North Dakota Mission: Lifeline Update



North Dakota’s Mission: Lifeline heart attack patient care initiative was launched on August 1, 2011.  The unprecedented collaboration spearheaded by the American Heart Association with $7.1 million in funding is saving lives of acute heart attack patients across North Dakota.  Thanks to healthcare and community partners working together great strides have been made in the past two years to develop and implement statewide equipment placement, training, protocols, policies, and quality improvement measures.

The goal of Mission: Lifeline is to create a system of care that improves the outcome for every acute heart attack patient by providing the most effective treatment within the timeframe recommended by the scientific guidelines.  Simply put – restoring blood flow to the heart muscle within 120 minutes of first medical contact.

Closing the Gaps at Every Point Along the System of Care:

Here are some of the challenges to saving the lives of patients who have the type of heart attack known as STEMI and the progress made to date in North Dakota: 

Ambulances responding to heart attack calls must be equipped with 12-lead electrocardiograms (ECGs).  98% licensed ground ambulance services responding to public 0-1-1 calls in ND are equipped with a 12-lead ECG monitor.

Paramedics/EMS staff must be trained in the use of 12-lead ECGs to diagnose STEMI events, so they can transport the patient to a hospital capable of providing the appropriate treatment and expedite the patient's care upon arrival.  Phase 1 and 2 of EMS training is complete.  Phase 3 training will begin this fall.

Hospitals that provide percutaneous coronary intervention (PCI) or angioplasty must develop protocols that enable them to perform the procedure within 90 minutes of the patient's arrival, or first medical contact as recommended by the American College of Cardiology.  PCI restores the blood flow to the heart and can save the patient's life.  All six PCI hospitals in the state have fully implemented protocols. 

Rural hospitals that do not offer PCI should develope protocols for treatment based upon recommended timelines for therapy and evaluate and transfer patients to PCI receiving hospitals within the recommended 45 minutes.  A statewide STEMI referring hospital protocol has been developed and provided to all ND referring hospitals. 

Emergency medical service providers (EMS) and hospital personnel at both PCI receiving and referring hospitals must develop communication systems to expedite and track the care of STEMI patients.  Statewide and regional feedback, data sharing, and interdisciplinary meetings have been established. 

Patients, family members, co-workers and the public at large must be educated to recognize the signs of heart attack and to call 9-1-1-.  In ND less than 40% of acute heart attack patients arrive via EMS compared to the national average of 67%.  "Your Life is on the Line - Call 9-1-1" public education campaign was launched in August 2013 to increase awareness of signs and symptoms and encourage calling 9-1-1 at the first signs of a heart attack. 

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ND Mission: Lifeline lead program funders:  The Leona M. and Harry B. Helmsley Charitable Trust ($4.4 million), State of North Dakota ($600,000), Dakota Medical Foundation ($100,000) and Otto Bremer Foundation ($100,000). 



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