Memorial Hermann Health System and the City of Houston Fire Department Emergency Medical Services today announced a unique partnership designed to decrease the need for unnecessary endotracheal intubation in patients with congestive heart failure (CHF) in a first responder setting. This partnership marks the first time that a hospital system and EMS department have worked together to reach patients outside the hospital in emergency care situations where every moment counts.
Nearly 53,000 deaths occurred in the U.S. in 2004 from CHF, a life-threatening condition in which the heart can no longer pump enough blood to the rest of the body resulting in fluid back up in the lungs. Traditionally, paramedics and emergency medical technicians perform endotracheal intubation to relieve the pressure. When intubation occurs, the body becomes susceptible to numerous complications and infections including ventilated associated pneumonia (VAP).
Using Continuous Positive Airway Pressure (CPAP) machines supplied by Memorial Hermann, HFD EMS now has an option other than intubation to relieve fluid buildup. Using CPAP will result in numerous benefits for patients and hospitals including reduced exposures to infections, shortened hospital stays, as well as decreased costs.
Partnership discussions began nearly two years ago when representatives from Memorial Hermann approached HFD EMS officials to discuss an innovative strategy to help save lives and reduce complications often associated with intubation. "We are excited to partner with HFD EMS to bring this life-saving program to the Houston community," said Tom Flanagan, chief operating officer for Memorial Hermann-Texas Medical Center. "By providing EMS divisions with additional tools and options, we believe that we can dramatically improve patient outcomes. It is our hope that other hospitals and hospital systems throughout the nation will follow our lead and begin to form partnerships of their own."
Memorial Hermann provided HFD's EMS with 51 CPAP machines and 900 circuits, as well as provided the training for paramedics and emergency medical technicians in the use of CPAP. Each of the nine Memorial Hermann emergency centers will use identical equipment. When patients arrive on CPAP, their treatment will be consistent.
Launched May 1, the use of CPAP in pre-hospital settings has already proven to be successful. Of 23 patients admitted to Memorial Hermann emergency centers, only four were intubated, an 83 percent success rate. While Memorial Hermann is the first to employ this treatment, the hope is that other hospitals will follow suit.
EMS Physician Director and Public Health Authority Dr. David E. Persse said, "Our partnership with area hospitals reflects the Houston Fire Department's commitment to provide the best medical care. With the ability to quickly improve a patient's breathing, Pre-Hospital CPAP can potentially improve patient outcome and reduce the need to be artificially ventilated."
CPAP, also referred to as non-invasive positive pressure ventilation (NIPPV), which utilizes pressure and oxygen to open the airways and forces the fluid back out of the lungs, has successfully been performed within a hospital setting since the early 1990s. The patient populations that have benefited from NIPPV over the years include those with congestive heart failure and chronic obstructed pulmonary disease as well as those on dialysis who become fluid overloaded.
In addition to HFD EMS, Memorial Hermann has partnered with Humble Fire and EMS and Atascocita Fire and EMS.