constant communication between cardiology and emergency services ensures superior care at Inova Loudoun
State of the Heart
Heart attack patients are in capable hands at Inova Loudoun Hospital (ILH). Specially trained doctors, streamlined communication and a first-class catheterization lab are some of the characteristics of ILH’s heart program.
State-of-the-Art Cath Lab
ILH first opened its cardiac catheterization (cath) lab in 2006, thanks to a gift from the Schaufeld family, for diagnostic procedures. Then, in 2009, doctors began performing interventions using balloons and stents to treat acute myocardial infarctions, or heart attacks. Since then, the cath lab has grown exponentially and now includes two labs — one for heart catheterization and one for interventional radiology, a subspecialty of radiology that involves using the least-invasive techniques to minimize patient risk and improve outcomes. The interventional program started on Oct. 9, 2015.
“When we developed the current cath lab, we recognized that every minute counts to save heart muscle by taking patients rapidly to have blocked coronary arteries opened up and stented to restore blood flow,” says Edward Puccio, MD, an emergency physician and Medical Director, Emergency Services, ILH. “When done quickly, this not only saves lives, but gives people a healthier outcome. Being able to provide this service has affected the patients in our community greatly for the past six years.”
In fact, the two cath labs at ILH perform more cases per room than any in the entire Inova system. The cath lab does approximately 700 heart cath cases yearly, half of which are coronary interventions. In addition, the cath lab takes care of at least 70 acute MI patients yearly and sees dramatically good results. In order to keep up with demand, ILH is adding a third cath lab.
“We’re currently in the design phase and are really excited about this expansion,” says Dean Pollock, MD, a cardiologist and Medical Director of the Cardiac Catheterization Lab at the Schaufeld Family Heart Center, ILH. “As our community continues to grow, our doctors are committed to providing for that growth. The progress has been really gratifying and the results have been rewarding.”
Unparalleled Emergency Communication for Heart Attack
When Emergency Medical Services, or EMS, thinks someone has the symptoms of a heart attack, the EMS team immediately communicates with the Emergency Room at ILH. “It’s simultaneous communication that happens between EMS, the Emergency Room and cardiology 24/7/365, almost instantaneously,” says Dr. Puccio.
Here’s how communication happens between EMS and the Emergency Room — all in a matter of just three or four minutes:
- When someone is experiencing chest pain or other cardiac symptoms, EMS does an EKG on the scene and electronically transmits it to the Emergency Room.
- An ER doctor (such as Dr. Puccio) looks at the EKG and decides whether or not it’s a heart attack.
- The ER doctor puts in a call to activate the cath lab if it is a heart attack.
- This call activates the hospital’s team to come to the lab and prepare to receive and treat the patient.
- Simultaneously the interventional cardiologist (such as Dr. Pollock) calls the ER doctor to gather clinical information as well as the EKG findings so they can anticipate
the patient’s status upon arrival.
- The team can often be assembled in the lab before the patient has even arrived at
the hospital.
“We have excellent collaboration between EMS, the ER and cardiology, which has been maintained from the beginning of this program, to get patients the fastest care possible,” says Dr. Puccio. “It’s been a seamless process and continues to save lives and improve patient outcomes.”
Both Drs. Puccio and Pollock agree that the communication between EMS, the Emergency Room and cardiology at ILH is unparalleled. “I’m excited about the future,” says Dr. Pollock, who has been with Inova Loudoun since 1986. “We’re growing steadily. It has been a great place to work and a great community to work in.”
New Blood Pressure Guidelines for the Elderly
New blood pressure guidelines suggest that in those over 60 years of age, it may not be necessary to lower systolic pressure to 120. A satisfactory number to aim for could be in the 140 to 150 range.
According to Dr. Pollock, blood pressure guidelines constantly change. But generally speaking, it’s not necessary to treat blood pressure quite as aggressively in older populations. Giving older people enough medication to get their blood pressure down to 120 could result in numerous side effects from the medication without lowering the number, he points out. “People have so many side effects that it’s just not worth it,” Dr. Pollock says. “There’s not a lot of data to support that lowering the systolic blood pressure from 140 to 120 has much benefit.”
Ashburn HealthPlex Emergency Room Opens
The recently opened Inova HealthPlex – Ashburn, located at the Dulles Greenway and Loudoun County Parkway, offers a 24/7 ER, as well as a lab and imaging center.
According to Dr. Puccio, about half of patients with chest pain will go home. Therefore, emergency rooms don’t necessarily need to be tied to hospitals. “We can actually put emergency rooms where the patients are and get them quicker and more efficient care closer to their homes,” he says.
If transport is necessary between the HealthPlex and the ILH Emergency Room at Lansdowne, the operative word is speed. In fact, the treatment would not be quicker if someone came initially to the ILH ER. In the time it takes to treat a heart attack patient in the ILH ER, the Ashburn ambulance is already in transport.
Heart Health for Loudoun County
To learn more about cardiac services at Inova Loudoun Hospital, call 703.858.8660 or visit inovaheart.org.