MARQUETTE - The house was in flames when the firefighters arrived at the scene on the morning of Oct. 10.
"The garage was down already and the living room was down," explained Ensign Township (Delta County) volunteer firefighter Jim Lundberg. "It was a fully involved structure fire, a real barnburner."
The 57-year-old Lundberg has been a volunteer firefighter in rural Rapid River since 1984 and serves as the department's training officer. The firefighters focused on the fundamentals of containing the fire and trying to save some yet unburned areas of the house.
Dr. David Pesola, left, performs a cardiac catheterization procedure at Marquette General Hospital. He’s assisted by Deb Wood, MGH cardiovascular tech. (MGH photo)
While helping pull hose to areas near the blaze, he began to realize something was wrong - with him.
"I just didn't feel good. I didn't feel any pain but something wasn't right, so I went over and sat on the edge of the truck. Some of the guys didn't like the way I looked so they brought the EMS crew over."
As is standard procedure, members of the Masonville EMS were at the scene of the fire. They quickly determined that a Rampart (MGH Delta) EMS ambulance should be summoned. The Rampart team arrived, placing Lundberg on a gurney, and began testing.
Lundberg was having a heart attack.
Rampart medics arrived to the patient at 9:52 a.m., and within two minutes a 12-lead EKG was done. Because the EKG showed that Lundberg was having a heart attack or ST segment Elevated Myocardial Infarction, Rampart paramedics made a crucial decision.
"They ran an EKG strip on me and determined I needed to go directly to Marquette General," Lundberg said.
Lundberg didn't know it at the time, but he was about to become the first Upper Peninsula Regional STEMI System patient from the Delta County area.
Pioneered by MGH Cardiologist Tom LeGalley and MGH STEMI Coordinator Anita Parsons in 2009, UPRSS has been widely used since in Marquette and Alger counties. It calls for emergency crews working with community hospitals and MGH to sometimes bypass a community hospital emergency department, bypass the MGH emergency department, and transport a patient from the heart attack scene directly to the MGH Cath Lab for an immediate catheterization procedure.
Lundberg also was unaware that he was about to make Marquette General history. It was 16 minutes from the time he arrived at MGH until his closed heart artery was opened at the Cath Lab by MGH Cardiologist Dr. David Pesola. The previous record from arrival to arterial blockage clearage was 18 minutes.
Because of the information, including photo imaging, sent electronically by Rampart to the MGH Emergency Department, Pesola and the Cath Lab team were standing by to receive the patient upon Rampart's arrival.
Lundberg was quickly prepped for the Cath Lab procedure, then Pesola obtained arterial access and ran a catheter over a wire to get up to the patient's heart (coronary) arteries. Angiograms (pictures) of his arteries showed the right coronary artery (RCA), that supplies blood to the back wall of the heart, was blocked by a large clot.
Pesola then inserted an aspiration catheter to remove the clot. Once the clot was removed, blood flow to the artery was restored, and his heart muscle was re-perfused with much needed blood and oxygen, ending his heart attack.
The entire process tookPesola and the Cath Lab team only 16 minutes.
"It was great," Lundberg said, "It was clockwork, like an orchestra. Everyone knew their place and what they had to do."
Pesola explained, "Mr. Lundberg did everything right in getting help and calling EMS. We were able to get his artery opened quickly and insert a drug-coated stent to restore normal blood flow to the artery. "
According to Pesola, the time factor in seeking treatment is the crucial element in the most successful patient outcomes.
He said, "Timely treatment for a heart attack really affects a person's chances of recovery. People need to recognize symptoms of heart attack (see table insert) and seek treatment right away. It is unfortunate that some people wait so long to seek treatment, and are left with long term heart failure and dysfunction."
Due to the short time frame from Lundberg's onset of symptoms, until his artery was opened, he preserved, or will recover, most of his heart function. By 9 a.m. the next morning, he had eaten breakfast, and was ready to be transferred out of the intensive care unit to a regular inpatient unit.
There was little major damage to Lundberg's heart muscle and after recovery he returned to his job as a member relations manager for a non-profit Internet network connectivity company.
This entire UPRSS process can save valuable time, which results in a better outcome for the patient. It also stresses the importance of calling EMS when a patient is experiencing symptoms of a heart attack. The average time for administering crucial catheter treatment in emergency situations at MGH ranks the U.P.'s regional medical center among the top hospitals in the nation.
EMS personnel do much more than provide care on scene. EMS staff can activate processes which mobilize resources and critical personal needed to provide the patient with the most up to date and comprehensive care available. In the rural Upper Peninsula, advanced EMS training combined with ever expanding medical procedures available at MGH, has changed health care delivery - and is saving lives.
Lundberg concluded, "It was a perfect storm, in a good way, in terms of having all the dominos in place - where all the right people were in all the right places. The time saved definitely reduced the potential for damage to my heart."
- Marquette General Hospital