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November 26, 2010

Va. paramedics to send EKGs directly to ER doctors

By Patrick Wilson
The Virginian-Pilot

NORFOLK, Va. — In an effort to save more lives, the city's paramedics are using technology to send information to doctors about heart attack patients. It's part of a push to enhance patients' treatment before they arrive at medical facilities .

Norfolk Fire-Rescue joined Virginia Beach and other agencies in Hampton Roads in upgrading defibrillators and computers so a detailed electrocardiogram reading can be sent directly to an emergency room physician.

Such transmissions shorten the time it takes to treat patients in cardiac arrest, saving lives, said Dr. Barry Knapp, an emergency room physician who works at Sentara Norfolk General Hospital and is the medical director for Norfolk Fire-Rescue.

The technology is not new, but it can be a challenge for governments because agencies need money for it. Norfolk began making upgrades a year ago at an estimated cost of $300,000.

"This is a huge step up for the region to implement pre-hospital EKGs. It's a huge step up for the city of Norfolk," Knapp said. "It does make a difference."

An EKG records heart activity, but the normal pattern stops when heart muscle is dead. A Blackberry hooked to the defibrillator sends information to the emergency room chosen by the medic.

"By knowing where on the heart the damage is, it helps the physician look at the course of treatment he needs to have for the long term," said fire Battalion Chief Daniel Norville, also the chief medical officer for Norfolk Fire-Rescue.

Paramedics with Norfolk Fire-Rescue transmitted 61 EKGs to emergency rooms in August, 63 in September and 57 in October.

Those numbers don't reflect every EKG run on a patient in Norfolk - just the ones in which patterns appeared abnormal or paramedics were concerned enough to transmit results directly to a doctor.

Hospitals in South Hampton Roads, and the Tidewater EMS Council, want every paramedic in southeastern Virginia to make such technology standard, Knapp and Norville said.

"Every agency in Hampton Roads is moving toward it if they're not already there," Norville said.

Knapp has another goal for Norfolk Fire-Rescue in the coming months that will help heart attack patients before they arrive at a hospital.

Doctors use cold saline to induce hypothermia in patients who have suffered cardiac arrest and then had their heart rhythm re-established. It helps them better recover mental capacities .

Paramedics will get refrigerators on ambulances to do that in route to the hospital.

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