Chicago ambulances lack EKG machines

September 2, 2009 (CHICAGO) So why don't all Chicago ambulances have one onboard?

The 12-lead electrocardiogram (EKG machine) can provide life-saving treatment by giving emergency responders quick direction on whether a patient is suffering from a more serious kind of heart attack, called an ST-Segment Elevation Myocardial Infraction, or STEMI.

Chicago has a fleet of 75 ambulances that lack the EKG machines. That lost time in transport without the equipment can lead to a loss of heart muscle.

Dr. Neeraj Jolly is the senior interventional cardiologist at University of Chicago's Cardiac Catheterization (Cath) Lab. He is frustrated that such machines -- which are readily present in ambulances serving Chicago's suburbs -- are not in city vehicles.

"What the scientific community wants is that these patients should be taken only to those hospitals that have the provision of providing this care, heart care treatment centers," Jolly said.

A state law directs emergency personnel to take patients with chest pain to the nearest hospital, not necessarily an institution like the University of Chicago Medical Center, Rush or Northwestern. Dr. Jolly says that rule is misguided.

Victims suffering a heart attack on the Chicago side of Austin Blvd are at least 5 percent more likely to die than someone who calls an ambulance from the Oak Park side, according to medical experts. The reason: ambulances in Oak Park and several suburbs have EKG equipment and a system for relaying information from it that saves lives.

"We have studies showing that if the patient is not taken to the right hospital to begin with, by ambulance, it wastes one to two hours. That is significant damage to the heart muscle," Jolly said.

Dr. Atman Shah, a cardiologist at the University of Chicago who returned to the city after interning and working in southern California, says a better system can be easily implemented. In the meantime, he said Chicagoans are being unnecessarily put in danger.

"Hospitals in Los Angeles, a city much larger than Chicago, a municipality like all municipalities suffering budget cuts, are able to implement this. Seattle has it, Washington has it. Chicago -- with its great traditions of great hospitals and a city that works-- should have this," Shah said.

A spokesman for the Chicago Fire Department, which runs the city's ambulances, issued a statement saying the department follows all regulations and will continue to work with the state if and when the regulations change.

Published reports have said outfitting the city's ambulances with 12-lead EKGs would cost $4 million. Reports say plans to outfit ambulances are waiting on a fire department reassessment of how it deals with heart attacks.

A generation ago, 30 percent of heart attack victims died, and now, in Chicago, the number is closer to 15 percent.

Nevertheless, the doctors said in Chicago that number should be much lower, and it is an issue of public health worth thought.

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