EMS PRO FEATURE
Emergency Treatment for Heart Attack Improving but Delays Still Occur
occurring. By identifying where delays occur, an- gioplasty centers can for- mulate effective transfer plans to improve patient care and outcomes.
Fast response is critical for ST-segment eleva- tion myocardial infarc- tion (STEMI) patients. This severe heart attack is caused by a complete blockage of blood supply to the heart. More than 250,000 people suffer a STEMI each year. But not all hospitals are equipped to perform ar- tery-opening angioplasty – only about 25 percent in the United States. Facilities that can’t per- form the procedure, also known as percutaneous coronary intervention, or PCI, typically refer and transfer patients to oth- ers that can.
Despite improvements in treating heart attack patients needing emer- gency artery-opening procedures, delays still occur, particularly in transferring patients to hospitals that can perform the procedure, according to a study in Circulation: Journal of the American Heart Association (AHA).
Study highlights include the fact that delays still occur in emergency heart attack treatment, particularly in transfer- ring patients to hospitals that perform artery- opening angioplasty.
Also, for the first time, researchers explored where those delays are
26 EMS PRO Magazine
“While we are making tremendous progress in PCI hospitals, delays are still occurring during the transfer process,” said Timothy D. Henry, M.D., the study’s senior author and director of research at the Minneapolis Heart Institute Foundation at Abbott Northwestern Hospital in Minneapolis. “This is the first study that examines and iden- tifies the specific reasons for delay of transfer patients,” Henry added.
Researchers examined data from 2,034 STEMI patients transferred from 31 local non-PCI hospi- tals in Minnesota and Wisconsin to the Min- neapolis Heart Institute from March 2003 to December 2009. Refer- ring hospitals were up to 210 miles away from the Institute.
Despite long-distance transfers, 65.7 percent of patients were treated within 120 minutes from the time of presentation at the initial referring hospitals.
However, 34.2 percent of patients experienced a delay in total treat- ment time, and the study found delays most frequently occurred at the referral hospital (64 percent), followed by the PCI center (15.7 percent) and during transport (12.6 percent). Specifically, the 64 percent of delays at the referral hospital were caused by: awaiting transport (26 percent), emergency department delays (14 percent), diagnostic dilemma (9 percent), initial negative test for heart attack (9 percent) and cardiac ar- rest (6 percent).
Delays related to cardiac arrest were the most
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44