While working out the kinks in the Cardiac Emergency Program she founded, director Barbara Unger, R.N., encountered some interesting moments.
“A physician I know called me at 11:30 one night,” she recalls. “He was coming in to respond to a Level 1 [heart attack]. He said, ‘I just want you to know that there are deer on the freeway, and that’s kind of slowing me down.’ I laughed and said, ‘Well, do you want me to shoot the deer?’”
Rest assured that no woodland mammals were harmed in the creation of the program. But Unger nevertheless has helped Minnesotans—even those in far-flung rural areas—get faster, better treatment for severe heart attacks.
Historically, service for such patients was problematic. There were multiple private entities involved in the aid, transportation, and care of a patient and, because there were “too many cooks,” it was hard to standardize the system to get the patient into surgery as quickly as possible.
Unger, however, was not daunted. Originally from the small town of Morris, she knew that the key was mutual understanding; a nurse in Grand Rapids would see the world differently than a technician in the Twin Cities performing angiograms. Some hospitals would have different facilities and procedures than others.
“You can’t have every specialty in every hospital in Minnesota,” she observes. “But if we connect and collaborate, we can give people the same excellent quality of life—no matter where they live.”
To make that dream a reality, Unger started visiting hospitals and talking about her idea. She got cardiologists to put their heads together and agree on a few basic policies: That they’d act on a rural hospital’s diagnosis without question, for example, and that they would administer drugs based on the paperwork generated along the way.
She noticed that every hospital had its own way of recording a patient’s history and physical for the cardiologist to read. She and her colleagues fixed the mish-mash by creating a single standardized sheet with multiple-choice questions.
“Again, we are in a hurry,” she stresses. “Doesn’t that make more sense than a cardiologist going through reams of paper? It’s all about the details.”
The streamlined Cardiac Emergency Program worked for a patient in Crosby, 120 miles north of Minneapolis-based Abbott Northwestern Hospital. The patient called 911; the ambulance arrived and performed an electrocardiogram. The responding paramedic called ahead to the emergency room so the local hospital knew what drugs to prepare; then he called the helicopter.
As the patient was wheeled into the Crosby hospital, staffers immediately administered drugs and gave the necessary tests. In 10 minutes, the helicopter lifted off, transporting the patient to Abbott. Meanwhile, the test results were transmitted. Exactly 86 minutes after the initial 911 call, surgeons opened the patient to correct an occluded blood vessel. The procedure was quite possibly life-saving.
More than 1,400 patients have now received faster cardiac care because of Unger’s system. It’s successful because it addresses every step of the process.“We now have 33 hospitals outstate that absolutely know exactly what to do,” she says. “All the forms are ready for blood tests. Ambulances are waiting at the door. It’s a big team, right down to the volunteer First Responders. And it works.”
