Lucas Device kept blood moving
By KEVIN SWEENEY Journal EditorArticle Photos
NEW ULM - Eva Klassen's quick and seemingly complete recovery from a heart attack in August is a gratifying outcome for the health care professionals who assisted in her treatment.
It hasn't been that long ago that someone in Eva's position would not have survived, or have recovered as completely.
John Richardson, manager of Allina Medical Transportation in New Ulm, said he has been an EMT for 20 years. Early on in his career, only about 5 percent of heart attack patients survived, even with quick attention and a quick trip to the hospital. Even now, the figure is about 20 percent.
What makes the difference now? Health care professionals are learning new techniques and new technology to assist the patient.
The key factor, early on, is restoring the patient's blood flow through CPR. In Eva's case, where she had no pulse, the quick action by her son-in-law in administering CPR kept the blood moving in the critical early minutes.
When the ambulance crew arrived, they used the Lucas Device, a fairly new piece of equipment, to perform the CPR.
The device performs the compressions to the chest that push the blood through the veins at the desired rate of 100 compressions per minute. It performs the compressions correctly, and consistently, far better than even highly trained EMTs and paramedics.
Giving CPR properly is a tiring exercise. EMTs are trained to switch off every two minutes to avoid exhausting themselves.
The Lucas Device's plunger is shaped like a suction cup. So not only does it compress the chest, it lifts the chest as well, which helps the heart fill with blood more completely.
Richardson compares the job of CPR to priming a water pump. Once the pump is primed the fluid keeps flowing. Each time someone delivering CPR has to stop even momentarily, the blood flow is interrupted. The Lucas Device works non-stop.
It also frees the paramedics and EMTs to perform other procedures, such as administer drugs and prepare the patient for transport.
The New Ulm Medical Center Foundation has agreed to purchase the Lucas Device for the Allina Transportation Service. Allina had been leasing the device for the past year on a trial basis. The Foundation is paying the $9,400 left on $12,000 cost of the device.
In Eva's case, paramedics started the task of cooling her body temperature as soon as they were in the ambulance, packing her in ice. Cooling the body lowers a person's metabolism and reduces the amount of oxygen the cells need to survive. By minimizing the damage to brain cells, health care professionals minimize neurological losses that affected so many heart attack patients in the past. Those who survived a heart attack often had a reduced quality of life as a result of the damage suffered.
Dr. Dale Bohlke, who was the emergency room physician when Eva was brought in, said she had a pulse and blood pressure, and that the cooling process was already underway.
"The EMTs and paramedics did everything just right," Bohlke said.
When Eva was diagnosed with a heart attack caused by a blockage in a cardiac artery, the Allina Level I program went into effect. While the hypothermia treatment continued, Bohlke contacted Abbott Northwestern Hospital to let them know she was coming, and started her on the medications to thin her blood and help stabilize and strengthen her heartbeat.
An air ambulance was called in for a transport to Abbott Northwestern. The Level I program's goal is to get a patient from New Ulm to Abbott Northwestern and get their artery unblocked within two hours of their arrival in the local emergency room.
Dr. Mike Mooney said that when Eva arrived in the Abbott Northwestern cardiac catheterization lab, her body temperature was already cooled to the proper level and she was ready for the catheterization process.
The hypothermia treatment was continued to help give the brain more time to recover. Eva had been placed on medications that paralyzed her to prevent shivering, and she was placed on a respirator to help her breathe. When the time came to warm her up and remove the breathing tube, Mooney said he wasn't sure how she would respond.
The fact that she was sitting up and communicating with her family within a matter of hours is very gratifying to the doctors and nurses who treated her, said Mooney.
Most of them have seen patients come in after suffering a heart attack, which led to brain damage. "When the family gets Mom back, it's not Mom anymore," said Mooney.
The hypothermia treatment has made a great difference in creating better outcomes, he said, along with the fact that doctors hundreds of miles apart are working on one coordinated treatment.
"We practice some pretty fancy medicine here," said Mooney, "but it all depends on what they do in New Ulm."
People in New Ulm should be pleased that they can get the same treatment and the same outcomes in cardiac cases as they would get if they were brought immediately to Abbott Northwestern, said Mooney. It all depends upon trust between the staffs, he said.
"Doctors in New Ulm have to be sure that the treatments they start there will continue up here. We have to trust that the patients who arrive here are ready for what we do."
In the case of Eva Klassen, everyone did his or her jobs exactly right, said Mooney.
