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| Home > News > 2006 News |
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St. John's heart attack time to
treatment among top performers
Nov. 15, 2006
NEW AHA STUDY SUGGESTS 90-MINUTE WINDOW:
ST. JOHN’S AVERAGE IS 83 MINUTES
A new study by the American Heart Association released Sunday surveyed 365
U.S. hospitals to determine what procedures they have in place to get
patients angioplasty quickly.
Studies show that reopening clogged arteries by inflating a tiny balloon at
the site of the blockage is the best way to treat a severe heart attack. The
procedure, balloon angioplasty, can cut a patient's risk of dying by 40
percent, but only if it is done within 90 minutes of the patient's arrival
at the hospital, the so-called door-to-balloon time.
Just 35 percent report an average door-to-balloon time of 90 minutes or
less, 48 percent had a door-to-balloon time of 91 to 120 minutes, 13 percent
came in at 121 to 150 minutes and 4 percent topped 150.
St. John’s has been tracking time to treatment for 10 years aggressively
working on ways to decrease it. Currently, the average door to balloon time
is 83 minutes.
“If you think about a patient arriving in the emergency room, you don’t know
they have a heart attack when they arrive, you make the diagnosis, call the
team in, get them to the lab and you do the angiogram and then get across
the total occluded vessel and open it up and you do that in less than 90
minutes, that takes a team effort a lot people to make happen,” Kelvin Van
Osdol, M.D., St. John’s chair of cardiology, explains.
As early as 1999, while a national debate was underway about standards of
care for heart attack patients, St. John’s cardiologists advocated for
getting patients to a cardiac catheterization lab quickly. Historically, the
use of thrombolytic drus that help dissolve blood clots were the chosen
course of action, particularly in rural areas where there wasn’t quick
access to a full-service cath lab.
While St. John’s cardiologists are proponents of this type of treatment when
patients aren’t able to get to a lab, they have consistently encouraged that
coronary angioplasty should be the treatment of choice when possible,
restoring blood flow more completely and increasing chances for survival.
Procedures have been put in place to make this happen – many of which were
outlined in the recent AHA report below.
The study found that the system works best when:
1. Paramedics perform an electrocardiogram en route
to the hospital.
St. John’s EMS was the first rural-based ambulance service in the United
States have cellular EKG capability onboard ambulances, introducing the
technology to the Ozarks in 1994.
2. The ER doctor uses it to activate the
angioplasty team without waiting to consult with anyone else.
Since 1999, St. John’s has had a cardiac activation process. The ER
physician, among others, can activate this process and the the cath lab is
available 24 hours a day, seven days a week.
3. The page operator can reach each member of the
team, and they can arrive within 20 minutes.
Since 1999
4. The hospital posts feedback on each case for the
angioplasty and ER teams.
St. John’s cardiovascular and emergency departments meet monthly to evaluate
quality measures, including time to treatment.
Ensuring heart attack patients are quickly treated in the cath lab poses a
particular challenge for emergency department staff seeing more than 75,000
patients each year. Of those, 5000 will present with chest pain. About 700
of those are having a heart attack.
“The challenge is that not everybody comes in and says, “Oh, I’m having a
heart attack.” Because, patients who are over 75, diabetics, or even women,
will present atypically. These are the individuals that come in with nausea
and vomiting, some shortness of breath, maybe some isolated jaw pain or arm
pain,” explains John Lorette, MD., St. John’s emergency physician.
FOR
MEDIA INFORMATION, CONTACT ST. JOHN’S MEDIA RELATIONS AT 417-820-2426 OR
CSCOTT@SPRG.MERCY.NET.
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