Recent standards of "door-to-balloon" time for treating and reversing heart attacks has challenged emergency services, requiring pre-hospital diagnosis of heart attacks and commencement of specialized treatments (interventional cardiology) within just 90 minutes. The standards relate to ST-segment elevation myocardial infarction (STEMI - a common type of acute heart attack that can be easily recognized on an ECG). The Calgary program used pre-hospital diagnosis and expedited transfer of patients directly to a facility offering specialized treatments. This allowed ambulances to bypass a time-consuming trip to regional hospitals.
In a related commentary, Dr. Andrew Travers reviews the recommendations for emergency treatment of STEMI and the difficulties in coordinating the different health care personnel involved in order to achieve the required "door-to-balloon" time in Canada.
p. 1833 Expedited transfer for primary percutaneous coronary intervention: a program evaluation
J.S. de Villiers, T. Anderson, J.D. McMeekin, R.C.M. Leung, M. Traboulsi, for the Foothills Interventional Cardiology Service and the Calgary STEMI QIHI group
cmaj.ca/pressrelease/pg1833.pdf
p. 1843 Achieving optimal care for ST-segment elevation myocardial infarction in Canada
A. Travers
cmaj.ca/pressrelease/pg1843.pdf
Contact: Jacobus S. de Villiers
Canadian Medical Association Journal
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