Cardiac Alert: Decreasing Door-to-Balloon Time for ST Elevation Myocardial Infarction
| Autor: | Danielle Albinger, Colleen Kordish, Stephen Crouch, Peter Kerwin |
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| Rok vydání: | 2008 |
| Předmět: |
Male
Emergency Medical Services medicine.medical_specialty Time Factors medicine.medical_treatment Myocardial Infarction Emergency Nursing Severity of Illness Index Electrocardiography Angioplasty Humans Medicine Angioplasty Balloon Coronary Societies Medical Patient Care Team medicine.diagnostic_test business.industry Mortality rate Percutaneous coronary intervention Electrocardiography in myocardial infarction Survival Analysis United States Practice Guidelines as Topic Emergency medicine Conventional PCI Door-to-balloon Female Guideline Adherence Myocardial infarction diagnosis Emergency Service Hospital business Delivery of Health Care |
| Zdroj: | Journal of Emergency Nursing. 34:116-120 |
| ISSN: | 0099-1767 |
| Popis: | The American College of Cardiology (ACC)/American Heart Association (AHA) 2004 guidelines recommend a door-to-balloon (D2B) time of less than 90 minutes for patients presenting with ST elevation myocardial infarction (STEMI) and treated with primary percutaneous coronary intervention (PCI). This update decreased the recommended D2B time from 120 minutes to 90 minutes. Berger et al. found that patients with a D2B time less than 60 minutes have significantly less 30-day mortality rates than do patients with D2B times greater than 90 minutes (1% vs 6.4%). Another analysis demonstrated that each 30-minute delay in reperfusion with PCI increases 1-year mortality by 7.5%. However, despite the evidence and the recommendations, many primary PCI facilities are unable to achieve this less than 90-minute D2B goal. One well-publicized study established the national average D2B time as 106 minutes after reviewing the data on more than 33,000 STEMI cases treated with PCI. To address these discrepancies, the American College of Cardiology has now begun a nationwide campaign, “Guidelines Applied in Practice (GAP) D2B: An Alliance for Quality” to enlist hospital administrators and urge them to support this goal. But is it possible that the problem is not being evaluated in the right way? Maybe the issue at hand is not the lack of desire to decrease D2B times but the lack of a clear process that effectively enables health care workers to effect a change for patients with STEMI. Assessment |
| Databáze: | OpenAIRE |
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