Feasibility of early emergency room notification to improve door-to-balloon times for patients with acute ST segment elevation myocardial infarction.
ABSTRACT An algorithm to lower time from first contact in the field by EMS personnel to in-hospital mechanical reperfusion is described. ECG tracings were telemetered via cellular phone to an emergency room physician, who then activated the cardiac catheterization call team to bypass usual delays seen during ER triage. Seventy-one ECGs were sent to the ER in the time interval from October 2003 to October 2004. Five ECGs (7.0%) failed to transmit due to failure of the cellular phone to receive an adequate signal. Sixty-six patients (93.0%) had an adequate ECG transmitted to the ER and six patients with ST elevation myocardial infarction were identified. Door-to-balloon times were lowered to 44 +/- 17.4 min, a substantial decrease over historical norms that range from 120 min (25th percentile) to 289 min (75th percentile).
Article: The effect of direct communication between emergency physicians and interventional cardiologists on door to balloon times in STEMI.[show abstract] [hide abstract]
ABSTRACT: We developed an institutional protocol mandating emergency physicians to contact the interventional cardiologist directly in all cases of ST-segment elevation myocardial infarction (STEMI) and hypothesized that this would reduce door-to-balloon-times (DTBT). From January 2004 to July 2006, 208 patients with STEMI were treated with primary percutaneous coronary intervention (PCI). A total of 144 patients were treated before implementing the new protocol ("before") and 64 patients were treated after the implementation ("after"). The DTBT was significantly reduced from 148+/-101 min to 108+/-56 min (p<0.05). While only 25% of the "before'' patients received PCI within 90 min after arrival, 50% of the "after'' patients received PCI within 90 min (p<0.05). There were no significant differences between two groups in other outcomes (postprocedural TIMI flow, mortality, subsequent stroke, heart failure, shock, reinfarction, length of stay in intensive care unit, and the total hospital length of stay). In conclusion, mandating emergency physicians to directly notify interventional cardiologists of all STEMI patients reduces DTBT.Journal of Korean Medical Science 09/2008; 23(4):706-10. · 0.99 Impact Factor
Article: Part 9: Acute coronary syndromes: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations.Circulation 10/2010; 122(16 Suppl 2):S422-65. · 14.74 Impact Factor
Article: Part 9: Acute coronary syndromes: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations.Resuscitation 10/2010; 81 Suppl 1:e175-212. · 3.60 Impact Factor