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Chest Pain? Why did the paramedics not take me to my local hospital?

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chest pain
Being as November is #CPRMonth and I recently saw a patient that was currently experiencing a heart attack it got me thinking about how much you guys currently know about chest pain and heart attacks. It is important to note first off that as soon as you feel any chest pain PLEASE CALL 911! The paramedics have certain questions and diagnostics they can perform to help determine the cause of your chest pain. Do not try to down play your symptoms and delay calling. What my partner and I always say to people we see who are experiencing any form of chest pain is that the only true defining test to determine if your chest pain is heart related or not is by blood work at the hospital and the physicians assessment. Only a medical doctor can give you a diagnosis of your chest pain. While there are many different diagnoses of chest pain and their symptoms can vary the focus of this will be the the kinds of chest pain related to heart attacks.

time is muscle

When you experience chest pain it is of crucial importance to call 911 immediately. The mantra that has been ingrained into me is that “Time is Muscle“. What does this mean? Well simply put your heart cannot repair itself like your skin does when there is an injury or damage. A heart attack is a blockage of one of the arteries that supplies your heart with oxygenated blood; that your heart needs to function. As soon as there is a blockage of one of the arteries the area of your heart that that artery supplies no longer receives what it needs to stay alive and tissue begins to die. So the sooner you can call 911 the less heart tissue that has the potential to die; Time is Muscle.

So you’re having chest pain, you call 911 right away, the paramedics arrive and determine you are having a heart attack ( you may also hear the term STEMI). You expect them to transport you to your local hospital. They explain to you that they will be transporting you to another hospital which can sometimes be farther away. But why? This does not make sense to you; you’re having chest pain so why are they taking you farther away; shouldn’t they take you to the closest hospital where you can get treatment and see a doctor sooner?

The reason for this is that there are certain types of heart attacks (STEMI’s) that the paramedics can determine on scene by doing an ECG or cardiogram. These types of heart attacks are best treated at hospitals that have whats called a heart catheterization lab. The process involves running a wire through an artery, most commonly your wrist but sometimes in the groin, all the way to your heart. A dye is then injected that is visible by X-Rays and the doctor can determine where and how best to treat your heart attack.

“But why do I need to go there now? Why can’t I just got to my local hospital get stabilized there then go to this “heart hospital”? Well it all goes back to the whole “Time is Muscle” thing. The only way to treat the blockage is with that heart catheterization and the sooner the doctor can see whats causing your heart attack and treat it the less permanent
damage there will be. By taking you the the local cardiac center vs the closer hospital the Paramedics are preventing further damage to your heart and getting you to the appropriate treatment at the soonest possible moment.

I hope this post has educated you a little and answered some questions you may have had. If you have any further questions please ask in the comments section. If it directly relates to your personal medical history/problems please discuss those with your doctor.

Here are some links with some more information you might find helpful

http://www.rougevalley.ca/code-stemi
http://firstrespondersnetwork.com/codestemi/what-is-a-stemi/
http://www.ottawaheart.ca/heart_disease/heart-attack.htm

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