Heart Health: No Time To Waste

By Michaela Gibson Morris/NEMS Daily Journal

When Jeff Kellum’s chest started hurting and his arm went numb on Jan. 10, he did what a lot of people in Mississippi do.
“We sat around for an hour and a half debating,” said the 51-year-old Hatley man.
Jeff Kellum figures he owes his survival to the good Lord; his son, Dusty Kellum, who convinced him to call for help; and a new statewide initiative that aims to get heart attack patients to the right place faster.
“This is one time, you can’t argue with me,’” Jeff Kellum remembers Dusty, a Hatley volunteer firefighter, telling him. “… I’m blessed.”

State initiative
Getting folks having heart attacks like Jeff Kellum to the right medical care quickly is the first initiative of the Mississippi Health Alliance, a partnership of cardiologists, hospitals and emergency services around the state.
“Mississippi is at rock bottom in heart attack deaths,” said Tupelo cardiologist Dr. Barry Bertolet, who is the vice president of the alliance. “We clearly need to do better.”
People having the most deadly kind of heart attacks need to quickly get to a hospital that has a cath lab available 24/7. There, cardiologists can clear the clogged artery. They typically use angioplasty, where a tiny balloon attached to a long wire is threaded through the blood vessels to reach the arteries that supply the heart’s muscles. The balloon breaks through the blockage, restoring the blood flow to the heart. The quicker this happens the better the heart will recover.
“If we can reduce the time between when a heart attack begins and when we get the artery open,” Bertolet said, “it may be the difference between living or dying, being disabled or not.”
The alliance has developed protocols so that ambulance crews who identify these killer heart attacks go directly to cardiac hospitals, bypassing closer community hospitals and calling ahead so the staff can get to the cath lab. In Northeast Mississippi, those hospitals are Baptist Memorial Hospitals in Oxford and Columbus, Magnolia Regional Health Center in Corinth and North Mississippi Medical Center-Tupelo.
“If someone in Tishomingo has a heart attack and you bypass the Iuka Hospital,” going straight to Magnolia, “it saves about an hour’s time,” said Corinth cardiologist Dr. John Prather. “Time is heart.”
All of the ambulances in North Mississippi, and most of them across the state, are outfitted with 12-lead electrocardiograms, commonly known as an EKG, that looks at the heart’s electrical signals.
“They can diagnose a heart attack in the field,” and transmit the results to cardiologists at the nearest cardiac center, Bertolet said.
The protocols also smooth the way for patients diagnosed in hospital emergency departments. The protocol developed by cardiologists spells out what medications should be given before transferring the patient to a cardiac center.
“The quicker we can get patients to intervention,” said Dr. Sam Mansour, NMMC-Pontotoc emergency department medical director.
In response to the protocol, Pontotoc emergency physicians have a goal to have patients who come in with a suspected heart attack analyzed with an EKG within 10 minutes of arrival, Mansour said.
“We have a role to play,” in better heart attack survivals, Mansour said.
The alliance is hosting a series of meetings around the state to spread the word about the new protocols to physicians and paramedics. State law needs to be revised to recognize the need to bypass closer hospitals to get patients to the appropriate level of care, Prather said.
But the potential rewards are substantial. Only one other state – North Carolina – has a coordinated system like Mississippi is developing.
“They were able to show substantial decrease in deaths, and they were far from the worst,” Bertolet said. “We have great opportunity for gains.”

Success story
On Jan. 10, Jeff Kellum of Hatley spent all day playing in the snow with his 16- and 13-year-old grandkids.
“We had a lot of activity,” Kellum said.
After grilling dinner, the Kellums settled down to watch Oregon and Auburn square off in the national college football championship game. Then suddenly Kellum started hurting and his arm went numb. After some debate, Jeff Kellum heeded his son Dusty’s insistence and the family called for help.
The ambulance crew evaluated Jeff Kellum with an EKG and identified an ST-elevated heart attack, the most deadly kind, Bertolet said.
“These are the Fred Sanford heart attacks,” Bertolet said, referring to the crusty character on the 1970s TV show who would clutch his chest and dramatically call for his late wife.
Instead of going to Gilmore Memorial Hospital in Amory, the crew headed to the closest hospital with a cath lab that can be activated around the clock.
“We made the long, icy trip to Tupelo in an ambulance,” Kellum said.
Kellum’s coronary artery was opened in the cath lab within 15 minutes of reaching the doors of NMMC.
“We watched the last 3 1/2 minutes of the game in the room,” Kellum said.
Even more importantly, Kellum was able to return to work at Cooper Tire a week after his heart attack, and he’ll be able to play in the snow with his grandkids again this winter.

Contact Michaela Gibson Morris at (662) 678-1599 or michaela.morris@journalinc.com.

Read more about heart healthy events in today’s NEMS Daily Journal.