Gene Poligardo awoke in the middle of a November night sweating profusely and feeling pressure in his chest.
His condition quickly deteriorated as an ambulance arrived to take him from his home in Elkridge to Howard County General Hospital.
"If we didn't get him to the hospital quickly, he was going to go into cardiac arrest," said Ashley Tartufo, a paramedic with the Elkridge Volunteer Fire Department.
Because of an unusual protocol in Howard County, Tartufo called ahead to alert the emergency room to bring in a cardiac catheterization team. Poligardo went into cardiac arrest minutes after arriving at the hospital. He was revived and immediately taken to the catheterization lab, where the team was waiting.
Howard County is the only jurisdiction in the Baltimore region with a countywide policy enabling a local hospital to assemble a catheterization team based solely on a paramedic's en route determination.
"It's hard to tell if someone would have lived or died, but there are cases where we can say someone would have died," said John Jerome, battalion chief of the emergency medical service training branch of the Howard County fire department.
As much as 30 minutes can be saved, Jerome said, which is significant in the case of a heart attack victim.
"There isn't a doubt in my mind that it's saving lives every day," Tartufo said.
In Baltimore City and Baltimore County, EMS paramedics can call for catheterization teams when transporting to some hospitals. But not all hospitals participate, and there is no jurisdiction-wide policy.
In Carroll County, ambulance staff can call ahead and alert the emergency room that a patient with a serious condition is on the way. In Anne Arundel County, a digital electrocardiogram can be sent from the ambulance to the emergency room. But an emergency room physician must read it before summoning the team.
Many medical and EMS professionals expect the Howard approach to spread. On Tuesday, Howard officials gave a presentation to representatives of other area hospitals at a meeting held by the Maryland Health Care Commission in Baltimore.
Howard County can rely on the EMS provider because, unlike in other counties, a paramedic-level emergency medical technician rides in every ambulance. State guidelines require at least an intermediate-level EMT on all ambulances.
Howard's paramedics perform a more advanced electrocardiogram in the ambulance, which enables them to make a determination of the severity of the case.
