County Should Rethink Its Cardiovascular Care

Re “More Hospitals Can Use Angioplasty, Study Finds,” April 17:

The findings published in the Journal of the American Medical Assn. demonstrate that heart attack patients who get immediate access to angioplasty have fewer strokes and recurrent heart attacks than patients treated initially with medications, especially anticoagulant therapy (TPA). The article also described a “two-tiered system” that exists in Orange County in which cardiac emergencies are take to the nearest hospital by paramedics.

When we developed the Orange County Emergency Medical System in the 1970s ( I was a principal architect), all that was required in a cardiac center was an intensive-care unit and a cardiologist. Thus every receiving hospital in the emergency system became a cardiac center.

Technology has exploded since then, and there are several excellent cardiac facilities in Orange County, yet cardiac emergencies are still taken to the nearest hospital. I have been the unfortunate victim of this situation on two occasions. Heart attack victims are being taken to a community hospital, and after much time is lost, are transported to a cardiac center for definitive evaluation and treatment.

The time is long past for the county’s Emergency Medical Care Committee to establish criteria and designate cardiovascular emergency centers, and to develop criteria for the diversion of cardiovascular emergencies by the base stations to those centers.

William M. Thompson

Huntington Beach