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Paramedics Step Up to Reduce Hospital Readmissions

Paramedics in Carmel, Indiana, a fast-growing community just outside Indianapolis are stepping forward to reduce hospital admissions by implementing the Mobile Integrated Health Care program.  In the past decade, according to the Joint National EMS Leadership Forum, close to 300 fire departments, ambulance services and hospital systems nationwide have launched programs like Carmel’s, initiatives commonly known as community paramedic or community paramedicine. 

For more on this story, CLICK HERE

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Advocate Spotlight: Dr. Joshua Wynne

Dr. Joshua Wynne North Dakota

Joshua Wynne, M.D., M.B.A., M.P.H. has been an advocate for cardiovascular health and wellness for decades. But in addition to helping thousands of patients with heart problems over many years in his role as a clinician, he also practices what he preaches!

As Vice President for Health Affairs at the University of North Dakota and Dean of the UND School of Medicine and Health Sciences, he has sponsored “Joggin’ with Josh”, an annual walk, jog, or run involving the UND and Grand Forks community. He has served as the 2010 Heart Walk Chair in Grand Forks, N.D. And he has ensured that the new medical school building that will be completed in 2016 is designed to encourage walking.

A New York native, Dr. Wynne’s medical education was in Boston. He has functioned as an academic cardiologist throughout his career, first at Harvard Medical School and Brigham and Women’s Hospital, then at Wayne State University, and most recently at UND. He is a longtime American Heart Association volunteer with leadership roles in Michigan, North Dakota, and the Midwest Affiliate, where he was a long-standing board member.

As a member of the Health North Dakota Strategic Visioning Committee, Dr. Wynne helped identify improved hypertension identification and treatment as an important public health initiative to reduce the rates of cardiovascular disease and stroke in North Dakota, since optimal blood pressure control remains elusive for many patients.

Heart disease treatment is a personal matter for Dr. Wynne; he is married to fellow cardiologist Dr. Susan Farkas, who is director of the Echocardiography Laboratory at Sanford Heath in Fargo and Governor of the American College of Cardiology for North Dakota. 

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AHA Joins Forces with Million Hearts®

American Heart Association/American Stroke Association is proud to join forces with Million Hearts® to build healthier lives, free of cardiovascular diseases and stroke.

Million Hearts® is a national initiative to prevent 1 million heart attacks and strokes by 2017. Million Hearts® brings together communities, health systems, nonprofit organizations, federal agencies, and private-sector partners from across the country to fight heart disease and stroke.  Million Hearts® focuses on the prevention of heart attacks and strokes through achieving excellence in the ABCS (Aspirin when appropriate, Blood pressure control, Cholesterol management, and Smoking cessation).

The Healthy North Dakota Statewide Visioning and Strategy core leadership along with strategic partners and stakeholders are proposing a multi-year public/private hypertension as a key wellness and prevention strategy.  The initiate aims to increase the percentage of North Dakotan’s who have their blood pressure under control.   The initiative also provides expanded smoking cessation support. The initiative will drive a culture of healthy by collaborating on best practices and measurable new strategies for employee, healthcare and community engagement. 

Cardiovascular disease is responsible for 1 out of every 3 deaths in the country.  Hypertension, also called high blood pressure, is a leading cause of heart disease and stroke, is estimated to contribute or cause nearly 1,000 deaths per day in 2009 according to CDC.  When your blood pressure is high you are 4 times more likely to die from a stroke and 3 times more likely to die from heart disease. 

In North Dakota, stroke is currently the third leading cause of death.  70% of strokes captured in the stroke registry have hypertension recorded as a key risk factor.  MediQhome reports that there are at least 100,000 North Dakota adults being monitored or treated for high blood pressure, and that only 75% are considered controlling their blood pressure.  

Working together and leading by example our state’s corporate, government and health organizations can create a culture in which healthy choices are the default choice.   Together we can meet the goal of improving the cardiovascular health of all North Dakotans by 20 percent by 2020. 

To learn how you can be one in a Million Hearts® go to 

For more information on lowering your blood pressure go to

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National Healthy Eating Day: Your Toolkit for Success

Take the first step to making healthier food choices by taking part in the American Heart Association's National Eating Healthy Day on Wednesday, Nov. 5, 2014. 

On this day, Americans are encouraged to commit to healthier eating. Celebrating National Eating Healthy Day is fun and easy! We provide a complete toolkit of materials and how-to information for workplaces, schools, individuals and community organizations.

A healthy diet and lifestyle are your best weapons to fight cardiovascular disease. It’s not as hard as you may think!  Remember, it's the overall pattern of your choices that counts. Make the simple steps below part of your life for long-term benefits to your health and your heart.

Remember, making small changes can put you on the right path to better health.  Start by eating a variety of nutritious foods from all the food groups.  You may be eating plenty of food, but your body may not be getting the nutrients it needs to be healthy. Nutrient-rich foods have vitamins, minerals, fiber and other nutrients but are lower in calories. Eating a variety of fruits and vegetables may help you control your weight, cholesterol and your blood pressure. Limit foods and beverages high in calories but low in nutrients. Also limit the amount of saturated fat, trans fat and sodium you eat. Read Nutrition Fact labels carefully — the Nutrition Facts panel tells you the amount of healthy and unhealthy nutrients in a food or beverage. 

To assist you in making healthier food choices, the American Heart Association has developed a toolkit for your use.  Included in this toolkit are recipes, heart-smart grocery shopping tips, helpful guidance on dining out, seasonal eating strategies, and much, much more. We encourage individuals, families, companies, organizations, schools and churches to register at to take advantage of all resources available.  

There is no one simple solution to the issue of obesity in our country. In order to reach our goal of improving cardiovascular health, we call on all Americans to recognize the severity of the obesity crisis, the toll it takes on our nation’s health and health care system, and the imperative need for collective action among food manufacturers, restaurants, government and consumers to change the direction we are headed.
In addition to the programs, tools and advocacy efforts already in place, the American Heart Association will continue to identify solutions to help Americans reverse obesity rates and improve their overall health. 

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Former Jamestown Student Saves Child’s Life Spurs CPR Smart Conversation

The importance of making CPR and AED training into a required curriculum for high school graduations has become an important point of conversation in the Jamestown School System after hearing of a former Jamestown High School student who saved a child’s life while babysitting.

Jamestown High School is currently working towards becoming a CPR Smart School. This would ensure that all students that are enrolled in a physical education course would go through CPR/AED training as approved by the school board.

The American Heart Association was proud to champion SB 2238 – the CPR in Schools funding bill designed to established a platform by which every graduating high school student will learn and practice how to perform CPR – creating our next generation of community lifesavers.   The legislature appropriated $450,000 in CPR training support for all North Dakota high schools – public and private. The intent to fund one grade level per year within a school.  Schools decide which grade level and the course which is already required for graduation.  AED training is also a required component of the training. The training can be done in one regular class period for Hands Only CPR training or a school can select a 4-6 hour certification course built into several class periods.

If you are interested in working with your local school to achieve CPR Smart School recognition send an e-mail to Kendra Krueger at   To learn more go to our CPR website –   

CLICK HERE for complete story on CPR save from the Jamestown Sun.  

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State of Obesity Report: North Dakota

In recognition of Childhood Obesity Awareness month, we are pleased to be able to provide our advocates with the most recent statistics on obesity in our state and across the nation. The State of Obesity Report (formerly F as in Fat), a project of the Trust for America’s Health and the Robert Wood Johnson Foundation, provides a close-up look at our progress toward reducing obesity across all populations and demographics, and the work that lies ahead of us to ensure our kids are growing up healthy and strong. 

For the past 11 years, this report has raised awareness about the serious nature of obesity, and encouraged the creation of a national obesity prevention strategy.  The American Heart Association has worked alongside our partners at the Trust and RWJ Foundation, and others, to develop effective approaches for reversing the obesity epidemic at the local, state and federal level. 

We are pleased to see this report reflects that childhood obesity appears to be stabilizing among all children ages 0-18 – that is, it is not going up as significantly as in previous years.  However, much of the stabilization is among ages birth – two years old; unfortunately, the obesity rate among high school students has continued to increase over the past two years.

As you know, obesity has a dramatic impact on other chronic diseases including cardiovascular disease and stroke, diabetes, hypertension, cancer and other serious illnesses. 

North Dakota is ranked 14th among all states and the District of Columbia with an obesity rate of 31%.  That is an increase of more than 19% since 1990, and a 7% increase in the last ten years.  We have a lot of work to do to bring obesity rates down among all age groups, and racial and ethnic disparities continue to exist. 

The report also highlights the various policy objectives that are important in our fight to reduce obesity.  Policy change at the local, state and federal level all can have a dramatic impact on reducing the impact of obesity.  In North Dakota, we can change the upward direction of obesity by encouraging physical activity before, during and after school, by ensuring our kids have healthy school lunches, improving access to healthy and affordable food, and reducing sodium consumption. 

Combatting obesity in our communities will take dedication, focus, innovation and cooperation.  Please join us in this fight!  Let us know obesity prevention is a priority for you and that you want to help us in our efforts.  Sign in to your profile at and click on your name in the upper right corner.  Under the Interests tab, check Obesity Prevention and Nutrition, or send me and email and let me know of your interest. 

For more on the full State of Obesity report, CLICK HERE.  For North Dakota specific information, CLICK HERE.  

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Advocate Spotlight: Dr. Robert Oatfield

Dr. Robert Oatfield, Professor of Medicine and Cardiac and Peripheral Interventional Cardiologist, has been involved as an advocate for the American Heart Association for decades and has seen the organization grow and change. His interest in advocacy stems from working with community leaders to make a difference in North Dakota, and seeing those efforts save lives.

A native of California, Dr. Oatfield appreciates the impact one person can have by getting involved in public policy in a small state like North Dakota.  His interest and involvement in improving systems of care started years ago training doctors in advanced cardiac Life Support and paramedics on performing and interpreting 12 Lead ECG's and encouraging bystander CPR.  His work in the field predates the current Mission: Lifeline program that equips all ambulances in North Dakota with 12-Lead ECG machines and the training for EMS staff.

Through the efforts of Dr. Oatfield and others, automated external defibrillators (AEDs) are accessible in public places throughout our state.  Through his advocacy efforts and his willingness to talk with key legislators, North Dakota may soon join the growing list of states that require CPR as a high school graduation requirement.

Dr. Oatfield encourages others to get involved with advocacy because it’s fun!

“In our state, we have the ability to be impactful on policy because our legislators are accessible and willing to listen to constituents ideas on improving our communities,” he said.

Col. Oatfield, a retired flight surgeon with the North Dakota Army National Guard, is licensed to practice in North Dakota, South Dakota, Alabama, Minnesota, Nebraska, and Georgia. In addition to his advocacy efforts, he is past president of the American Heart Association Dakota Affiliate, serves on the state’s AHA Advocacy Committee, and he has lobbied on behalf of the AHA in Bismarck and Washington, D.C.  Dr. Oatfield also does Cardiac Interventions in Ecuador.

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ND Notes a Decline in Deaths From Cardiovascular Disease

According to new research in the American Heart Association journal "Circulation," hospitalizations and deaths from heart disease and stroke in the U.S. dropped significantly in the last decade. Shelly Arnold, manager of trauma, stroke and cardiac care at Sanford Health in Bismarck and chair of North Dakota's AHA Advocacy Committee, says one key in improving outcomes locally has been the establishment of statewide systems of stroke and cardiac care. In addition to the improvements in quality of care, also contributing to the decrease were public awareness, prevention strategies and improved lifestyle. For more on this story, CLICK HERE.  

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AHA Issues Statement on E-Cigs

Electronic cigarettes might help some people quit smoking, but the American Heart Association recommends them only as a last resort and only with several notes of caution.

AHA President Elliott Antman, M.D., underscored the careful approach Tuesday, a day after the organization’s first policy statement on e-cigarettes drew widespread media attention.  The policy statement called for strong new regulations to prevent access, sales and marketing of e-cigarettes to youth.

To read more, CLICK HERE.  

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ND Mission: Lifeline Transition to ND Cardiac System of Care

The American Heart Association ND Mission: Lifeline grant funded program launched on August 1, 2011 and will be coming to a close on August 31, 2014 after 3 years of statewide STEMI system enhancement.   The AHA staff have worked diligently with Mission: Lifeline leadership, taskforce members, ND Department of Health and advocates to ensure a strong sustainability plan is in place to support the STEMI system.  One important element of the transition will be the movement of the STEMI program under a larger umbrella which will be known as the ND Cardiac System of Care.   The expanded focus will include NSTEMI, chest pain, and cardiac arrest system quality improvement with oversight by the ND DOH Division of EMS and Trauma.  Education models utilized for clinical continuing education of EMS and hospital personnel with the ND M: L program will continue in the upcoming year including a 2015 conference with grant funding provided by ND M:L to the ND DOH.

The 3rd annual M: L STEMI and Acute Stroke Conference was held August 5 – 6, 2014 at the Ramada Plaza Conference Center in Fargo with over 240 in attendance over the two days.   The first day was a stroke focus with a STEMI focus on day two.  The days were filled with continuing educational presentations, quality reports, survivor stories, GWTG quality award presentations, vendor displays, and stroke and STEMI simulation training scenarios provided by SIM-ND. CLICK HERE for news coverage. 

The conference highlighted the outstanding support, commitment and collaboration from every participating agency including EMS, Critical access hospitals and PCI hospitals. Huge strides have been made to improve the quality and consistency of STEMI care delivered throughout the state.  In a number of measures North Dakota is exceeding the national bench marks.   We are much closer to attaining the goal that where you live doesn’t determine if you live!   

While significant improvements have been made in the STEMI system of care from first medical contact to restored blood flow to the heart, two major challenges remains in rural North Dakota.   Only 26% of individuals experiencing a STEMI call 9-1-1 in rural areas of the state.   In addition, the time from first onset of heart attack symptoms to first medical contact can be over 90 minutes.  These delays in treatment increase the person’s chance of death or permanent heart damage.    We have plans to expand the public awareness campaign:  Your Life is on the Line: Dial 9-1-1.    Free materials are available for use in communities across the state at

While the grant support for Mission: Lifeline is at a close, be assured that the American Heart Association staff team will maintain an active and collaborative role in the cardiac system of care work in ND.   There is more work to be done to reduce death and disability from cardiovascular diseases in North Dakota. 

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