What Do We Know About
The Paul Dudley White Coronary Care System, St. Agnes Healthcare, Baltimore, MD and
THE EARLY HEART ATTACK CARE (EHAC) PROGRAM
and its relationship to Chest Pain Emergency Departments
THE STRATEGY OF EHAC DISSEMINATION
I. NATIONAL GOALS
A. To maintain the National Registry of Chest Pain Emergency Departments (approximately 1000 Chest Pain Centers)
B. To promote a National Chest Pain Awareness program that recognizes chest pain as a risk factor for heart attack.
C. Mission Statement
The purpose of this non-profit organization is to help community hospitals set up Chest Pain Centers in Emergency Departments, throughout the U.S. and the world, to provide comprehensive management of patients presenting with chest pain so that we can shift the paradigm of care away from thrombolytic management to the relentless pursuit of prodromal symptom recognition of the heart attack problem.
D. Definition: EHAC is the acronym for Early Heart Attack Care. Simply stated, it is the recognition of the early symptoms of a heart attack. EHAC is an awareness strategy that encourages intervention early and so prevents death and damage in patients with heart attacks. EHAC symptoms are very specific and are as follows:
1. Central chest discomfort not perceived as chest pain and therefore not perceived by the individual as important enough to be checked out early. The discomfort comes on with activity and goes away with rest.
2. Symptoms are usually intermittent, coming and going. This deceives the individual into thinking that the discomfort will go away and not come back. Time is lost.3. The person experiencing these symptoms is usually not recognizable in a crowd, so the usual formula for early recognition is not there. The first responder is not under peer pressure to take time to help the victim, thus enabling the denial process.
4. Finally, EHAC is not currently part of the Chain of Survival. It is postulated that adding this fifth link for early recognition and response will go a long way in strengthening the Chain of Survival and preventing many Americans from suffering death and disability from heart attack.
E. Promote EHAC as a fifth link in the Chain of Survival
II. NATIONAL CONFERENCES ON CHEST PAIN/CHEST PAIN
CENTERS
A. Conferences sponsored/co-sponsored by the Paul Dudley White Coronary
Care System, Baltimore, MD
1998 Clinician 1998 1998
3rd National Congress of Chest Pain Centers in Emergency Departments
"Heart Attack - A Public Health Problem: Putting the Pieces Together" Co-presenters: Michael Ross, M.D., Beaumont Hospital, Royal Oaks, Michigan, and Observation Section, American College of Emergency Physicians and Raymond D. Bahr, M.D., The Paul Dudley White Coronary Care System, St. Agnes HealthCare, Baltimore, MD.
Dearborn, Michigan September 18 and 19, 1998
1997
1st Maryland Chest Pain Center (ED) Research Conference (April 11 and 12, 1997) "A Multidisciplinary Conference for Believers" (An Emergency Medical System /JEMS Conference)
Co-sponsors: University of Maryland Medical Center, Baltimore, MD and The Paul Dudley White Coronary Care System, St. Agnes HealthCare, Baltimore, MD.1995 The 2nd National Congress of Chest Pain Centers
"Acute Myocardial Ischemia: Finding the Right Message"
Co-sponsor: Arizona Heart Institute, Phoenix, AZ1994 Kyle Swisher Symposium (October, 1994)
"Acute Prevention in Heart Attack: The Shifting Paradigm to Earlier Heart Attack Care," Baltimore, Maryland1994 The 1st National Congress of Chest Pain Centers
"Launching Centers of Excellence to Fight America's Number 1
Health Problem"
Co-sponsors: Savannah Regional Health Center, Candler Hospital in Savannah, and the Paul Dudley White Coronary Care System, St. Agnes HealthCare in Baltimore, MD. In Savannah, GA. May 15 -17,1994.B. Conferences sponsored by others
American Heart Association 1998 AHA 71st Annual Scientific Sessions, Dallas, TX
Dates: November 8 - 11, 1998; Exhibits: November 9 -11, 1998
Raymond D. Bahr, M.D., C.M. "Sam" Copeland, RN and Jane Strong RN
Display booth: Number 1715
American Association of Critical Care Nurses
1998 AACCN (Best Practice)
"The concept and the Development of Chest Pain Emergency Departments as a Strategy in the War Against Heart Attack" by Raymond D. Bahr Critical Care Nursing Clinics of North America
March 1998 10:1 41-51.
III. DISSEMINATING THE EHAC CONCEPT
The EHAC concept has been presented to the following:
A. Medical Professionals 1998 California Wellness Conference
American Heart Association
National Heart Attack Alert Program
"Benefits of Expanding the Chain of Survival to Include Acute Myocardial Infarction" by Raymond D. Bahr, MD. "Chest Pain Centers in Emergency Departments as a Strategy to Render Quality Care for Acute Myocardial Infarction While Reducing Healthcare Costs" by Raymond D. Bahr, MD Tape:
States 1997 Maryland
1998 First Chest Pain Center Conference (May, 1998 Jacksonville, FL)
1998 Michigan1998 World Congress of Cardiology, Brazil (April 23 - 30, 1998)
Inter-American Heart Foundation
FUNCOR - Brazilian Resuscitation Council, Pro Cardico Chest Pain Center Conference
1998 American College of Cardiology Conference (March 28 - April 1, 1998) Panel Discussion: Participants: Raymond Bahr, MD, Sanjiv Kaul, MD, Robert Hendel, MD, Alan Jaffe, MD.
"Evaluation of Chest Pain in the Emergency Room: Quality and Cost-Effective Issues". (Audiotape: ACC 98 326). Available from:
American College of Cardiology, National Audio Video, Inc., 4465 Washington St., Denver, CO 80216Cardiologists
American College of Cardiology1997 American College of Cardiology (ACC) Anaheim, CA
" The Acute Evaluation of Chest Pain: New Methods in Triage" by Brian Gibler and Raymond D. Bahr. From the Symposium on Chest Pain Centers at the ACC 1997 Scientific Sessions (Anaheim, CA). (Audiotape: ACC 97:206) Available from: American College of Cardiology, National Audio Video, Inc., 4465 Washington St., Denver CO 80216 Physician Assistants 1997 American Association of Physician Assistants
"Chest Pain Evaluation in the Emergency Department & the Emergence of Chest Pain Centers" by Raymond D. Bahr. American Academy of Physician Assistants. (Audiotape: 95 PA97095)
Available from: ACTS, 14153 Clayton Rd., Town & Country, MO 63017Emergency Cardiac Care Providers 1996 Emergency Cardiac Care Update Conference (Montreal, Canada)
"Chest Pain and Early Heart Attack Care" by R. Bahr. (Audiotape: Jem106 Scientific Sessions 2:30-3:30 PM) ECCU 9th Annual conference. Available from AVEN/Audio Visual Education Network, Inc. 1-800-810-TAPE. "The Benefits of Expanding the Chain of Survival to Include AMI" by Raymond Bahr. (Audiotape: JEM898) FROM THE Emergency Cardiac Care Update 1998 Conference. Available from: AVEN/Audio Visual Education Network, Inc. 1-800-810 TAPE. Hospital Administrators Tape A - General - "Concept of a Chest Pain Center" by R. Bahr. Audiotape available from The Paul Dudley White Coronary Care System, St. Agnes HealthCare, Baltimore, MD (410-368-3200) Tape B - Specific problems with Chest Pain Centers" by R. D. Bahr. Daughters of Charity Conference. Audiotape: "Early Heart Attack Awareness" available from The Paul Dudley White Coronary Care System, St. Agnes HealthCare, Baltimore, MD (410-368-3200) Critical Care Nurses 1996 American Association of Critical Care Nurses
Website: bestprac@iqnow.com "Critical Care Nursing in Chest Pain Emergency Departments" by Raymond Bahr. (Audiotape: NTI May 1996, 60 and 61). Available from American Association of Critical-Care Nurses, National Nursing Network, Inc., Washington St., Denver, CO 80216 "Early Heart-Attack Care-The Critical Shift Toward Prevention" (Interview) by Michael Villaire. Critical Care Nurse February 1996 16:1 79-85. "The Concept and the Development of Chest Pain Emergency Departments as Strategy in the War Against Heart Attack" by Raymond D. Bahr. Critical Care Nursing Clinics of North America March 1998 10:1 Nurse Practitioners 1996 American Association of Nurse Practitioners Conference, Annual Scientific and Clinical Sessions. Oct. 23-26, 1996 Arlington, VA.
"NPs To Be Taught Early Heart Attack Care (EHAC) Concept" by Marilyn Edwards, Ph.D., ANPC. Nurse Practitioner World News May/June 1996 1:3 14-15. "Early Heart Attack Care" by Raymond Bahr, C. Copeland, J Strong. From the National Nurse Practitioner Conference, Baltimore, Maryland May 1997. (Audiotape:#020 NNPS 778 5/7/97) Available from Audio Recording Services, Inc., 102 Chester Village, Chester, MD 21619. (410) 643-4220. Cardiovascular and Pulmonary Rehabilitators 1995 American Association of Cardiovascular and Pulmonary Rehabilitation
Letters: From Jody Heggestad, Co-Chair, Public Education Committee, AACVPR 1993; and from Raymond D. Bahr, 1994. Available from The Paul Dudley White Coronary Care System, St. Agnes HealthCare, Baltimore, MD (410) 368-3200
Pharmacists "How Pharmacists Can Help Prevent Heart Attacks" by Raymond D. Bahr. Pharmacy Times 1994 60:11 33-38. "Pharmacists Pump Up Awareness of Early Heart Attack Warnings". Pharmacy Times November 1994 60:11 29-33. National Safety Council 1995 National Safety Council Congresses
"Early Heart Attack Care in the Workplace" presented by Raymond D. Bahr. National Safety Council Congress and Exposition, Oct. 27 - November 1, 1996 "Heart Attacks Have Beginnings" by Robert S. Rehberg. National Safety Council First Aid Institute in First Aid Instructor Newsletter, Spring 1996. Cardiovascular Administrators 1994 American Association of Cardiovascular Administrators
"Wiping Out Heart Disease Before the Year 2000: An Obtainable goal, A Prediction for the Future" by Raymond D. Bahr. The Journal of Cardiovascular Management May/June 1993 4:3 40-43. "The EHAC Strategy: Citizens Chart the Course for Healthy People in the Year 2000" by Raymond D. Bahr. Journal of Cardiovascular Management May/June 1995 "Chest pain centers: Enhancing quality patient care in the ED". American Health Consultants ED Management June 1995 7:6 61-72 1994 American College of Emergency Physicians
"The Changing Paradigm of Acute Heart Attack Prevention in the Emergency Department: A Futuristic Viewpoint?" (Editorial) by Raymond D. Bahr Annals of Emergency Medicine Jan 1995 25:1 95-96. "American College of Emergency Physicians Information Paper: Chest Pain Units in Emergency Departments-a Report from the Short-term Observation Services Section". American Journal of Cardiology Nov 15, 1995 76:1036-1039. "Reducing Time to Therapy in AMI patients: the New Paradigm" by Raymond D. Bahr American Journal of Emergency Medicine July 1994 12:4 50-1-503 "Growth in chest pain emergency departments throughout the United States: A cardiologist's spin on solving the heart attack problem" by Raymond D. Bahr. Coronary Artery Disease Oct 1995 6:10 "Chest Pain Centers: Real Innovation or Marketing Hype?" by Raymond D. Bahr
Cyberounds www.cyberounds.com/conferen ... ular_medicine/0697/conference.html
B. General Public 1998
1997
1997
28 Major League Baseball Teams form EHAC partnerships, distribute EHAC videos and brochures to fans, and appoint an EHAC spokesman from their teams.
1997
EHAC website established
(www.EHAC.org) (www.chestpaincenter.org) 1997
"He Declared War on Heart Attacks" by Carol Krucoff Readers' Digest February, 1997.
1996
"The Bart Giamatti Heart Attack Care Program: Heart Attacks Have Beginnings" brochure and videotape: Available from The Paul Dudley White Coronary Care System, St. Agnes HealthCare, 900 Caton Ave., Baltimore, MD 21229
1995
"New Ways to Foil Heart Attacks" by E. Faltermayer
Fortune Magazine February 20, 19951995
SpectraVision Cable television makes EHAC message available to 180,000 hotel rooms nationwide
1992
Blockbuster Video stocks its 4000 stores nationwide with EHAC videos (free rentals).
"Don't Ignore Chest Pain" (videotape)
"Heart Attack in the Workplace" (videotape)
"Fan Alert" The Bart Giamatti Heart Attack Care videotape
"Early Symptom Recognition of a Heart Attack" (videotape)
Dr. Raymond Bahr, Paul Dudley White Coronary Care System
St. Agnes HealthCare, Baltimore, Maryland 21229
(410) 368-3200 Voice, (410) 368-3207 Fax
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