SOUTH LAKE TAHOE - The night before his wife's 78th birthday, Richard "Mack" Brown walked out of his bedroom and into the living room where his wife was sitting.
His wife Pat, a former surgical technician, knew something was wrong.
"When he walked out of the bedroom he was the worst color I've ever seen and sweating profusely," Pat said. "Being in the medical field I thought, 'This isn't good.'"
Mack, a survivor of three previous heart attacks, knew the symptoms - a heavy pain in his chest and back.
Within seven minutes a team of firefighter paramedics from Tahoe Douglas Fire District was at the Brown home. In another few minutes Mack was hooked up to a 12-lead heart monitor and defibrillator - a machine that allows paramedics to get a close look at a patient's heart functions while in the field.
"They moved so fast and they were so efficient that it was really comforting to me because I knew he was in good hands," Pat said.
Once the paramedics received the reading from the 12-lead they knew what they were dealing with - a heart attack caused by a prolonged period of blocked blood supply, also known as a STEMI. A STEMI deprives the heart of oxygen and kills off heart tissue. Because of the long-lasting effects of heart muscle death, federal guidelines require a patient to be treated within 90 minutes from the time they leave their house.
"Every minute that goes by you are jeopardizing heart muscle," said Annette Patellos, director of Carson Tahoe Regional Medical Center's Cardiac and Vascular Catheterization Laboratory.
Paramedics raced Brown out the door and into an ambulance ready to go to Carson Tahoe, where Brown could be treated in the Vascular Catheterization Laboratory.
"I said I'll be right behind you," Pat said. "They said, 'You won't be behind us, by the time you get out of the driveway we'll be halfway there.'"
A life-saving protocol
On Dec. 8 Mack celebrated his 77th birthday - a milestone reached with the help of an agreement between the Tahoe Douglas Fire District and Carson Tahoe Regional Medical Center for STEMI heart attacks.
The Harrah's Foundation awarded a grant to the fire district in August 2007 to purchase almost $100,000 worth of portable heart monitoring devices. The purchase included three 12-lead heart monitors/defibrillators and three wireless laptops that allow paramedics to transfer information to Carson Tahoe Regional Medical Center.
"We knew this was a real life-saving opportunity and it's good for us and good for the community," said Harrah's spokesman John Packer.
Once the equipment was purchased, the fire district began to work with Carson Tahoe to create a protocol so that when patients showed signs of a STEMI they would be transferred directly to Carson Tahoe for treatment. Before this equipment and protocol, patients would be taken to Barton Memorial Hospital, where a series of drugs and tests would be administered. But, because Barton does not have a team of cardiologists or the equipment needed to treat a STEMI heart attack, the patient would be transported to Carson or Reno - well outside of the 90-minute federal guideline.
Jeopardized heart muscle can mean death or a severely decreased quality of life for patients who do survive, said Dr. John Watson, fire district medical director.
About 1 in 10 chest pain reports can result in a STEMI heart attack, Watson said. Since the protocol was put in place in September 2008, fire district paramedics have transported 30 patients to Carson Tahoe - all have survived.
"It is one of the greatest things and whoever devised that ought to be commended," Mack said. "They are really something."