Best local hospitals for emergency cardiac care?

[Bluesman]

Last night one of our guests was having chest pains and fortunately it turned out to be nothing.

It made me realize that while I have been living in the area for a few years, I know very little about the medical services in the lakes region.

Does anyone have recommendations of where to go locally in an emergency specifically for heart attack or stroke symptoms ?

I am in Holderness so close to me seem to be Speare in Plymouth and the Lakes Region Hospital.

Thanks

[winnipiseogee]

Hi Bluesman - Full disclosure.... I run the local 911 ambulance service so I'm probably a bit biased. That said, Meredith, Moultonboro, Center Harbor, Sandwich, Laconia, Gilford and a few other towns implemented the STEMI destination protocols (STEMI being the acronym for most heart attacks). That means if you call 911 in those communities we can bypass LRGH and take you directly to the catheter lab at Concord Hospital.

As a result of these protocols we have a cardiac save rate that is 5 times the national average. Its really a phenomenally successful program. We actually transported a doc who headed up a major ER in Boston and he said that the lakes region's cardiac care was better than he would have received in his own hospital!

Speare is a wonderful hospital and does a very large number of things incredibly well - but they do not yet have STEMI destination in place. That means you go first to Speare then to the cath lab in Concord. During a heart attack any delay to a cath is not a good thing. So if I were having a potential heart issue I'd drive over the center harbor or meredith town line and dial 911.

[ARV]

While not local, Catholic medical center in Manchester is "the" heart institute of NH and I have heard of MANY people who go there and have their care transferred to there while being in the hospital.

I agree though that all towns in the lakes region have caring, educated first responders that will know what to do and it's always best to dial 911!!!

[Cindido]

Winnipiseogee: Does East Alton and Wolfeboro have this system in place or would we be transported to Huggins first and then on to Concord. I've heard that Huggins is merging with Catholic, so maybe we'd bypass Huggins for CMC when that happens?

[winnipiseogee]

Originally Posted by Cindido

Winnipiseogee: Does East Alton and Wolfeboro have this system in place

In wolfeboro the belief is that we are so close to Huggins its worth stopping into the hospital first and then we do currently head straight to CMC. Its almost always with the same EMTs and Ambulance so its a very quick visit!

We don't handle the 911 for Alton and I don't believe they currently have the staffing for STEMI protocols (normal 911s require 2 EMTs but STEMIs require 3). So in Alton a heart attack with be transported to the nearest appropriate facility (either Huggins or Frisbie). If its Huggins you then get transferred to our ambulance and we bring you to CMC. Not the ideal scenario but it is how its done in most of the state.

Oh and CMC is outstanding! Its where I had my heart condition treated.

[Newbiesaukee]

but what about response to the symptoms of stroke where the situation may at least be as time sensitive as a heart attack? Are there similar protocols as STEMI as to where patients are taken for diagnosis/ treatment?

[Outdoorsman]

Originally Posted by winnipiseogee

Hi Bluesman - Full disclosure.... I run the local 911 ambulance service so I'm probably a bit biased. That said, Meredith, Moultonboro, Center Harbor, Sandwich, Laconia, Gilford and a few other towns implemented the STEMI destination protocols (STEMI being the acronym for most heart attacks). That means if you call 911 in those communities we can bypass LRGH and take you directly to the catheter lab at Concord Hospital.

As a result of these protocols we have a cardiac save rate that is 5 times the national average. Its really a phenomenally successful program. We actually transported a doc who headed up a major ER in Boston and he said that the lakes region's cardiac care was better than he would have received in his own hospital!

Speare is a wonderful hospital and does a very large number of things incredibly well - but they do not yet have STEMI destination in place. That means you go first to Speare then to the cath lab in Concord. During a heart attack any delay to a cath is not a good thing. So if I were having a potential heart issue I'd drive over the center harbor or meredith town line and dial 911.

I am appalled and disgusted that you would suggest that someone having a heart related issue should be transported to another location (Center Harbor or Meredith) BEFORE calling 911

Originally Posted by winnipiseogee

so I'm probably a bit biased.

Biased or $@#* ?

[Seaplane Pilot]

Originally Posted by Outdoorsman

I am appalled and disgusted that you would suggest that someone having a heart related issue should be transported to another location (Center Harbor or Meredith) BEFORE calling 911



Biased or $@#* ?

Who cares?

[VitaBene]

Originally Posted by Outdoorsman

I am appalled and disgusted that you would suggest that someone having a heart related issue should be transported to another location (Center Harbor or Meredith) BEFORE calling 911



Biased or $@#* ?

It was what Winni would do, not a suggestion for others.

[winnipiseogee]

Originally Posted by Outdoorsman

I am appalled and disgusted

I am sorry you feel that way. But as someone who has needed emergency cardiac surgery and someone who has a house in Holderness I stand by my earlier statement. Holderness has amazing first responders who are very quick to respond and wonderful at what they do but like so many small towns they have to outsource their ambulance service to a larger community (in this case Plymouth). So when you dial 911 you are waiting for an ambulance from Plymouth to transport you to Plymouth. Then once you get to Speare you are waiting for one of our ambulances to come from Meredith or Moultonborough to come up to Plymouth, pick you up and drive you down to Concord.

You are right that I should probably clarify my statement and say that if you are in northern Holderness near Plymouth or Campton then dialing 911 in those areas and waiting for Plymouth Fire to show up is probably the best thing to do. Also, YOU SHOULD NEVER DRIVE YOURSELF! But if you are near Meredith or near Center Harbor and you've got someone to drive you then being transported from those communities is going to get you to a cath lab 45 to 60 minutes faster.

[Merrymeeting]

From the Alton Circle, it would be almost a tossup on the time it would take to get to either Huggins in Wolfeboro or Frisbie in Rochester. Given that choice, I'd head to Rochester. Nothing against Huggins, but Frisbie is a larger facility with more critical care options.

[Bluesman]

Originally Posted by winnipiseogee

I am sorry you feel that way. But as someone who has needed emergency cardiac surgery and someone who has a house in Holderness I stand by my earlier statement. Holderness has amazing first responders who are very quick to respond and wonderful at what they do but like so many small towns they have to outsource their ambulance service to a larger community (in this case Plymouth). So when you dial 911 you are waiting for an ambulance from Plymouth to transport you to Plymouth. Then once you get to Speare you are waiting for one of our ambulances to come from Meredith or Moultonborough to come up to Plymouth, pick you up and drive you down to Concord.

You are right that I should probably clarify my statement and say that if you are in northern Holderness near Plymouth or Campton then dialing 911 in those areas and waiting for Plymouth Fire to show up is probably the best thing to do. Also, YOU SHOULD NEVER DRIVE YOURSELF! But if you are near Meredith or near Center Harbor and you've got someone to drive you then being transported from those communities is going to get you to a cath lab 45 to 60 minutes faster.

That is very helpful information. Thank you for posting. I live near the center by the library in Holderness. Someone assisting another person in trouble could call ahead and then drive them to Merideth in the same time it would take for an ambulance to arrive from Plymouth.

Do you need to be in Merideth before you call?

I guess my next question is what happens during the ambulance ride? The ride from holderness to Plymouth is around 15 minutes. The ride from Merideth to Concord is like 45 minutes. What are the typical risks for a cardiac event, being in anmbulance for an extra 30 minutes, is this time usually critical?

Thanks for the insite. I appreciate any and all opinions, because we are just brainstorming options here.

[Newbiesaukee]

Winnipiseogee has really performed a public service. The more we understand what really happens in an emergency, the better we can make informed decisions. The following was from the AMA email I get each morning. It discusses trauma care, but it is really the same issue. And that issue is that certain emergencies require care that is not always available at your "local" hospital. It even refers to the kind of transfer arrangements that Winni discusses:

Leading the News:

Report calls for integrated national trauma care system
The Wall Street Journal (6/17, Phillips, Stevens, Subscription Publication) reported that the National Academies of Sciences, Engineering and Medicine released a report on Friday demonstrating that nearly a fifth of the US deaths resulting from trauma, the leading cause of death for people under the age of 45, are preventable. The authors of the report stressed that military advancements in treating battlefield trauma have not been adequately or evenly adopted by civilian hospitals.

The AP (6/17, Neergaard) reported, “The Centers for Disease Control and Prevention has triage guidelines for EMS in deciding what type of care a patient needs, but as of 2011, the latest data, only 16 states had at least partially implemented them, the panel found.” Meanwhile, “hospitals that can’t handle severe injuries have to transfer patients, and those patients are nearly 25 percent more likely to die than those taken immediately to a trauma center, the report concluded.”

Bloomberg News (6/17, Tozzi), reported that “the report calls for a number of systematic changes, including better sharing of data and research.” Additionally, “there are some practical steps...such as using tourniquets more aggressively and strengthening the role of ‘prehospital’ care, such as emergency medical technicians.”

We may all like to believe that the closest hospital is best able to handle all emergencies. At the same time, the idea is to share information so that all ERs are able to better treat patients. Winni is just trying to point out that detailed plans are being made to get you to the best hospital. And yes, that MAY mean having someone drive you. In the best situations these plans are in effect all over so that you can be confident that the EMS people get you to the correct place without your having to make the decision.