Critical Resources, Critical Care

November 4, 2022

Located on the U.S.-Mexico border, Imperial County, California is largely rural or desert land with a sparse population and a poverty rate more than double the national average. These facts often equate to medically underserved communities, and this is true of Imperial County, in that the nearest advanced healthcare centers are more than 100 miles west in San Diego. 

This means that local hospitals and emergency medical services (EMS) providers must work more closely to ensure patients can reach the level of care they need, when they need it, with no drop off in continuity of care. That is why an ongoing partnership between REACH Air Medical Services and Pioneers Memorial Hospital is so important to local citizens. And why a recent air transport from Pioneers to San Diego, utilizing special equipment for cardiac patients, is the latest proof of this essential relationship.  

Balloon Pump Stabilization
When Pioneers opened a full cardiac lab in 2021, it was an instant critical resource for Imperial County citizens and an important step toward bringing higher levels of care to the region. However, even with these new capabilities, cardiac patients who require even more advanced care still need to be transported to San Diego or other cities with cardiac centers. Often, this will require what is known as an intra-aortic balloon pump (IABP) to stabilize a patient. And Pioneers added this capability to their lab in 2022. 

An IABP is a therapeutic device that helps a patient’s heart pump more blood into the coronary arteries by inflating and deflating like a balloon. It’s inserted in the aorta with a catheter running to the femoral artery where the contractions can be controlled. Critically, this short-term treatment must remain working in-transit between facilities, requiring coordination of equipment and skills with EMS. Only REACH could match Pioneer’s cutting-edge technology and highly trained personnel. 

Continuity of Care
REACH has enjoyed a 15-year partnership with Pioneers and understood the critical need to add equipment to match the cardiac lab. The company purchased a portable balloon pump and worked to reconfigure its aircraft to be able to access it while not losing other resources. Flight Nurse Grace Verduzco, who had previously worked at Pioneers for more than a decade, and her crew partner, Flight Nurse Evelyna (Nina) Montano, were trained on the IABP and got a chance to put that training into action in August of 2022.

“The patient that day presented as very ill and was fitted with a balloon pump by Pioneers,” said Verduzco. “Sometimes when people have heart failure the pump is needed to help contract the weakened heart. This was the first time Pioneers had done this procedure and the patient required transport to San Diego. So it was the first time we were able to use the portable pump.”

Positive Outcomes
Time is of the essence when a patient is having a cardiac event. They need to get the best treatment as quickly as possible with no drop off in the level of care. Verduzco and Montano were able to keep their patient stabilized in route to San Diego, a fairly short flight by air ambulance, allowing them to receive the higher level of care they required.

“It was a great test of our capabilities as a team working closely with Pioneers,” said Verduzco. “Literally, no other transport provider has this capability in this region, and we’re proud we’re part of enabling more positive outcomes because of it.”
Montano added, “It’s empowering for the entire community here, where access to higher levels of care is limited but the need is great. Hopefully, we can continue to work with Pioneers to add more advanced treatments.”

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