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Time to ECG diagnosis delays inter-hospital transfer to revascularization in STEMI patients presenting to a regional emergency department: a five-year audit.
Ir J Med Sci
October 2024
School of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland.
Background: Reducing the door-to-balloon time (D2BT) in ST-elevation myocardial infarction (STEMI) patients maximizes myocardial salvage and mitigates morbidity/mortality.
Aims: To assess the D2BT in STEMI patients requiring inter-hospital transfer for revascularization and identify any potential causes of delay.
Methods: Consecutive patients presenting to the Connolly Hospital Blanchardstown (CHB) emergency department (ED) who were transferred to the Mater Misericordiae University Hospital in Dublin for primary percutaneous coronary intervention from January 2018 to October 2022 were identified in a regional database and their D2BTs calculated.
Objective: From the perspective of percutaneous coronary intervention (PCI) centers, locations of ST-segment elevation myocardial infarction (STEMI) diagnosis can include a referring facility, emergency medical services (EMS) transporting to a PCI center, or the PCI center's emergency department (ED). This challenges the use of door-to-balloon-time as the primary evaluative measure of STEMI treatment pathways. Our objective was to identify opportunities to improve care by quantifying differences in the timeliness of STEMI treatment mobilization based on the location of the diagnostic ECG.
View Article and Find Full Text PDFDevelopments in pre-hospital patient transport in ST-elevation myocardial infarction.
Rev Port Cardiol
November 2017
Serviço de Cardiologia, Centro Hospitalar do Porto, Porto, Portugal.
Introduction: ST-elevation myocardial infarction (STEMI) is a medical emergency that benefits from rapid access to specialized care. The objective of this study was to describe developments in patient transport via the pre-hospital emergency medical system (EMS) and its impact on clinical outcomes.
Methods: We retrospectively studied STEMI patients who underwent primary percutaneous coronary intervention between January 2008 and July 2015.
STEMI notification by EMS predicts shorter door-to-balloon time and smaller infarct size.
Am J Emerg Med
August 2016
Department of Cardiology, Mount Sinai Beth Israel, New York.
Background: Emergency medical services (EMS) transportation is associated with shorter door-to-balloon (DTB) time in patients with ST-segment elevation myocardial infarction (STEMI). In addition to EMS transportation, prehospital notification of STEMI by EMS to receiving hospital might be able to further shorten DTB time. We evaluated the impact of STEMI notification on DTB time as well as infarct size.
View Article and Find Full Text PDF[Impacts of establishment of chest pain center on the door-to-balloon time and the short-term outcome after primary percutaneous coronary intervention of patients with ST segment elevated myocardial infarction].
Zhonghua Xin Xue Guan Bing Za Zhi
July 2013
Department of Cardiology, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou 510010, China.
Objective: To investigate the impact of the establishment of chest pain center (CPC) model based on the pre-hospital real-time tele-12-lead electrocardiogram on the door-to-balloon (D-to-B) time and short-term outcome after primary percutaneous coronary intervention (PPCI) of patients with ST-segment elevated myocardial infarction (STEMI).
Methods: A regular CPC was established with pre-hospital transmitted real-time 12-lead electrocardiogram system for pre-hospital diagnosis of STEMI and enabled the STEMI patients to bypass the emergency room and directly treated in the catheter lab to shorten the D-to-B time. The mean D-to-B time, the short-term outcome and medical costs were compared in PPCI patients before (93 cases, group A) and after (149 cases, group B) the establishment of CPC.
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