Rural/Metro Participates in STEMI Care Research Project

SYRACUSE, New York (May 3, 2012) – Rural/Metro Medical Services, Crouse Hospital and the Central New York Emergency Medical Services Program are pleased to announce preliminary results and publication of a major collaborative research project to improve early detection and treatment of patients who suffer the most serious form of heart attack, ST-Segment Elevation Myocardial Infarction (STEMI).

Through a data-driven research model, the team reviewed factors involved in the diagnosis and treatment of heart attack patients through the entire patient experience, from inception of emergency care and beyond. Ultimately, the results will impact local, state and national protocols that indicate when certain types of diagnostic tests should be used.

“Rural/Metro is very proud to play a prominent role in this important research study for cardiac care,” said Michael P. DiMino, President and Chief Executive Officer. “Our organization is committed to providing exceptional prehospital care and to advancing clinical excellence at every opportunity.  We commend the members of our team in Central New York for their dedication to this project.”

Each year, thousands of people suffer heart attacks, with the most commonly reported symptom being chest pain. As such, current EMS protocols use that symptom as an indication to obtain a 12-lead diagnostic electrocardiogram (EKG) in the ambulance, prior to hospital arrival. In Central New York, Rural/Metro participates in the LifeNet program, which transmits these important tests to the hospital electronically from the ambulance. In 2011, Rural/Metro transmitted more than 10,000 EKGs to area hospitals through LifeNet. This action provides a basis for collaborative care between the hospital and paramedics prior to patient arrival at the Emergency Room.

Research has shown, however, that only 67% of patients experiencing a heart attack actually complain of chest pain. This means that nearly one third of those who suffer heart attacks may not complain of chest pain. Other symptoms can include shortness of breath, fatigue, nausea, heartburn, dizziness or pain in other areas of the body. 

The research analyzed relationships between patient symptoms, how the patient got to the hospital (ambulance or otherwise), as well as the timing of the first EKG. Results were statistically significant, and showed that limiting prehospital EKG testing only to patients who complain of chest pain can significantly delay diagnosis and negatively impact treatment time.

“Not everyone having a heart attack has chest pain,” said Troy Hogue, Rural/Metro’s Syracuse Area Manager and one of the lead researchers on the project. “As medical providers, we know that there can be a variety of ways a heart attack can present itself. The goal here was to identify ways to incorporate those other signs and symptoms into guidelines that can ensure the most appropriate use of an EKG in the field as a diagnostic tool.”

The multi-phase project was largely driven by quantitative statistical data from Crouse Hospital and Rural/Metro, which was, in turn, analyzed in a collaborative approach covering both emergency medical services and inpatient hospital care. The results validated the hypothesis that the selection criteria for EKG testing needs to be broadened.

“This type of collaboration between emergency medical services, the hospital, and governing agencies is the partnership of the future,” said Dr. Michael Jorolemon, DO, Senior Quality Officer, Crouse Hospital. “Focusing on doing the right thing for the patient in the field and streamlining the transition of care is really putting the patient first.  Further, it strengthens the relationship between the different partners involved in patient care.  It’s truly a win-win-win for the patient, EMS, and the hospital.”

The organizations involved in the project would ideally like to work collaboratively with the Regional Emergency Medical Advisory Council to establish new protocols. As Central New York’s largest EMS organization, Rural/Metro is an ideal pilot test location for potential positive changes. In collaboration with Crouse Hospital, the effort can be analyzed long-term through the transition from field to inpatient care. Over time, these new protocols could be further evaluated and considered for broader use throughout the region, state, and beyond.

“We are very pleased to be involved in bringing a data-driven, scientific research process into the development of emergency medical protocols,” said Hogue, speaking on behalf of the partnership. “Finding a way to combine objective experiences with scientific data truly has the potential to improve the process and outcome for our patients. We’re all very excited to continue through the final phases of implementation.”

Of note, the project has been accepted for publication in Prehospital Emergency Care and Clinical Pathways in Cardiology.  Additionally, the project has been accepted for presentation at the National Association of EMS Physician’s National Scientific Symposium, 15th Annual Society of Chest Pain Center’s Annual Congress, and the New York American College of Emergency Physician Scientific Assembly. The Crouse and Rural/Metro partnership research team are also working collaboratively on multiple other projects that continue to examine various aspects of patient care in the emergency medical services environment.

About Rural/Metro

Rural/Metro Corporation is a leading national provider of 911 emergency and non-emergency interfacility ambulance services and private fire protection services in 20 states and approximately 500 communities throughout the United States. In Central New York, Rural/Metro Medical Services is the region’s largest private emergency medical services provider, with more than 300 employees. The Company serves more than 600,000 residents of a six-county area and is the region’s only nationally-accredited ambulance agency. For more information, visit www.ruralmetro.com or www.ruralmetrosyracuse.com.

About Crouse Hospital

Crouse Hospital has been caring for generations of Central New Yorkers since 1887, with a mission to provide the best in patient care by exceeding the expectations of patients and promoting community health. A private, not-for-profit hospital, Crouse serves more than 23,000 inpatients, 66,000 emergency services patients, and more than 250,000 outpatients a year from a 15-county area in Central and Northern New York.

About Central New York Regional Emergency Medical Services Council

The Central New York Regional Emergency Medical Services Council serves the region of Cayuga, Cortland, Onondaga, Oswego, and Tompkins Counties in Upstate New York. As one of 19 EMS Program Agencies in New York State, CNYEMS assists the Regional EMS Council and the New York State Department of Health to support and help develop regional EMS systems. The program’s role is defined in Section 3003-a of Article 30 of the New York State Public Health Law.

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