Emergency angioplasty: the paramedic's role
Philip Sweeney is clinical field operations trainer with the East of England Ambulance Service.
When there’s a suspected heart attack, we try to get the paramedic to the person as quickly as possible. Once we arrive, we find out their medical history and carry out checks such as blood pressure and pulse, as we would with any patient. We do an ECG to monitor the heart for abnormalities in all patients complaining of chest pain.
From this and their medical history we can usually tell if it’s a heart attack or not. If there’s any uncertainty, we can fax the ECG from the ambulance to the hospital for further assessment. If the patient is having a heart attack, we give aspirin and clopidogrel, which both reduce the risk of a further clot forming. These drugs take some time to work so it’s important to give them as early as possible.
"If it’s a heart attack then calling 999 means they will get treatment quicker and more heart muscle can be saved. We may even save their life"
We also try to relieve pain, starting with nitrates in the form of a GTN spray under the tongue. We might also use gas and air, morphine given through a drip, and usually oxygen.
We phone the primary angioplasty coordinator at the hospital to let them know we’re on the way then we explain to the patient briefly what’s going to happen to them. When we arrive at the hospital we’re met by a nurse and a doctor and we give them a handover on the way up to the cardiology department.
The quicker someone calls us, the quicker we can get them to hospital. If it does turn out to be just a bit of indigestion, it doesn’t matter, we will still check them over. But if it’s a heart attack then calling 999 means they will get treatment quicker and more heart muscle can be saved. We may even save their life.