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Published on February 16, 2017

Priority One saves time, saves lives

Gundersen Health System's Priority One Heart Attack Program removes time barriers to get a heart attack patient's blocked artery open as quickly as possible.

More than a decade ago, Gundersen Health System launched its Priority One Heart Attack Program for patients with acute ST-elevation myocardial infarction (STEMI).

It uses evidence-based protocols and a team approach to quickly assess, stabilize, transport and treat heart attack patients.

Priority One at Gundersen was the first of its kind in Wisconsin. At the heart of the program is a network of more than 15 regional emergency departments (see complete list below) that have partnered with Gundersen. One of the first partners was Vernon Memorial Healthcare in Viroqua, Wis.

Vernon Memorial has had a long-established collaborative relationship with Gundersen. Relatively close, at just over 30 miles from Gundersen's Catheterization Lab in La Crosse, it seemed an ideal choice to prove what was a relatively new concept in 2005.

According to Vernon Memorial Emergency Department nursing supervisor Laurie Nundahl, RN, MSN, and medical director A. Macasaet, MD, FACEP, over the course of more than a decade and 100 Priority One calls, it certainly has proven itself successful.

"When a patient comes in with chest pains or other symptoms of a heart attack, we do an early EKG to determine if it is a STEMI. Then using program protocols, the provider calls the cardiologist and that call activates the Priority One while our emergency department personnel stabilize and prepare the patient for transport," Laurie explains.

With that single call, emergency medical transportation is dispatched and a specialized team is mobilized to prepare for the patient. Upon arrival at Gundersen, the patient is taken directly to the Cardiac Catheterization Lab. Gundersen also has cardiac surgery available if needed, including minimally invasive heart bypass.

"Over the years, we've worked with Gundersen to streamline the program so we now can have the patient ready to transport in about 20 minutes. It used to take about 30. Also in the early days, we thought it was important to transport the patient by helicopter but we've learned that for our location, ground transportation is just as fast and effective in most cases. Gundersen has been very good about customizing Priority One to meet our needs and those of our patients," Laurie adds.

Priority One patients who present at any regional partner location are transported to Gundersen in La Crosse. There a specialized heart team—available 24 hours a day—is prepared to provide primary percutaneous intervention (PCI), such as coronary artery balloon angioplasty and stenting, as soon as the patient arrives. Since the Priority One program began, Gundersen has treated more than 1,200 patients.

If your facility would like to be considered as a Priority One regional partner, please contact Nada Ghandour, MD, MBA, administrative director, Gundersen Heart Institute, via MedLink at (800) 336-5465 or (608) 775-5465.

Our Priority One Heart Attack Program regional partners:

  • Vernon Memorial Healthcare, Viroqua, Wis.
  • Black River Memorial Hospital, Black River Falls, Wis.
  • Crossing Rivers Health, Prairie du Chien, Wis.
  • Gundersen Boscobel Area Hospital and Clinics, Boscobel, Wis. 
  • Gundersen Onalaska Clinic Urgent Care, Onalaska, Wis.
  • Gundersen Palmer Lutheran Hospital and Clinics, West Union, Iowa
  • Gundersen St. Joseph’s Hospital and Clinics, Hillsboro, Wis.
  • Gundersen Tri-County Hospital and Clinics, Whitehall, Wis. 
  • Mayo Clinic Health System – Franciscan Healthcare, Sparta, Wis.
  • Mile Bluff Medical Center, Mauston, Wis.
  • Regional Health Services of Howard County, Cresco, Iowa
  • Richland Hospital, Richland Center, Wis.
  • Tomah Memorial Hospital, Tomah, Wis.
  • Veterans Memorial Hospital, Waukon, Iowa
  • Winneshiek Medical Center, Decorah, Iowa
  • Winona Health, Winona, Minn.
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