ER collaboration with EMS and specialists saves lives

In the emergency room, every second counts, especially when it comes to matters of the heart.

So, when a man in his fifties came into the AdventHealth Lake Nona ER complaining of chest pain, Dr. Nathan Weagraff didn’t skip a beat.

“The patient didn’t look good on arrival,” said Weagraff, who also serves as emergency department medical director at AdventHealth East Orlando, Waterford Lakes ER and Lake Nona ER. “He was sweating profusely and just looked pale and really uncomfortable.”

Weagraff immediately administered an EKG and confirmed the patient, who had no prior medical problems, was having a heart attack.

In less than an hour, the patient went from walking into the ER on his own power to flying in a Flight 1 helicopter to AdventHealth East Orlando where the interventional cardiology team removed a clot from an artery supplying blood to his heart.

“Time is tissue, so the longer that clot stayed in his artery, the poorer his prognosis,” said Weagraff. “The patient had significant damage to his heart. Within seconds, we activated the nursing staff, the flight team was there in minutes, and the Cath Lab was waiting for him. It was a big collaboration from multiple service lines to help save this guy’s life.”

AdventHealth Flight 1 EMS director Kevin Wall said teamwork between EMS, the ER and the cardiology interventional team plays a huge role in providing definitive, emergent care to patients.

"Time is so critical to our role as we move patients to the highest level of definitive care, and the ability to work seamlessly with EMS and the ER teams is essential to our success in saving lives,” said Wall. “The coordination of efforts that involve Flight 1 helicopters and AdventHealth EMS ambulances leads to better patient outcomes. It's a team effort."

Weagraff said the relationships in place among those emergency specialists and the interventional cardiology team help make the system-wide AdventHealth cardiology program one of the strongest in Central Florida.

“100 percent. They’re responsive, compassionate and always willing to do what’s best for the patient,” he said.

Well-connected ER care
It’s rare to see a urologist in the emergency room in the middle of the night. But that’s exactly where Dr. Daniel Cohen finds himself at 11:30 pm on a Wednesday – talking to nurse practitioner Sarah Long in the AdventHealth Winter Park ER.

“Hi, are you Dr. Cohen?” Long asks amid the low, constant hum of conversation and beeping monitors. “It’s nice to meet you. I’ve never met you before.” She’s worked in emergency medicine for nine years and agrees tonight is unusual.

A patient came in with a painful infection and Long consulted over the phone with Dr. Cohen, the on-call specialist. They worked together to diagnose the patient and start a treatment plan. Long immediately connected the patient with continuing care in the middle of the night.

Dr. Cohen says it’s vital to have good coordination and support between the ER, hospitalists and specialists.

“When they work well, and we work well, it’s a beautiful dance,” he said. “We got [this patient] admitted. We got him on the right treatment. Now we’re coordinating his care for tomorrow. He’s a very satisfied patient who had the right diagnosis, the correct treatment initiated, and now I can take over the care.”