Timely access to services a matter of life and death

It has been said that timing is everything. In Tom Holloway’s case, truer words were never spoken.

On April 18, 2013 at approximately 7:00 p.m., Tom was rushed to William Osler Health System’s (Osler) Brampton Civic Hospital site by Peel Regional Paramedic Services with chest pain, numbness and shortness of breath. Once he reached the hospital, doctors confirmed that Tom was suffering from a blocked coronary artery. He immediately underwent Percutaneous Coronary Intervention (PCI), also known as a coronary angioplasty.

PCI is considered the ‘gold standard’ for individuals experiencing a heart attack due to blocked arteries. These procedures are used to treat the patients by dilating the blood vessels of the heart with a balloon and stent. PCI is offered to a wide range of patients with heart disease, including elective patients with stable chest pain and urgent hospitalized patients with unstable chest pain.

For patients experiencing a heart attack due to blocked arteries, timely access to PCI treatment can be a matter of life and death. Guidelines recommend these patients receive the treatment within 90 minutes of presenting at an emergency department (ED).

From the time paramedics arrived on scene to help Tom, to when his health care team began PCI at the hospital, just 43 minutes had elapsed. Tom’s angioplasty was successful and he was out of the hospital just a few days later.

What Tom did not know at the time was that if his heart attack had occurred just three days earlier, the outcome may have been much different.

On April 15, 2013, Osler moved to around-the-clock ST-Elevation Myocardial Infarction or ‘Code STEMI’ coverage for patients requiring PCI.

For almost a year, Osler had been performing daytime code STEMI service direct from the field with Peel Regional Paramedic Services and from Osler EDs. As of April 15 however, Osler expanded the service to cover nights and weekends. Before that time, patients requiring after-hours code STEMI service were brought to other hospitals within the region, but approximately 30 minutes away.

These 30 minutes could have had a significant impact in Tom’s situation. The longer he went without PCI, the more damage his heart would have sustained.

“I’m extremely fortunate that this service became available when it did,” said Tom Holloway. “It’s important that services like these are offered close to home and there for you when you need them most. I can’t say enough good things about the health care team that treated me, and about the follow-up care I am currently receiving at Brampton Civic Hospital.

PCI is an important service for Osler given the growing incidence of heart disease within the region, as well as the community’s higher than average prevalence for chronic diseases such as diabetes, which is linked to heart disease. About 36 per cent of residents have one chronic condition and 14 per cent have multiple chronic conditions. The rate of diabetes is the third highest in the province and expected to continue to rise.

“Bringing around-the-clock access to STEMI has been a tremendous team effort involving colleagues from across the organization – both in clinical and administrative functions,” said Dr. Dominic Raco, Corporate Chief of Cardiology and Medical Director Cardiovascular Health System. “We are very fortunate for the support we have had for the program at all levels of the hospital. It takes a finely synchronized and cohesive group effort to produce the outcomes that we have achieved at Osler in just a short period of time.”

For more information about Osler programs and services, go to www.williamoslerhs.ca.

William Osler Health System (Osler) is a hospital system ‘Accredited with Exemplary Standing’ from Accreditation Canada serving 1.3 million residents of Brampton, Etobicoke, and surrounding communities of the Central West Local Health Integration Network. Osler delivers more babies than any other hospital in the province, and its emergency departments are among the busiest in Ontario.