Anatomy of an ambulance

Itasca paramedics saved a man's life this spring with a plastic box the size of a pack of cigarettes.

When the 51-year-old man reported severe chest pain, paramedics took an electrocardiogram and used a new Rosetta transmitter to send the results to Alexian Brothers Medical Center. Doctors diagnosed a heart attack and called in an angioplasty team to clear the victim's blocked artery.

Within eight minutes of arriving at the emergency room, the patient was in the cardiac catheterization room. Two days later, he went home in good condition.

Paramedics credited the Rosetta transmitter as a lifesaver. It's the latest step in an evolution toward paramedics alerting hospitals to life-threatening cases to cut treatment time and save lives.

The trend started years ago when hospitals arranged for paramedics to notify them of incoming severe trauma cases like car accidents.

In the past decade, hospitals set up cardiac alerts like the one that saved the Itasca man. While many departments phone in a general computerized diagnosis to the hospital, the $800 Rosetta transmitter lets ER doctors see the raw EKG data and judge for themselves whether to call in a cardiac team.

Now, hospitals and paramedics are extending the same philosophy to strokes. Paramedics can diagnose strokes from the field and alert the hospital, so doctors will clear access for a CT scan, and if necessary, perform surgery or give blood clot-busting drugs that can save lives if given within 90 minutes of the stroke.

Since starting such a program last year, Lutheran General Hospital in Park Ridge reduced the average time to take a patient from ER to CT scan from about 45 minutes to 22, and significantly increased its use of clot-busting drugs.

To complement this high level of coordination between doctors and paramedics, advanced life support ambulances have become rolling emergency rooms, capable of many of the same procedures as at an ER.

To illustrate the many ways paramedics can save a life, the Barrington Countryside Fire Department, Alexian Brothers Medical Center in Elk Grove Village, and the American College of Emergency Physicians recently explained the latest additions to their bag of tricks:

CPAP

A continuous positive airway pressure machine forces air into a patient's lungs. While it's traditionally been used in homes to help people with common sleep apnea, it's now used on emergency vehicles as a way to avoid having to push a tube down the patient's throat.

Bone marrow drill

When patients suffer a heart attack, shock or heart failure, their veins may collapse, making it hard to get in an intravenous tube to give them drugs or fluids.

Now, paramedics have the option of using an electric drill to screw a needle directly into the bone marrow. There, fluids can be easily absorbed by the body.

The device is known as Vidacare's EZ IO, for the intraosseous delivery route it uses.

Rescue pod

When performing CPR, this small plastic device prevents overinflating the lungs, and increases oxygenated blood flow to the heart and brain. It should be in all ambulances in the Northwest Community Hospital Emergency Medical Services system by next year.

King Emergency Airway Tool

The King Airway tube lets paramedics put a tube down the throat of a patient with a closed airway, then inflate a balloon to block the esophagus, so no stomach fluids are aspirated into the lungs, which can cause severe problems.