In a heart attack, the blood flow is blocked and cardiac tissue starts to die.
“Time is muscle,” says Dr. Cullen Hebert, in charge of critical care and medicine services at Our Lady of the Lake Regional Medical Center.
The ideal, he says, is to clear the arterial blockage through cardiac catheterization—inflating a balloon in the coronary artery to clear it—within 90 minutes.
Recently, a local ambulance crew and doctors treated a patient from 911 call to “balloon time” in just 37 minutes, thanks to a telemedicine program that let paramedics videoconference with hospital staff to speed up diagnoses and be ready for procedures on arrival at the ER.
“This is not about doctors watching over their shoulders,” says Chad Guillot, EMS assistant administrator for East Baton Rouge Parish Emergency Medical Services. “This is about getting stuff done faster in the field.”
The Louisiana Municipal Association recently honored the city for its Baton Rouge Med-Connect pilot program, begun in March with one ambulance serving Our Lady of the Lake. The association gave its “basic services” award for cities with populations over 25,000. Baton Rouge is the second city after Tucson, Ariz., to begin ambulance telemedicine.
The city’s long-term plan is to network all seven local hospitals and 21 ambulances using grant and stimulus money. Guillot said Baton Rouge General Medical Center is next and could be online by the end of next month.
Med-Connect runs on the city’s Wi-Fi network, the same one that lets police monitor crime cameras, and lets paramedics transmit such vital data as EKG test results and high-definition video.
Paramedics can get advice from a doctor who controls a ceiling-mounted camera from the hospital and communicates to the ambulance crew on their headsets. Inside the rig is a sonogram machine and a laryngoscopic camera that the remote physician can use to verify that an intubation—putting in a breathing tube—has gone successfully.
“A picture’s worth a thousand words,” Guillot says. “Well, live video is worth even more than that.”
He says Acadian Ambulance Service sends EKG results to hospitals but does not have audio or video capacity like Baton Rouge’s system.
For now, the local program is a seedling, and EMS personnel are cooperating to make it a successful model.
“We’re working with the guys in the fire department over in Tucson,” Guillot says. “We have no secrets.”
