ROUND-THE-CLOCK services for all heart attack patients in the Mid-West will be operational “within weeks” the HSE has said amid an outpouring of rage over the news some of the most serious cases were being brought by ambulance to Galway, bypassing the Mid-Western Regional Hospital.
One of the country’s top cardiologists, Dr Brendan Meaney, this week described as “unsafe” the practice whereby certain Limerick heart attack victims were being brought to Galway as a cath lab in Limerick is only operational from 8am and 5pm, Monday to Friday.
The Limerick-based consultant warned of potential “disasters” if patients went into cardiac arrest during the lengthy ambulance journey or arrived in Galway too late.
Best practice requires that victims of STEMI (ST elevation myocardial infarction) heart attacks - the most serious kind where the coronary artery is entirely blocked - need an urgent angiogram and a surgical intervention - where a balloon is inserted to relieve the blockage - within 90 minutes to two hours.
These services cannot currently be provided in Dooradoyle at night or on weekends and this, Dr Meaney said, was because the HSE had failed to date to provide the necessary support staff, including radiographers and nurses, in Limerick.
And Deputy Kieran O’Donnell - who said he had received assurances the staff and equipment were already in place in Limerick - wants to see the Limerick cath lab opened sooner than the “weeks” referred to by the HSE this week.
“Brendan Meaney has obviously come out and spoken very passionately this week and when you have a senior cardiologist in the region saying such things, somebody who is expert in the area, that’s good enough for me,” said Deputy O’Donnell.
Having spoken to the Minister for Health Dr James Reilly and local HSE management on the matter this week, Deputy O’Donnell said he had also raised the issue with acting HSE CEO Tony O’Brien when he appeared before the Public Accounts Committee - of which Deputy O’Donnell is vice-chairman - on Tuesday evening.
“I have been given an assurance that the two radiographers and the two nurses needed to have the cath lab open on a 24-hour basis are in place and that all that is now required is an inspection by the clinical lead of the (acute coronary syndrome) national programme. Tony O’Brien has said that that inspection is to take place in the next three weeks and while I welcome that, the timeframe is unacceptable to me,” said Deputy O’Donnell.
The HSE explained that the “acute coronary syndrome is a national clinical programme aimed at improving cardiac care throughout the country by providing patients with prompt access to higher level investigations and treatment such as cardiac catherisation (angiography), advanced radiology and critical care.”
“This service which is for a specific type of heart attack (STEMI) is currently provided at the Mid-Western Regional Hospital Limerick, Monday to Friday, 8am to 5pm. The number of patients requiring this service out of hours in the Mid-West each year is approximately 58. It is anticipated that Limerick will become a 24-hour centre for these patients within the next few weeks as the programme is rolled out throughout the country following an inspection by the national clinical ACS programme lead.”
The HSE added that cardiology services were being expanded with the appointment of a fifth cardiologist in Limerick. The coronary care unit, which is open round-the-clock with a cardiologist on call at all times, would shortly be moving into the state-of-the-art critical care block which is nearing completion on the Dooradoyle campus.
The HSE also stressed that people in the region who have actually gone into cardiac arrest are still being brought to Limerick Regional “24-7, 365 days a year”.