Wake County EMS System has partnered with Rex Healthcare and WakeMed Health and Hospitals' Raleigh campus, the two cardiac catheterization-capable facilities in Wake County, in a concerted effort to reduce the time it takes to get heart attack patients definitive cardiac catheterization (Cath) treatment. The program is called "Fast Cath."

What is a heart attack?
A heart attack, or myocardial infarction (MI), is a condition in which heart muscle tissue begins to die as a result of inadequate oxygenation. The most common immediate cause is decreased blood flow through narrowed coronary arteries that supply the heart oxygen.

The heart beats as minute electrical impulses rhythmically travel through the heart. A 12-lead electrocardiogram (EKG), is a monitoring machine that measures and graphs the characteristics of the impulses that travel through the heart. A heart attack will typically display a "signature wave form" on the EKG. That EKG signature, known as a "STEMI," is the "red flag" that initiates the Cath-lab preparation process.

 

 
Cardiac catheterization refers to an invasive technique used to restore blood flow to an oxygen-starved heart. Inserting a catheter into the coronary artery and inflating a small balloon increases the blood-carrying diameter of the artery. This procedure is only performed in hospitals with special heart catheterization laboratories.
 
What is "Fast Cath"?
Time is an essential component of the catheterization procedure. The sooner it is done, the greater the overall outcome of the patient. "Time is muscle" refers to the need to act quickly to protect the heart muscle. Rex Healthcare and WakeMed Raleigh will open and prepare their catheterization labs based on electrocardiogram (EKG) information and verbal reports they received from paramedics in the field. Prior to "Fast Cath," the process for opening cath labs was not started until after full evaluation in the hospital Emergency Department.
 
How does "Fast Cath" work?
With "Fast Cath," advanced technology allows for rapid notification and streamlined procedures. "Fast Cath" accomplishes time savings through wireless (Bluetooth) technology that allows field paramedics to transmit 12-lead EKG information directly to:

 

  • Emergency Department physicians
  • The Cath Lab itself
  • The on-call cardiologist
  • The Wake EMS System Medical Director

"Fast Cath" works to close a critical gap between hospital diagnosis of a heart attack and the initiation of the cardiac catheterization procedure. This is accomplished by a collaborative field and hospital determination of a heart attack, which allows the catheterization preparation process to start before the patient even reaches the hospital. "Fast Cath" works to reduce the most significant threats associated with heart attack:

  • A second heart attack
  • Stroke
  • Death

Wake County EMS estimates that "Fast Cath" will prevent the above complications as often as every 15th heart attack patient.

Why is this important?
According to both the American Heart Association and the American College of Cardiology websites, the national goal is to have heart attack patients in the Cath Lab within 90 minutes of their arrival at the hospital. On average nationwide, 62% of heart attack patients reach that goal. The Wake County EMS System's goal with "Fast Cath" is to cut that time in half, with patients getting to the Cath Lab 45 minutes after arrival at the emergency department.