Hospital Main Number: 931-528-2541
"Being so close was the difference between life or death."
Sixty-nine-year-old Boyd Brown is used to running many miles a week and working out at the gym at least three times a week, in addition to running a farm and fixing up old cars. Because he leads such an active life, a heart attack was the last thing he expected. It all started with crushing chest pain when Brown and his running partner and cousin Carolyn had just completed their regular three-mile morning run near her home in Lake Tansi.
“I’ve never had that much pain anywhere, even when I got hit in the head with something,” said Brown. “I was already sweating from the run, but when I started having the heart attack, it looked like I was taking a shower.”
Since they were near Carolyn’s house, she ran to get her car and came and picked up Brown and gave him three aspirin. Brown asked her to take him to the emergency room, but instead, she took him to the emergency medical services (EMS) substation just a few blocks away.
“We walked into the security office, and the security officer looked at me and said, ‘I’m going to get you some help,’” said Brown. “He knew I was in trouble. It didn’t take but just a couple of minutes and the EMTs (emergency medical technicians) came out and put me on the crash cart and put the EKG machine on me and one of them said ‘You’re having a heart attack. The protocol is for us to take you straight to the cath lab in Cookeville.’ I said, ‘That’s fine. Let’s go. I’ve got to have some relief.’”
Said paramedic Amory Myers, “You could just tell by looking at him. As far as his color, he had all the classic signs and symptoms of a heart attack: sweating profusely, the ashen color, chest pain, numbness to the left side. We got him into the back of the ambulance, started an IV on him, and did a 12-lead EKG on him.”
She and paramedic Jason Edmonds took Brown to Cookeville Regional Medical Center. They chose CRMC because it was the closest hospital that does interventional heart catheterization — the standard treatment for a heart attack in progress — and because CRMC uses the Code 37 protocol, through which paramedics in transit can call the hospital right away and get the heart team ready and on standby so that they’re waiting when the patient arrives.
“I advised our dispatch that we would transfer from here to CRMC, and our dispatch advised the hospital at that time what we were en route with and got the appropriate steps taken care of,” said Edmonds. “Then, possibly 12 to 15 minutes out, I called Cookeville Regional on our truck radio and told them his vitals and that he was still having severe chest pain and that we had given him the appropriate medicine — nitroglycerin — to help relieve what we could, but that he was still in severe pain. So they knew all the details of the situation before we arrived.”
Because of their communication with the ambulance, Cookeville Regional’s heart cath team was ready to meet the ambulance at the entrance to the emergency room and to work on Brown continuously as they wheeled him from the ambulance to the cardiac cath lab.
“When the operator paged out ‘Code 37 EMS Crossville,’ we knew we had 30 to 45 minutes before they would be here, which gave us time to get everything ready for Mr. Brown,” said Dr. Stacy Brewington, the Tennessee Heart cardiologist who was on call that day and who happens to have spearheaded the Code 37 initiative nearly seven years ago at Cookeville Regional. “They got him to us very quickly — 34 minutes — and then it usually takes us about 15 to 20 minutes to get someone into the cath lab and get their artery open.”
Dr. Brewington discovered that Brown’s left anterior descending artery — the main artery to the heart — was completely blocked. “Frequently, when that artery occludes, or someone has a heart attack in that artery, the patient doesn’t survive,” said Dr. Brewington. “That’s why a heart attack involving this artery has historically been referred to as the ‘widow-maker.’”
The entire procedure — from the moment the paramedics at the Lake Tansi EMS substation assessed the problem to the time Mr. Brown’s blockage was cleared at Cookeville Regional — was 70 minutes.
“In this business, we have a saying that time is muscle, so the longer the time delay in treating a heart attack, the more heart muscle is damaged or dies,” said Brewington. “Mr. Brown walked away with virtually no heart damage. He was fortunate in that he recognized the symptoms and the paramedics diagnosed the heart attack quickly. The Code 37 protocol helped get him into the cath lab and helped get the artery open, thus limiting heart damage.”
Added Brown, “The fact that the paramedics were there and this Code 37 was in place meant that I got treatment a whole lot faster than I normally would have, and therefore I had no heart damage, and I’m feeling great now.”
As of three weeks after his surgery, Brown was back to walking and biking — carefully and with a heart monitor, of course.
“We’re really fortunate to have a hospital like Cookeville Regional Medical Center and the heart unit they have so close, because time makes a difference,” said Brown. “If it had been 90 minutes instead of 70 minutes, I would probably have had a lot more problems with my heart, or I might not have made it.”
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