In August of 2009, Francine Confetti of Pittsburgh awoke one Saturday morning and felt pressure in her chest. She thought it was indigestion. Because the pressure persisted, she woke her husband Dominic and asked him to bring her a 7-Up to relieve the indigestion. When he returned with the drink, she was perspiring profusely. Dom thought they should drive to the hospital, but when Francine stood up, she passed out. He called 911 at 6:46 AM.
6:50 AM The paramedics arrive at the Confetti home.
6:53 AM The paramedics attempt an EKG and with the little data they can get – the leads wouldn’t stick – they determine that they need to go to a STEMI receiving center and so they activate their STEMI system.
A STEMI is a high risk heart attack. A STEMI system is a network that incorporates Emergency Medical Services and the Cardiac Catheterization Laboratory. Both the Walnut Creek and Concord campuses are designated STEMI RECEIVING CENTERS by Contra Costa County. These centers allow for rapid assessment, diagnosis, and immediate treatment/intervention in the cardiac catheterization lab using a coordinated team approach.
6:58 AM On the way to the hospital, the paramedics repeat the EKG and this time it reads Acute Myocardial Infarction so their decision to activate the STEMI earlier was confirmed.
7:05 AM Dr. Kavanaugh and the Cath Lab are alerted.
7:15 AM Francine arrives at the Emergency Department at John Muir Medical Center – Concord Campus.
7:20 AM A 2nd IV line is started because of low blood pressure and Francine is placed on a cardiac monitor with pacing because of her low Heart Rate.
7:25 AM Patrick Kavanaugh, M.D. arrives and speaks with Francine and Dominic.
7:41 AM Francine arrives in the Cardiac Cath Lab.
7:49 AM The procedure starts.
7:56 AM Balloon inflation occurs and Francine’s heart blockage is cleared with a door to balloon time of 41 minutes.
Once the blood flow is reestablished a patient experiences an incredible feeling of good health. Dr. Kavanaugh said he has had some patients ask if they can go home. However, Francine, like all cardiac patients was admitted to a cardiac monitoring unit and observed for 24 to 48 hours. Risk factors such as diabetes, blood pressure, cholesterol and smoking are addressed if present and advice and counseling on diet and exercise is provided before release as well as cardiac medications that are indicated. Follow-up visits are arranged with the cardiologist on a regular basis.
Research has shown that a patient’s survival improves when the blocked coronary artery is re-opened within 90 minutes after arrival in the Emergency Department. The 90 minute time is called “door to balloon time.” Francine
Confetti’s excellent door to balloon time is indicative of the teamwork between EMT and John Muir Emergency Services and the cardiology team of specialists which assure a successful outcome for our heart attack patients.