Wes Keeley of Annandale has a new lease on life. The 50-year-old figures he’s lucky to be among the living after a brush with death three weeks ago. Without knowing it, he suffered a massive heart attack on Monday, March 1. But a combination of factors – including Keeley’s instinct to seek help and a new method being used by Allina hospitals to treat heart attack patients – conspired to save his life. Survival chances better The new approach, which speeds a patient to a hospital where a blocked artery can be opened, increases a person’s chances of surviving an attack, according to officials. “I think somebody’s watching over me,” Keeley said last week. “I don’t know why,” he laughed, “but I’ll take it.” The Amtrak ticket agent sat in an easy chair in his apartment above the Annandale Laundromat on Main Street. He’s lived there since June, a stone’s throw from the Annandale Fire Department and police station, where he received help the morning of the attack. He had heard about the apartment because it’s owned by a co-worker’s sister, Keeley said. But “I think somebody moved me up here for a reason.” After working the night of Sunday, Feb. 29, at the St. Paul station, Keeley woke up about 9:30 the next morning with aching shoulders and arms. That was accompanied by a bit of discomfort in his chest. “It wasn’t excruciating by any means,” he said, and he didn’t recognize the pains as heart attack symptoms. Instead of taking a nap in hopes it would go away, Keeley tried to get rid of the pain by doing arm exercises. But after about an hour he decided to get it checked out by the ambulance medics in the fire hall. When he pushed the buzzer at the door on the south side, though, there was no answer. Keeley said he sat on a concrete bench near the city hall parking lot for a while deciding what to do. Then he went to the police office inside the Annandale City Hall, where he told secretary Gina Sandin at the counter: “I may be having a heart attack. I’m not sure.” Officer Nancy Engfer told him to sit down while she radioed the ambulance. Paramedic Scott Hatlestadt and EMT Mark Konietzko arrived in several minutes at 12:12 p.m. The medics attached ledes from a portable 12-lede electrocardiograph to his body and quickly determined that he was having a massive heart attack. 91 minutes They put him in the ambulance and by 1:43 p.m. – 91 minutes later – Keeley was in the cardiac catheterization lab at Mercy Hospital in Coon Rapids, where angioplasty was performed to reopen a blocked artery. The 100 percent blockage was in a main artery of his heart, Keeley said. He was the beneficiary of a new pilot medical protocol begun in November by Allina’s Buffalo and Mercy hospitals and Allina Medical Transportation, its ambulance service. It’s called Rapid AMI Transfer, or RAT for short. The idea is to get a heart attack patient to a hospital heart catheterization lab and clear the blockage in 90 minutes. “They told me if this hadn’t been in place I probably would’ve died,” Keeley said, referring to one of the doctors. Keeley was the first case in which the protocol was initiated by an ambulance paramedic, said Allina ambulance manager Mike Reid. Other rapid transfers have been between hospitals. Goal: save lives “Our goal here is simple: save lives,” said Dr. Charles Lick, medical director of the Buffalo Hospital emergency department and Allina Medical Transportation. “This new pilot will give our patients the best cardiac care available.” Dr. Jeff Chambers, Mercy Hospital medical director for inpatient cardiovascular services, added: “Our hope is to have the blockage open within 90 minutes. Every minute counts. Studies show that the faster we can open the blockage the less damage that is done to the heart muscle and the more lives we can save.” Reid said research indicates that if medics can get a patient to a catheterization lab in 90 minutes, the outcome will be better. A patient’s chances of surviving a heart attack are much better than before, Reid said. “Survivability and outcomes have increased by getting you into the cath lab quickly. “This is a major advancement, particularly in pre-hospital cardiac care.” ‘Just amazing’ Until the new protocol, it could take hours or even until the next day to get an Annandale patient into a hospital catheterization lab, he said. Ninety minutes is “just amazing.” St. Cloud Hospital is probably the nearest one to Annandale with a heart catheterization lab, but it doesn’t have a similar program, Reid said, though it could in the future. If a patient meets certain criteria, paramedics can start the RAT procedure, alerting specialists at Buffalo and Mercy. In Keeley’s case, the ambulance stopped for 15 minutes at Buffalo where a team stabilized him and assessed him to make sure he was an appropriate candidate for angioplasty. He was never taken off the ambulance stretcher. At Mercy, another team prepared to treat Keeley. To save more time, the ambulance bypassed the emergency room and took him directly to the catheterization lab. During the angioplasty, Dr. Daniel Dulas threaded a thin plastic tube through Keeley’s artery in the groin to the blockage. He inflated a balloon at the end of the tube to open the artery, then installed a small mesh tube called a stent to keep it open. Keeley was awake during the angioplasty and didn’t feel it, he said. He was released from the hospital three days later and the next week saw EMT Konietzko for the first time since the emergency. Keeley thanked him and they shook hands. “He wouldn’t have made breakfast (the next day), I don’t think,” the EMT said, if it hadn’t been for the rapid transfer protocol. Keeley’s taking medication and making some lifestyle changes. He’s cutting out fast foods, he’s exercising and he’s wearing a nicotoine patch instead of smoking. He planned to be back to work on Thursday, March 25. “I feel good enough to go back to work now,” he said. “I feel real good.” There’s something for others to learn from Keeley’s experience, Reid said. “If you’re having signs and symptoms … call for help immediately even if you’re not sure.”
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