October 20, 2011

VUMC rolls out new Level 1 Cardiac Emergency System

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LifeFlight is one component of Vanderbilt’s Level 1 Cardiac Emergency System, which delivers rapid, coordinated care for heart patients. (photo by Joe Howell)

VUMC rolls out new Level 1 Cardiac Emergency System

Vanderbilt University Medical Center is the first health care institution in the state, and third in the nation, to implement a Level 1 Cardiac Emergency System, designed to deliver coordinated, expedited care for heart patients.

Modeled after its successful STEMI Network, which aims to get myocardial infarction patients into the cath lab as quickly as possible, and the hypothermia after cardiac arrest program, this newly organized system extends that same level of care to patients suffering from cardiogenic shock, acute pulmonary embolism and aortic dissection.

“Aortic dissection mortality is 1 percent per hour,” said Joseph Fredi, M.D., assistant professor of Medicine and director of the STEMI Network. “These are things that will kill people if not dealt with rapidly and properly.”

The goal of the Level 1 system is early recognition and rapid diagnosis of catastrophic heart problems that are very time dependent.

It is a way for referring physicians to quickly coordinate their patients’ care with Vanderbilt cardiologists when those patients are transferred to Vanderbilt’s cardiovascular intensive care unit, cardiac catheterization lab or operating room.

At the heart of the Level 1 system is single phone call activation.

With one phone call, referring physicians can activate rapid, coordinated care for their heart patient before they arrive at Vanderbilt. Upon arrival, the patient undergoes standardized protocols of care. The referring physician receives a follow-up phone call. In addition, data is collected on all of the patients and entered into a central registry.

LifeFlight is critical to the success of the network through its ability to carry blood on board, to keep saline cold for the hypothermia protocol and to carry intra-aortic balloon pumps for people in cardiogenic shock who are transferred from outside hospitals.

“These patients are really sick and need critical nursing care during the transport,” Fredi said. “When LifeFlight arrives at a scene, the patient becomes a Vanderbilt patient, and LifeFlight has access to all of Vanderbilt in caring for the patient.”