(This article was originally published in 2012 and has been updated to reflect ACC Accreditation Services and new EHAC Pledge numbers)
I have been involved in heart attack care for the last 50 years and I have seen many medical advancements in the field. However, over the last three months I have experienced more excitement about the possibility of finally removing heart disease as the number one killer in the United States - a title it has held for the last 150 years. Cardiovascular disease kills an estimated 800,000 Americans every year. This is more Americans killed in one year than all of the soldiers killed in past wars. The reason is because we, as a nation, allow heart attacks to present in a crashing way to our emergency rooms. We spend too much time and money focused on improving late presentations on a heart attack versus providing the early education that can help save more lives.
Chest Pain Centers in emergency rooms began in 1981 in an effort to provide a comprehensive plan for managing patients presenting with heart attacks. They discovered that 50% of heart attacks had beginnings that could be identified. This knowledge led to the conclusion that heart attacks have an "Achilles heel" and providing proper education is a key to helping a patient. EUREKA! Heart attacks are vulnerable. Let's get out this secret and bring these patients in the early stages to the hospital in order to intervene with medicine in order to prevent a heart attack from ever occurring. If we could set up Chest Pain Centers in all 5,000 hospitals in the United States and practice this approach, we could prevent up to 400,000 heart attack deaths in one year!
ACC Accrediation Services (formerly the Society of Cardiovascular Patient Care) has been involved in setting up Chest Pain Centers in the United States. Key elements for a Chest Pain Center were identified and we were requested to accredit hospitals that met these requirements. We now have over 1000 accredited Chest Pain Centers and we continue to grow. Our emphasis within these these hospitals has been to shift the paradigm to Early Heart Attack Care (EHAC). As a result, we have elevated Community Outreach to Key Element 1 in the accreditation process because of its importance in educating the hospital and its community.
Now comes the exciting part. Over the last few months, our EHAC education has shown amazing results. We started a counter to measure the number of people who took the EHAC course and the oath on our website. We also requested that all accredited hospitalstrain every employee in order to spread the message. When we started a few months ago, we only had 3,000 deputies. Today, we have over 20,000! (Update as of March 2018 we have 850,000+)
To what do we attribute this success? There is no doubt in my mind that at the literal and figurative heart of the movement are the nurses and chest pain coordinators in all of the hospitals! Nurses are born with the DNA for teaching and they have quickly adopted the challenge of setting up programs to teach EHAC for their hospitals and their community. With the assistance of the nurses, there is a greal deal of power behind the EHAC movement, because these are the people on the front lines who have embraced this as an idea whose time has come.
Congratulations to the nurses and the Chest Pain Center teams for responding so overwhelmingly to Community Outreach (EHAC). For someone who has been around for 50 years with this message, I can only tip my hat and say "Thank You!" This has been coming a long time, but now it is jelling so fast that the end result that we all desire appears to be within our sights!
Best of Luck in Saving a Life,
Raymond D.Bahr MD