Heart attacks, strokes down across state

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Progress has been made in regard to the number of people admitted to Hawaii hospitals for cardiovascular disease or lost because of it.

Progress has been made in regard to the number of people admitted to Hawaii hospitals for cardiovascular disease or lost because of it.

According to Hawaii Health Information Corp., the number of admissions for heart attack or stroke statewide dropped from 2,818 in 2006 to 2,285 in 2012. Mortality rates have also fallen, from 8.9 percent in 2006 to 6.6 percent in 2012. These statistics were shared Friday during the Big Island Symposium on Cardiac and Stroke at the Hapuna Beach Prince Hotel.

During the welcoming remarks, Dan Brinkman, Hilo Medical Center’s chief nurse executive, said the decline can be attributed to many things, including the reduction in smoking, now socially less acceptable, and advances in medical treatments available. But for Brinkman, a major factor is the collaboration of many organizations, partners and individuals across Hawaii. Such working relationships have bettered the outcomes from patients, especially those who would otherwise be at a disadvantage because of the rural-urban disparities in available care and specialists.

Those types of partnerships did not exist eight years ago, added Cathy Young, vice president of cardiac services at The Queen’s Medical Center.

The symposium highlighted numerous ways local physicians, nurses, program coordinators and administrators are improving care in their communities, often while using a broad spectrum of experts and the latest technology, including telemedicine services. Participants also learn how to identify and treat patients with acute coronary syndrome. There were discussions about the current and emerging treatments. Approximately 130 people attended the event, organized by The Queen’s Medical Center.

The event provided the latest science and most up-to-date evidence-based practices for acute cardiac and stroke care. The goal was to standardize care for emergency stroke patients within rural and community hospitals. The organizers and participants also hoped to build a better tertiary cardiac and stroke services collaboration.

“Time is of the essence, and with heart attacks and strokes, every minute counts,” said Arthur Sampaga Jr., Hilo Medical Center’s cardiovascular/emergency/surgical service director. “By standardizing, everyone is on the same page and the patient is getting the best care and treatment. This results in a better outcome.”

Sampaga said there’s a common misconception that all of the cardiac and stroke patients must be transferred off island. The reality is most remain on the Big Island, where initial treatment, including stabilization, medicines, X-rays and Computer Axial Tomography scans, is done. Only if a patient needs more intervention or a higher level of care is he transported elsewhere, Sampaga added.

In fact, Hilo Medical Center established its first-ever cardiovascular unit with highly trained staff in 2007 because it believed such services were of high priority. The program has grown to include two cardiology clinics and numerous partnerships, including with Hawaii Fire Department Emergency Medical Services, The Queen’s Medical Center and air medical transport services companies, Sampaga said.

The Fire Department’s ambulances have been equipped with Bluetooth technology to enable rapid, wireless transmissions of electrocardiogram, or EKG, directly to hospitals islandwide. This initiative, which began last year with Hilo Medical Center, has helped deliver fast, accurate information that allows the hospital’s medical team to prepare and make decisions early, in many cases before the patient even arrives, Sampaga said.

During the morning break, Brinkman spoke about the TeleStroke Program, which is being used to improve the speed and effectiveness of communication between neurologists from The Queen’s Medical Center and the emergency room teams at Hilo Medical Center. He explained how the TeleStroke Program has audio, video and digital connections that basically put a neurologist in the emergency room. Virtually, the neurologist can see the patients, monitor their vital signs and talk with them, as well as use diagnostic tools — all of which increases the diagnosis accuracy, the response time and emergency treatment.