Heart Attack and what You need to know to Save a Life!

1

Early Heart Attack CareBefore the Crash

2PROPERTY OF THE SOCIETY OF CARDIOVASCULAR PATIENT CARE COPYRIGHT ©2014

Dr. Raymond D. Bahr

Founder:

• Society of Cardiovascular Patient Care (Originally the Society of Chest

Pain Centers)

• Deputy Heart Attack Program

• Early Heart Attack Care Education

About Dr. Raymond D. Bahr


Did you Know?


1. The Deputy Heart Attack Program disseminates Early Heart

Attack Care (EHAC) Education.

2. EHAC education is the mission of the Society of

Cardiovascular Patient Care (SCPC) and the foundation for

CPC accreditation.

3. DHA and EHAC are solely funded by the SCPC.

4. The Deputy Heart Attack program is free to all SCPC facilities

and the EHAC education materials are free to download and

disseminate to your community.

Definitions of Note


1. In the 1970’s, it was discovered that emergency rooms were

not truly prepared to care for heart attacks and care was

considered “variable.”

2. However, it was discovered that 50% of heart attack patients

had early or “prodromal” symptoms. These had been

defined in medical literature for over 100 years.

3. In 1981, St. Agnes Hospital in Baltimore, MD, created the

first chest pain center in the emergency room. It created a

standardized heart attack approach and united cardiologists,

ER physicians and critical care nurses.

4. St. Agnes was awarded a grant to promote this approach to

other hospitals and 2000 chest pain centers were created

over a ten year period.

5. It was an “Idea whose time had come.”

A History of Heart Attack Care




6. St. Agnes started the National Congress to keep the medical

community updated on the knowledge base and changing

protocols.

7. At the Fourth National Congress, it was proposed to setup a

new society to expand the movement. The Society of Chest

Pain Centers was created. The mission? Significantly reduce

heart attack deaths in the United States.

8. HCFA (now known as CMS) had other ideas. They wanted to

stop reimbursement for patients in the Observation Unit of

the chest pain center.

9. SCPC helped to achieve a reversal of the HCFA ruling.

However, HCFA asked the SCPC to create an evaluation

process in order to accredit the “true” chest pain centers.

10.This became the foundation of accreditation for hospitals.



It’s been a long 30 years, but our mission continues – sharing

the signs, symptoms and treatment for a potential heart attack

victim can save a life AND a person’s quality of life.

1. Observation Units have been shown to best manage patients

with low probability for ischemic heart disease.

2. Approximately 15% of patients turn out to have active

ischemia and require further tests.

3. The remaining 85% can be safely sent home. Prior to a

patient’s release is a critical point. We define this as the

“teachable moment” where you can share the risk factors in

order to prevent a heart attack.

What We’ve Learned


1. Our mission is to reduce the death rate by focusing on the

50% of heart attacks that present with early symptoms.

2. If there are 800,000 deaths per year, Early Heart Attack

Care could reduce this to 400,000.

3. In the last 18 months 400,000+ have taken the EHAC course

on the Deputy Heart Attack website.

4. If we reach our goal of adding 200-300 accredited facilities

this year, we could potentially reach 1.2 million EHAC

deputies from over 1200 accredited chest pain centers.

5. We want to share EHAC with 300 million Americans.

6. Due to Cycle IV and Version 5 CPC accreditation, all hospital

employees are required to take the EHAC course.

Do the Math


Expanding the Audience


In order to accomplish our mission, we are asking you to

become more involved in sharing the life-saving EHAC message

between the hospital and the community:

1. Spread the message throughout the community that heart

attacks are like other diseases - they have beginnings and

early detection will save a life.

2. Spread the message that your accredited chest pain center

provides a user-friendly and cost-effective pathway to

evaluate patients presenting with these early chest

symptoms.

Spread the Message


Quick History:

1. In the days of the wild west, the sheriff would deputize all of

the townspeople so they could share the message that there

was a crisis. A deputy was the look-out who could act on the

sheriff’s behalf.

2. The Deputy Heart Attack program utilizes

the sheriff’s badge as a symbol.

“You’ve been deputized to let people

know there is a heart attack crisis.”

3. Dr. Bahr is our sheriff.

What’s up with the badges?


It’s called the Buddy Badge. It answers the question, “Will you

take the time to get someone to emergency care if they are in

distress?”

1. The answer is critical. It’s easy to brush-off someone with

early heart attack signs. But it can be hard to get someone

to acknowledge that they are having the signs and get them

help.

2. We know that you, as a C4, understand

the importance of getting someone to

early care. But would a co-worker? A neighbor?

What’s with the other badge?


LATE CARE

Because we’ve been treating the wrong way

RESUSCITATION

STEMI

NSTE-ACS

ACT IN TIME

“The day has come when we consider heart attacks as not the first indication for treatment, but as a

MEDICAL FAILURE.”

William Kannel, MD, Professor of Medicine and Public Health at Boston University.

EARLY CARE

Begins with Recognition

EHAC

We are barking up the wrong tree if we want to reduce

Heart Attacks Deaths


The 5th Link in the chain of survival acknowledges that the

earlier you get a patient to care, their chance of survival

increases.

Do you know the 5th Link?


The Earlier the Treatment

Failure to Prevent = Heart Attack

Prevention of Heart Disease

EHAC

Acute Prevention of Heart Attack Failure to Prevent

NSTE-ACS

ST

EM

I

RE

SU

SC

ITA

TIO

N

High LOW-RISKLow LOW-RISK

‘Chest Pain’ is a Risk Factor


Acute Prevention


Early Heart Attack Care Reduces Mortality

BEST BETTER GOOD

<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<< PREVENTION

Amount

of Heart

Muscle

Saved

1.2% Mortality

5% Mortality

Median Time ED Arrival

12% Mortality

100%

50%

0%

Hours: 1 2 3 4 5 6 7 8

PRODROME ONSET TIME OF CORONARY OCCLUSION


We Know This Works!

Spreading the word

encourages

bystanders to

participate to save

a life!


Thus, the Deputy Heart Attack program created all of the

information you need to share with your community.

• The website deputyheartattack.org contains the EHAC

course, the free EHAC materials you can download and the

collection of Dr. Bahr’s articles.

• The EHAC course can also be streamed through your

hospital’s Learning Management System.

• All EHAC materials can also be purchased at cost through our

website.

The Information For You To Share


The Information For You To Share


We’ve created the materials you can download for free. Each

piece contains the symbols, symptoms and the most important

message – Call 911!

1. EHAC Brochure – in English & Spanish

2. EHAC Syllabus – outlines how to train your community

3. Quick Training – outlines how to train at a health fair or

other event.

4. EHAC Course – the printed version of the online course

5. EHAC Registration Form – a form you can use to register your

new deputies at an event.

You can find all of these materials by clicking on the “Training

Your Community” link at deputyheartattack.org

Early Heart Attack Care Information


Deeper EHAC penetration into the community

1. Schools, elementary and high school

2. Community Colleges

3. Educational TV Channel in hospital

4. Secretaries in physician’s offices

5. Add EHAC to all CPR and ACLS Programs

6. Boy Scouts and Girl Scouts

7. Medical School Students

8. EMS, Fire and Police Departments

9. Pharmacists

10.Nurse Practioners and Physician Assistants

11.Workplaces and National Safety Workers

12.Speakers Bureau

Where To Share


How do I share DHA/EHAC?


We want to publicize your hard work! On our website and on

our social channels, we will publish your pictures and event

information! Just submit your pictures and a summary of your

outreach to Jenn using her e-mail address,

[email protected].

How Can You Share Your Outreach?

mailto:[email protected]


As part of your accreditation, many hospitals find it easy to add our

EHAC course and information to their Learning Management Systems

(HealthStream, etc)

1. Contact your hospital educational coordinator (many hospitals use

different titles) to find out the correct procedures for adding

modules to your LMS.

2. Give them the website link in order to access the “Standard” EHAC

course (see below).

3. When your employees log into your LMS at your hospital, they are

automatically registered in your system. Using this link prevents

them from having to register in the DHA system and the potential to

double count EHAC deputies.

Link: http://www.deputyheartattack.org/courses/standard1.html

Questions: Contact Jenn Cash at [email protected] or

727.515.8996

Adding EHAC to your LMS

http://www.deputyheartattack.org/courses/standard1.html

mailto:[email protected]


Incorporate the EHAC Standard Course into your LMS


EHAC Resources at Your Finger Tips

FREE

Employee and Community Training Materials

http://www.deputyheartattack.org/ehac-training-your-community.html


http://www.deputyheartattack.org/ehac-training-your-community.html

Healthcare

Heart Attack and what You need to know to Save a Life!