Saving lives faster

Published 12:00 am Saturday, January 23, 2010

Emergency room personnel at Andalusia Regional Hospital said they have literally seen a new piece of ER equipment help them save lives.

Emergency room director Amy Herrington, R.N., explained that AutoPulse, one of three new pieces of technology in the ER at ARH, does that same thing as human-administered CPR, only faster and more efficiently.

The non-invasive cardiac support pump looks very much like a back board used by emergency personnel. The board is laced underneath a patient who is in cardiac arrest and a lifeband is placed around the chest.

“It automatically sizes a patient and starts circumferential compressions based on the person’s size,” Herrington said. “I have seen it turn a person who’s blue pink.”

She said the new technology “gives a patient the best chance of survival from cardiac arrest.”

It’s more efficient that traditional CPR because the machine doesn’t get tired, she said. Its compression of the entire chest also promotes healthier blood flow.

“I can’t press on your chest hard enough to make your blood flow,” she said. “With this, you also aren’t dealing with staff fatigue.”

Traditional CPR also often results in cracked ribs, she said.

“With the AutoPulse doing compressions, it gives us time to think of why the patient is in the situation and begin treatment,” she said.

The AutoPulse is housed on a mobile cart for easy transport within the ER and to other areas of the hospital, she said.

“The ER responds anytime someone is in cardiac arrest in the hospital,” Herrington said. “We can take easily transfer this anywhere in the hospital.”

While the ER staff generally sees three to four people in cardiac arrest in any given month, almost daily they receive patients who are having chest pains. Another new piece of equipment allows the staff to determine if the patient is actually having a heart attack or myocardial infarction (MI).

Biosite’s point of care testing equipment allows ER personnel to quickly take a blood sample and test it for cardiac enzymes.

“That and an EKG are what we need to test when a patient admits with chest pain,” Herrington said. “When we draw blood, we now have results within 15 minutes.”

With the new equipment, she said, “We’ve reduced the time between when they break the door to clot-busting medication.”

Previously, blood work had to be sent to the hospital’s lab and it took about 45 minutes to complete the process.

“We’ve shaved 30 minutes off the process, and this is vital to the patient,” Herrington said. “The longer it takes, the more damage there is to the heart.”

There are four of the monitors in the ER and another in the lab.

“We’ve had this in place for about a year now,” she said. “It’s made a big difference with us.”

A third new piece of equipment, the EZ-IO, is designed to allow emergency personnel to quickly start an intraosseous line, more simply explained as putting fluids or medication into the bone marrow rather than a vein.

Herrington said this process is used when a vein can’t be located in severely dehydrated children, or in the case of acute trauma in adults. In children, the needle is inserted below the knee.

In the past, emergency personnel used a twisting motion on a T-shaped special needle to get it to the marrow. Now, the EZ-IO, which looks like a small drill, gets them to the marrow in seconds.

“It was probably more traumatic for us than the patient to do this I the past,” Herrington said. “In cases where we do this, the patient is so sick that they really don’t feel it.”

Herrington said the EZ-IO has been tested on fully alert patients who rate the pain as a “two on a scale of one to 10.”

While the equipment has been available for three or four years, it’s only in about the past 18 months that it has been discussed in medical circles.