Frequently Asked Questions with Dr. Raymond Bahr


Dr. Ray Bahr is more than just the Founder of the Society of Cardiovascular Patient Care. He's the soul of the organization. Dr. Bahr is the President Emeritus and sits on the Board of Trustees of the Society, which was founded as the Society of Chest Pain Centers. His Early Heart Attack Care program is a benchmark of community outreach and education for heart disease.

Q: EHAC just passed 245,000 pledges ... why is that number so significant?
A: Because the growth of the EHAC message by thousands is heading in the direction of viral growth to millions. It is taking off before our eyes. It is a message that all Americans need to know to protect their heart by being tuned in for early signs of heart trouble. Becoming deputized into the EHAC message allows all of us to take action.

Q: And with this momentum, where is EHAC going?
A: Nationwide ... so that one day everyone in America (300 million people) will know what to do when they have the onset of chest discomfort symptoms that keep coming back. We want them to think, "This could be the start of something BIG ... I need to protect my heart, because my family depends on me, and I'd rather be safe and not sorry."

Q: How can people help it go nationwide?
A: By understanding the EHAC message and helping to spread the online course. They can pass the test and become deputized into action by taking the pledge to become involved. Deputized EHAC experts know to stay involved until the person with the early symptoms is checked out in the hospital.

Q: Great, so what can SCPC member hospitals do now to accelerate this program?
A: By finding out their hospital's internet service (usually HealthStream) that has online competency programs and adding the EHAC module www.DeputyHeartAttack.org. Also, by making it a required course for all hospital employees, as it is for Chest Pain Center Accreditation (Cycle IV). In a 400-bed hospital this amounts to about 2,000-3,000 employees. With 800 Chest Pain Centers in the United States, this would amount to 2-3 million EHAC deputies.

Q: What about community programs or involvement?
A: As hospitals set up Chest Pain Centers to deliver EHAC, the next step is to teach their employees why there is a Chest Pain Center in their Emergency Department. Then they will be able to teach people in their community about the EHAC way to save lives. We are asking each Accredited Chest Pain Center to teach 500-1000 people annually in the local community. This can easily be done by using the short 5-minute course on www.deputyheartattack.org. It can also be done by giving the program in a lecture and submitting the roster of participants to the Society's office so they can get credit for taking the EHAC course. The community approach can be enhanced by setting up EHAC training in the schools in the community around the hospital.

Q: So, EHAC isn't just for the hospital anymore? It can go out into the community?
A: You got it! Ascension Health Hospitals now number 70 hospitals ... about 16 already have Chest Pain Centers and I will be working to get more of the remaining 54 hospitals to set up Chest Pain Centers. In the meantime, we will be adding the EHAC Teaching Module to the Ascension Health Learning System and begin teaching the EHAC message to employees in all 70 of their hospitals ... not just the ones with Chest Pain Centers. This strategy is easily accomplished without any new funding ... just working with the right people with the right idea at the right time.

Q: What's the ultimate goal?
A: The ultimate goal is to change the culture of America and have 300 million Americans thinking the same about how they can become involved earlier when it comes to heart attacks. Only then can we begin to think about reducing significantly the 800,000 heart attack deaths in the United States each year. Our mission is slowly but surely becoming a reality!

Frequently Asked Questions with Dr. Raymond Bahr

Q: Are there tools to take this outside the doors of the hospital and into the community?
A: The tools revolve around the standard EHAC course on the www.DeputvHeartAttack.org website. The short 5-minute EHAC course can be used by staff for members of the community. This EHAC course can also be downloaded and used as handouts. Those who pass can take the EHAC Oath. The names of the attendees can be sent to the Society's office to be given credit and included in the EHAC count.

Q: What is the Society of Cardiovascular Patient Care's strategy to accomplish our mission?
A: The mission is to reduce significantly heart attack deaths in the United States and take heart disease deaths out of first place where it has been for over 150 years. The Society's strategy is to reduce the heart attack deaths each year to half this amount ( 400,000 deaths).

We can do so by focusing on the 50% of the patients who start out with early chest symptoms, but don't get into the hospital soon enough. The Society has set up Chest Pain Centers in nearly 800 hospitals to provide a user friendly pathway for patients coming in with these early heart symptoms. These enters can be found on the free app "Best Heart Hospitals" and can be located on I-phones that provide directions using their GPS location.

We now have a standard way of educating the community on when to come to the hospital to be checked out. We start first by educating the hospital employees.

As of September 25, 2013 we have over 124,000 EHAC-trained deputies who have pledged to stop what they are doing and attend to a person in their midst who is having the early symptoms of a heart attack. Can you imagine how many lives can be saved with this army of 124,000 who are out in the community to spot such early heart attacks and are ready to act to prevent them from occurring?

The Society's future plan is to continue to grow the number of Accredited Chest Pain Centers to between 2500-5000 and continue to grow the EHAC-trained deputies from the present 124,000 to about 3-5 million and hope that this will be enough to take it virally to the 300 million Americans. Then, we'll know that we have changed the culture of America for dealing with the heart attack problem.

To remove heart attack deaths as the number one killer of the adult population in the United States is the reason why the Chest Pain Centers came into being and why the Society of Cardiovascular Patient Care continues to carry out this plan of action. This strategy is working but a lot more work is needed before we can claim victory.

Q: You talk a lot about Saver or Enabler. What does that mean?
A: The bystander is perhaps the most important when someone is in the midst having a heart attack. There are three types of heart attack presentations everyone should know about…

Q: What are they?
A: There is the one that drops you dead and you have no chance at all to survive unless you can be defibrillated fast (chances are not that good). However, if the bystander knows how to perform Cardio Pulmonary Resuscitation – CPR – there is a chance of survival.

With the second type, the patient will appear very weak and sweating cold beads across their foreheads. The person here is most likely experiencing severe pain across the chest. They will often describe it as "an elephant or Mack truck sitting on their chest". The saver knows quickly to call 911 and get an ambulance. Time is important — 80% of the heart damage will occur within the first two hours. Unfortunately, the average time to get into the hospital is about two hours and this has not changed much over the years. Even within the Hospital, the average time to open the clotted blocked heart vessel is 60-90 minutes.

The third type begins when the patient experiences "beginning mild chest symptoms" before they progress to the severe chest pain that will bring them into the hospital. It is here where the bystander or becomes either an enabler or saver.

Frequently Asked Questions with Dr. Raymond Bahr

Q: Is it really "enabling?"
A: In the first two presentations, it is obvious what is taking place and the Bystander will be usually … no getting around this. But, in the third type, the patient in the early stage will not look sick and no one will suspect that anything is taking place. The patient many times will be denying their symptoms because the "inconvenience" will ruin their day. That's when the bystander then becomes the enabler, because they behave like it's no big deal.

Q: So even "little" episodes are a big deal?
A: Heart attack is the No. 1 killer of the adult population in the U.S., because we allow it to be a crashing illness. It need not be. Everyone forgets about what is happening until it is too late. Taking action early prevent s the heart attack from progressing.

Q: So what should everyone know…the basics?
A: To save a life, overcome the resistance and struggles that the patient may throw up to avoid not going to the hospital.

Q: Yes, but how do you do that?
A: The ideal approach to intervention can be recalled through a simple acronym: SPICE which stands for: simple, persistent,
influential, calm, empathetic

Q: So do all that, but take action, don't wait?
A: Do not take the time to attempt an evaluation. Get them to medical care as soon as possible. Find out what they need . To be a saver, the bystander needs to interrupt their day to save the life of another … and what could be a better use of someone's time than that?



How can you use this information in your education programs?

  

Dr. Raymond Bahr's Articles & Videos

Dr. Raymond Bahr writes a monthly article about the EHAC movement that appears in the Society of Cardiovascular Patient Care newsletter. He has also done several videos that outline the importance of Early Heart Attack Care.




Meet our Founder

Dr. Raymond Bahr

Dr. Raymond Bahr is passionate about cardiac care and preventive education. As the founding father of SCPC, his passion to disseminate lifesaving information is a driving force at SCPC. Throughout his career, he has created multiple programs to help others understand the life saving measures that can save a life. In 1981 at St. Agnes Hospital, Dr. Bahr established the Chest Pain Emergency Department (CPED), the first such unit in the world. The initial purpose of this CPED was prompt and effective treatment of patients presenting with heart attack/sudden death. The CPED was coupled with an aggressive education program that taught the community the early warning signs of a heart attack. This education program extended to middle and high school students via health and science curricula.