Evaluation of a primary care paramedic STEMI bypass guideline
| Autor: | Chris Olynyk, Sheldon Cheskes, Garry Ross, Linda Turner, Jonathan L Kwong, Adam Thurston, P. Richard Verbeek |
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| Rok vydání: | 2017 |
| Předmět: |
Male
Canada Emergency Medical Services medicine.medical_specialty Time Factors medicine.medical_treatment Primary care 030204 cardiovascular system & hematology Electrocardiography 03 medical and health sciences Percutaneous Coronary Intervention 0302 clinical medicine Emergency medical services Humans Medicine Myocardial infarction Aged Retrospective Studies Primary Health Care business.industry Percutaneous coronary intervention 030208 emergency & critical care medicine Guideline Emergency department Middle Aged medicine.disease Emergency Medical Technicians Transportation of Patients Practice Guidelines as Topic Conventional PCI Emergency medicine Emergency Medicine ST Elevation Myocardial Infarction Female business Prehospital Emergency Care |
| Zdroj: | CJEM. 20:850-856 |
| ISSN: | 1481-8043 1481-8035 |
| DOI: | 10.1017/cem.2017.415 |
| Popis: | ObjectiveLimited evidence supports primary care paramedic (PCP) direct transport of ST-segment elevation myocardial infarction (STEMI) patients for percutaneous coronary intervention (PCI). The goal of this study was to evaluate an urban-based PCP STEMI bypass guideline.MethodsWe reviewed consecutive Toronto Paramedic Services call reports between April 7, 2015, and May 31, 2016, regarding STEMI patients identified by PCPs. The primary outcome was patient assignment (stable versus unstable) according to guideline criteria. Secondary outcomes were the proportion of PCP-transported patients who had an indication for an advanced care intervention (ACI) or who received an ACI when PCPs rendezvoused with an advanced care paramedic (ACP). Lastly, we reviewed prehospital outcomes of cardiac arrest patients and calculated the difference in transport intervals between direct PCP bypass and a PCI-centre and predicted transport interval to the closest emergency department (ED).ResultsOf 361 patients, 232 were PCP transports and 129 were ACP-rendezvous transports. There was a significant difference in the distribution of stable and unstable patients between PCPs and ACPs (pConclusionsWe found a significant difference in the distribution of stable and unstable patients and fewer patients with indications for an ACI in PCP patients. This PCP STEMI bypass guideline appears feasible. |
| Databáze: | OpenAIRE |
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