Current Trends in Cardiology

All submissions of the EM system will be redirected to Online Manuscript Submission System. Authors are requested to submit articles directly to Online Manuscript Submission System of respective journal.
Reach Us +1 (202) 780-3397

Research Article - Current Trends in Cardiology (2019) Volume 3, Issue 1

Designated fast tract improving the treatment of patients with ST elevation myocardial infarction.

Introduction: A fast and correct diagnosis of ST Elevation Myocardial Infarction (STEMI) in the emergency department (ED) significantly correlates with decreased morbidity and mortality. Nevertheless, delayed diagnosis still occurs in 5%-15% of the patients who were diagnosed with STEMI. Objective: To evaluate a 'fast-track' program to reduce door-to-balloon time (DTBT) in patients with STEMI, who present to ED triage with chest pain. Methods: A retrospective-archive study was conducted to evaluate and compare the adherence to clinical guidelines between all STEMI patients (n=140) who attended the ED before (i.e. throughout 2015, n=60) and after (i.e. throughout 2016, n=80) the intervention program was implemented. The program comprised of four steps: 1) Immediate bed rest; 2) Marking the patient chart with a dedicated sticker; 3) Assessing the time-lags according to defined clinical guidelines; and 4) Signing a dedicated sticker on the ECG by the physician. Results: We observed a significant post-intervention improvement in adherence to clinical guidelines. While pre-intervention, an ECG was conducted within 10 minutes for only 40% (n=24) of patients, the post-intervention percentage increased to 57.5% (n=46) (P=0.04). Similarly, while 61.7% (n=37) of patients were re-perfused within 90 minutes in the catheterization coronary lab, the post-intervention percentage increased to 70% (n=56) (P=0.30). During program implementation, more patients were classified correctly in life threatening (P1) and severe (P2) categories (n=18, 30% vs. n=40, 50%; p<0.001). A logistic regression model to predict DTBT showed that the factors impacting re-perfusion within 90 minutes were morning shifts and adherence to the P scale and time to physician. Conclusion: A ?fast-track? evaluation and treatment program for patients with chest pain enables early diagnosis of STEMI in the ED and decrease waiting times for re-perfusion catheterization. These findings have significant implications on life-saving conditions and the quality of care of patients attending at ED due to chest pain. Author(s): Saban Mor, Salama R, Darawsha A, Shachar Tal

Abstract PDF

Get the App