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Title

Prehospital emergency physician activation of interventional cardiology team reduces door-to-balloon time in ST-elevation myocardial infarction

Authors
Plojoux, Jerome
Keller, Pierre-Frederic
Published in Schweizerische medizinische Wochenschrift. 2010, vol. 140, no. 15-16, p. 228-232
Abstract QUESTION UNDER STUDY: To explore whether early activation of an interventional cardiology team, by prehospital emergency physicians, reduces door-to-balloon time (DTBT) in patients with ST-elevation myocardial infarction (STEMI) diagnosed with prehospital ECG. METHODS: Design: before-after comparison. Setting: emergency department (ED) of an urban teaching hospital with a catheterisation laboratory open continuously. Study subjects: patients with STEMI diagnosed in the prehospital setting or in the ED within 12 hours of symptoms. Intervention: a paging system or "STEMI alarm", activated by prehospital physicians, which simultaneously notified both the catherisation laboratory and cardiology teams before the patient's arrival to the ED. Outcome measures: DTBT and the proportion of patients with DTBT <90 minutes. RESULTS: A total of 196 patients were included; 77 before and 119 after implementation of the "STEMI alarm". Between the two periods, median DTBT decreased from 109 to 76 minutes (p <0.001) and the proportion of patients treated within 90 minutes increased from 36% to 66% (p <0.001). During intervention, the STEMI alarm was activated in 67 patients (56%). In these cases the median DTBT was 50 minutes, with 96% within 90 minutes. The alarm was inappropriately activated in 9 cases (11%). CONCLUSIONS: Catheterisation laboratory activation by a prehospital emergency physician markedly reduces DTBT in STEMI patients.
Keywords *Angioplasty, Balloon, CoronaryElectrocardiography*Emergency Medical ServicesHospital Communication SystemsHospitals, UniversityHumansMyocardial Infarction/diagnosis/*therapyTime Factors
Identifiers
PMID: 20131111
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Structures
Research groups Biologie du myocarde (22)
Syncope (24)
L'athérosclérose et ses complications cliniques (591)
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GROSGURIN, Olivier et al. Prehospital emergency physician activation of interventional cardiology team reduces door-to-balloon time in ST-elevation myocardial infarction. In: Schweizerische medizinische Wochenschrift, 2010, vol. 140, n° 15-16, p. 228-232. https://archive-ouverte.unige.ch/unige:20476

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Deposited on : 2012-05-22

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