Level One Cardiovascular Emergencies Programs

What to Expect

Fast Action When Every Second Count

The moment your physician at a community hospital notifies IU Health about your Level One cardiovascular emergency, we take steps to help you get the care you need as fast as possible. This includes arranging for air or ground transportation to get you to an IU Health facility that provides the specialized care required for your diagnosis and preparing the treatment team for your arrival.

IU Health transfer protocols guide referring hospitals to begin important therapy before transport so that you begin receiving treatment even before you arrive at an IU Health facility – no matter where you are when you are diagnosed with cardiovascular emergency.

IU Health Level One Cardiovascular Emergency programs include:

Level One Heart Attack

STEMI is a type of heart attack that occurs when a blood clot forms within an artery leading to the heart muscle and blood flow is completely blocked. Opening the artery quickly is key to providing the best chance for recovery. The goal is to restore blood-flow to the heart within 90 minutes of first contact with a healthcare provider. This is most often done by angioplasty, in which a balloon-tipped tube (catheter) is inserted into an artery and moved to the point of blockage. The balloon is inflated, opening the narrow spot. Doctors may place a stent (a tiny wire mesh tube) in the artery to hold it open.

IU Health hospitals with 24/7 Level One Heart Attack Program:

• IU Health Arnett
• IU Health Ball Memorial
• IU Health Bloomington
• IU Health Methodist
• IU Health North
• IU Health Saxony
• IU Health West

Level One Cardiogenic Shock

Cardiogenic shock occurs when your heart suddenly can’t pump enough blood to meet your body’s needs. It is most often caused by a heart attack and can be fatal if not treated immediately. Speed is the key in the treatment of shock emergencies. Treatment of cardiogenic shock may include:

• Special medications to improve your heart function
• A breathing machine (ventilator) to increase your oxygen levels
• Mechanical devices to help your heart pump. Some of these devices include intra-aortic balloon pump, Impella®, ventricular assist device (VAD), or extracorporeal membrane oxygenation (ECMO).

Rapid assessment and initiation of therapy by the treatment team help ensure you have the best chance of survival and recovery from this critical diagnosis. IU Health Methodist Hospital has the only Level One Cardiogenic Shock Program of its kind in the state of Indiana.

Level One Vascular Emergency Program

The Level One Vascular Emergency Program is designed to reduce treatment delays and improve outcomes for patients with extremely complex vascular emergencies. Rapid treatment of these emergencies increases your chance of survival. Dangerous vascular conditions may include:

• Abdominal aortic aneurysm (AAA) is a bulge in your aorta (the large blood vessel that extends from your heart to your abdomen) that occurs when the aorta’s walls are weakened. You will need surgery if your aneurysm is leaking or has burst. This may be done through an incision or through a tube inserted in an artery (endovascular).
• Aortic dissection is a serious condition in which there is a tear in the wall of the artery carrying blood out of your heart. The layers of the artery wall can separate, allowing blood to flow between them, which can lead to decreased blood flow to the internal organs. Surgery to repair aortic dissection may be done with standard or endovascular procedures.
• Acute limb ischemia occurs when there is a sudden decrease in blood flowing to one of your legs or arms usually caused by a blood clot that totally blocks an artery. Doctors may perform special X-rays of your arteries (arteriograms) to help determine where the blockage is and how best to treat it. Treatment with clot dissolvers or surgery to remove the clot or bypass the blockage is done to restore blood flow as quickly as possible.

The Level One Vascular Emergency Program at IU Health Methodist Hospital provides specialized emergency care to patients with life-threatening vascular emergencies in Indiana and surrounding states.

Level One Pulmonary Embolism Program

Pulmonary embolism (PE) is usually caused by a blood clot that travels from your legs or another part of your body to an artery in your lungs. The artery is totally blocked, cutting off blood supply to the lungs. Pulmonary embolism can be fatal, and as with other emergency diagnoses, prompt treatment can greatly improve chances of recovery. A special Pulmonary Embolism Response Team (PERT) team made up of physicians from multiple specialties (emergency, pulmonology, radiology, cardiology) springs into action when they receive word a patient with PE has arrived or is on the way from an outside hospital. Together they decide on the best treatment for each patient with pulmonary embolism. Treatment may include:

• Clot dissolvers (thrombolytics) given intravenously or via a small catheter (catheter directed treatment) inserted and directed to the blocked artery in the lungs
• Blood thinners (anticoagulants) which help prevent new clots from forming while your body works to break up the clots in your lungs
• Removal of blood clots through a catheter (non-surgical procedure) or through surgery in the operating room
• The most severe cases may require support with extracorporeal membrane oxygenation (ECMO).

IU Health Methodist Hospital has the only Level One Pulmonary Embolism Program in the state for treatment of complex PE

Level One Esophageal Emergency Program

A tear or hole in your esophagus (the pathway from your throat to your stomach) can occur spontaneously due to forceful vomiting, trauma, chemical injury or other disorders such as cancer.

Esophageal rupture can be potentially devastating and rapid diagnosis and treatment provide the best chance for survival. IU Health has a novel Level One Esophageal Emergency Program designed exclusively to speed and improve the management of patients with life-threatening esophageal emergencies. Treatment options for perforation may include:

• Stent placement through a tube inserted into the esophagus through your mouth
• Surgery with open repair
• Observation and treatment with medications if the opening is small and closes without intervention

Patients with esophageal emergencies receive treatment at IU Health University Hospital by a specialized team of thoracic surgeons and gastroenterologists.