New Hanover Regional EMS Grows in Scope and Reputation

September 11, 2007
Minutes can feel like hours when faced with a life-threatening emergency. Whether it's a heart attack or traumatic injury, you want expert medical help fast.

Fortunately for residents of the Lower Cape Fear and beyond, there's New
Hanover Regional Emergency Medical Services (NHREMS), which has evolved over recent years to become one of the state’s top medical assets.

New Hanover Regional Medical Center acquired the EMS service from New Hanover County in 1998. Since then it has grown significantly in capabilities and scope.
NHREMS now includes paramedic service as well as air and ground critical care transport, inter-hospital transfer, and VitaLine, a 24-hour nurse call system. It was designated North Carolina's first model EMS system in 2004.

For victims of heart attack, NHREMS has proven especially lifesaving, as it currently boasts a cardiac arrest save rate of 39 percent, a figure well above the national average of around 30 percent and one that has witnessed a dramatic jump from its previous 1 percent to 3 percent save rate less than a decade ago.

“Time equals heart muscle,” said Tommy Gonda, shift commander for VitaLink,
NHRMC’s ground critical care transport. “Our biggest goal is to get heart attack victims to the door of the cardiac catheterization lab as fast and safely as possible.”
According to the American College of Cardiology, if a patient’s blocked artery
can be opened by balloon catheterization within 90 minutes after hospital arrival, chances of survival with only minimal damage increase dramatically.

The period of time beginning with the patient’s arrival by ambulance to the emergency room to the moment the heart artery is opened with balloon angioplasty in the Cath Lab is commonly known as the "door-to-balloon" time.
More than just getting some place fast, however, it's getting there with the
right equipment and technical expertise, said paramedic Jeremy Huffman, Administrative Chief of Field Operations for New Hanover Regional EMS. Huffman said several factors have contributed to New Hanover's stellar cardiac save rate.

"At New Hanover EMS there is an increased focus on maintaining adequate,
strong and deep chest compressions in conjunction with advanced cardiac life support intervention, including airway management, manual defibrillation and medications," Huffman said.

One lifesaving technology that has revolutionized pre-hospital cardiac care in the field is the automated external defibrillator, or AED, which is used to restore normal heart rhythm to patients in cardiac arrest.

Now standard equipment for use by first responders, AEDs have become increasingly commonplace in schools and office buildings, even churches.
Other lifesaving equipment includes the mobile 12-lead EKG, which examines the electrical activity of the heart from 12 points of view, allowing for a more precise diagnosis of a cardiac event.

Improved communication, said Huffman, has also contributed to saving more lives.
"We maintain an intense performance improvement program where 911 calls are
reviewed in an attempt to find better methods to continue to provide the ultimate pre-hospital emergency care in the country," he said.

A better-educated public able to recognize and respond to a cardiac emergency,
including using CPR, has also contributed to the increased save rate, Huffman
said.

"Within the community, individuals are getting better at recognizing cardiac
emergencies and have the training to perform CPR," he said.

“Combined,” said Huffman, “these capabilities demonstrate New Hanover Regional EMS's readiness to handle any and all kinds of emergency situations, once again reinforcing our reputation as a regional leader in pre-hospital care.”